University:
Herzing University
Course:
NSG 121 | Health Assessment
Academic year:

2020
Views:

183

Pages:

1
Author:

KLogan

RECOGNIZING SHOCKS LACK OF BLOOD FLOW THAT MAY LEAD TO ORGAN FAILURE Cardiogenic Etiology Signs/Symptoms Hypovolemic Anything that causes Hemorrhage: damage to the heart will Postpartum, upper GI weaking the muscle of the bleed, severe blunt trauma heart from properly doing Other: its job: Severe dehydration due to • Myocardial infarction, vomiting or diarrhea, burns arrhythmias, heart failure, blunt trauma, myocarditis • Hypotension • Tachycardia • Weak thready pulse • Cool, pale skin • Oliguria (<30mL/hr) • Slow capillary refill • Confusion/agitation Cardiogenic: WEAK heart; Hypovolemic: LOSS of fluid Cardiogenic: crackles and tachypnea, chest pain Cardiac Output • Decreased CO Systemic Vascular Resistance (SVR) • Increased systemic vascular resistance (due to vasoconstriction) Treatment Immediate EKG Supplemental O2 Pain control Immediate reperfusion BP meds: o Dopamine, Norepinephrine, Dobutamine, Pressors • Watch for fluid overload lungs • • • • • • Trendelenburg • Fluids NS or LR until blood can be matched • Monitor fluid overload (JVD, crackles, RR) • Monitor VS q15m • Supplemental O2 • Monitor urine output • Pressors/N/D Meds Septic Anaphylactic Neurogenic Response to an untreated infection • The end result of sepsis Histamine response due to exposure to an allergen • Via inhalation, injection, oral, or contact • Ex: bee sting, food allergy, drug reaction Inability of the sympathetic nervous system to stimulate nerve impulses: • Spinal cord injury (T6 or higher), TBI, drugs, spinal anesthesia Hypotension Tachycardia Flushed, warm, skin Vasodilation (blood volume is not diminished) • Hypotension • Bradycardia • Warm, dry extremities, cold core • Hypothermia • Loss of bladder control • Vasodilation (blood volume is not diminished) • • • • Septic: fever, BP does not respond to fluids, increased respiratory rate Anaphylactic: bronchoconstriction, dyspnea, wheezing, swelling, itchy • Increased CO (may fall later on) • Decreased CO • Decreased systemic vascular resistance (due to vasodilation) • Antibiotics FIRST within ONE hour of shock • Vasopressors • Fluid therapy • Supplemental O2 • • • • • • • Establish airway! Trendelenburg Epinephrine Albuterol Antihistamines/steroids Remove the allergen Teach patient to carry Epi-pen • Keep spine immobilized • IV fluids to increase CO (watch fluid overload) • Atropine to increase HR • Monitor urine output