Shock and Its Management
Shock and Its Management
Shock and Its Management
Management
Definition
Shock is a state of circulatory failure that happens when the organs and body
tissues do not receive enough blood flow to support their oxygen and metabolic
demands, putting them at risk of hypoxia and cellular injury.
Shock is a continuum of events that progresses through several stages, including
compensated, decompensated or progressive, and irreversible shock.
Stages of Shock
• Body shunts blood from organs, such as skin , kidney, heart, GI tract , lungs
Results in cool and clammy skin, Hypoactive, Bowel sounds , Decrease urine output
Metabolic acidosis, Increased respiratory rate, Change in mental status, Confusion
PROGRESSIVE STAGE(Uncompensated shock)
• Compensatory mechanism become ineffective.
• Impaired perfusion results in anaerobic metabolism and cellular
hypoxia.
• Renal ischemia stimulates RAAS which further causes vasoconstriction.
At least , two IV lines are inserted to administer fluid, medications and or blood.
Lactated Ringer; solution, colloids or 0.9% NS are administered to restore
intravascular volume.
Blood products are used only if other alternatives are unavailable or blood loss is
extensive and rapid.
Redistribution of fluids
Pharmacologic management
Vasoactive medications to prevent cardiac failure.
Nursing management
Causes
Coronary Non-Coronary
Tension
pneumothorax
Cardiogenic shock - Pathophysiology
Decrease cardiac
contractility
Decrease Stroke
volume &
Cardiac output
Decrease
Pulmonary Decrease systemic
Coronary Artery
Congestion tissue perfusion
Perfusion
Cardiogenic shock – Clinical Manifestation
• Pain of angina
• Dysrhythmia
• Complain of Fatigue
• Express feeling of DOOM
• Sign of Hemodynamic Instability