SLCC Nursing ~ Med-Surg 3 ~ unit 3 test
Hypovolemic iishock ii- iiAnswers ii-Hypovolemic iishock iioccurs iifrom iiinadequate iifluid
iivolume iiin iithe iiintravascular iispace, iileads iito iidecreased iitissue iiperfusion iiand
iiinitiation iiof iithe iigeneral iishock iiresponse. iiHypovolemic iishock iiis iithe iimost iicommonly
iioccurring iiform iiof iishock.
Hypovolemic iishock iicauses ii- iiAnswers ii-loss iiof iiwhole iiblood iidue iito iihemorrhage
Loss iiof iiblood iiplasma iidue iito iiburns
Loss iiof iiinterstitial iifluids iidue iito iidiaphoresis, iidiabetes, iiemesis, iidiuretics
Hypovolemic iishock iibegins iito iidevelop iiwhen iiintravascular iivolume iihas iidecreased
iiby iiapproximately ii15%.
Hypovolemic iiShock iisigns iiand iisymptoms ii- iiAnswers ii-Poor iiskin iiturgor ii
Increased iithirst
Oliguria
Tachycardia
Hypovolemic iishock iiinterventions ii- iiAnswers ii-Nursing iiinterventions iiinclude
iiminimizing iifluid iiloss, iiadministering iivolume iireplacement, iiassessing iiresponse iito
iitherapy, iiproviding iicomfort iiand iiemotional iisupport, iiand iipreventing iiand iimaintaining
iisurveillance iifor iicomplications.
Stages iiof iiShock ii- iiAnswers ii-1.During iithe iiinitial iistage, iicardiac iioutput ii(CO) iiis
iidecreased, iiand iitissue iiperfusion iiis iithreatened. ii
2.Compensatory iistage iibegins iias iithe iibody's iihomeostatic iimechanisms iiattempt iito
iimaintain iiCO, iiblood iipressure, iiand iitissue iiperfusion. ii
3.Progressive iistage, iithe iicompensatory iimechanisms iibegin iifailing iito iimeet iitissue
iimetabolic iineeds, iiand iithe iishock iicycle iiis iiperpetuated. ii
4.Refractory iistage, iishock iibecomes iiunresponsive iito iitherapy iiand iiis iiconsidered
iiirreversible. iiPoint iiof iino iireturn
, What iiMAP iidefines iishock ii- iiAnswers ii-The iiclient iiwith iia iiMAP iiless iithan ii60 iimm iiHg
iior iiwith iievidence iiof iiglobal iitissue iihypo iiperfusion iiis iiconsidered iito iibe iiin iia iishock
iistate.
What iiis iithe iimost iicommon iitype iiof iishock ii- iiAnswers ii-Hypovolemic iishock iiis iithe
iimost iicommonly iioccurring iiform iiof iishock.
What iishock iitypes iiare iidistributive ii- iiAnswers ii-1.Septic
2.Anaphylactic
3.Neurogenic
Cardiogenic iiShock ii- iiAnswers ii-Cardiogenic iishock iiis iithe iiresult iiof iifailure iiof iithe
iiheart iito iieffectively iipump iiblood iiforward
It iican iioccur iiwith iidysfunction iiof iithe iiright iior iithe iileft iiventricle, iior iiboth
The iilack iiof iiadequate iipumping iifunction iileads iito iidecreased iitissue iiperfusion iiand
iicirculatory iifailure
Cardiogenic iiShock iiSigns iiand iiSymptoms ii- iiAnswers ii-The iipatient iimay iicomplain iiof
iichest iipain. iiTachycardia iidevelops iito iicompensate iifor iithe iidecrease iiin iiCO. iiThe
iirespiratory iirate iiincreases iito iiimprove iioxygenation.
ii
ABG iivalues iiindicate iirespiratory iialkalosis. ii
As iithe iileft iiventricle iifails, iiauscultation iiof iithe iilungs iimay iidisclose iicrackles iiand
iirhonchi, iiindicating iipulmonary iiedema. iiHypoxemia iioccurs.
Cardiogenic iiShock iiCauses ii- iiAnswers ii-MI
Cardiogenic iiShock iiInterventions ii- iiAnswers ii-Preventive iimeasures iiinclude iithe
iiidentification iiof iipatients iiat iirisk, iifacilitation iiof iiearly iireperfusion iitherapy iifor iiacute
iiMI, iiand iifrequent iiassessment iiand iimanagement iiof iithe iipatient's iicardiopulmonary
iistatus. ii
Patients iiwho iirequire iimechanical iidevice iitherapy ii(intra-aortic iiballoon iipump ii[IABP],
iileft iiventricular iiassist iidevice ii[LVAD], iior iiextracorporeal iimembrane iioxygenation
ii[ECMO]) iineed iito iibe iiobserved iifrequently iifor iicomplications, iiwhich iimay iiinclude
iiinfection, iibleeding, iithrombocytopenia, iihemolysis, iiembolus, iistroke, iidevice
iimalfunction, iicirculatory iicompromise iiof iia iicannulated iiextremity, iiSIRS, iiand iisepsis.
Anaphylactic iishock ii- iiAnswers ii-Anaphylactic iishock, iia iitype iiof iidistributive iishock, iiis
iithe iiresult iiof iian iiimmediate iihypersensitivity iireaction. iiIt iiis iia iilife-threatening iievent
iithat iirequires iiprompt iiintervention. iiThe iisevere iiand iisystemic iiresponse iileads iito
iidecreased iitissue iiperfusion iiand iiinitiation iiof iithe iigeneral iishock iiresponse.
Anaphylactic iishock iisigns iiand iisymptoms ii- iiAnswers ii-Massive iivasodilation
Itchy iirash
Low iiBP
Hypovolemic iishock ii- iiAnswers ii-Hypovolemic iishock iioccurs iifrom iiinadequate iifluid
iivolume iiin iithe iiintravascular iispace, iileads iito iidecreased iitissue iiperfusion iiand
iiinitiation iiof iithe iigeneral iishock iiresponse. iiHypovolemic iishock iiis iithe iimost iicommonly
iioccurring iiform iiof iishock.
Hypovolemic iishock iicauses ii- iiAnswers ii-loss iiof iiwhole iiblood iidue iito iihemorrhage
Loss iiof iiblood iiplasma iidue iito iiburns
Loss iiof iiinterstitial iifluids iidue iito iidiaphoresis, iidiabetes, iiemesis, iidiuretics
Hypovolemic iishock iibegins iito iidevelop iiwhen iiintravascular iivolume iihas iidecreased
iiby iiapproximately ii15%.
Hypovolemic iiShock iisigns iiand iisymptoms ii- iiAnswers ii-Poor iiskin iiturgor ii
Increased iithirst
Oliguria
Tachycardia
Hypovolemic iishock iiinterventions ii- iiAnswers ii-Nursing iiinterventions iiinclude
iiminimizing iifluid iiloss, iiadministering iivolume iireplacement, iiassessing iiresponse iito
iitherapy, iiproviding iicomfort iiand iiemotional iisupport, iiand iipreventing iiand iimaintaining
iisurveillance iifor iicomplications.
Stages iiof iiShock ii- iiAnswers ii-1.During iithe iiinitial iistage, iicardiac iioutput ii(CO) iiis
iidecreased, iiand iitissue iiperfusion iiis iithreatened. ii
2.Compensatory iistage iibegins iias iithe iibody's iihomeostatic iimechanisms iiattempt iito
iimaintain iiCO, iiblood iipressure, iiand iitissue iiperfusion. ii
3.Progressive iistage, iithe iicompensatory iimechanisms iibegin iifailing iito iimeet iitissue
iimetabolic iineeds, iiand iithe iishock iicycle iiis iiperpetuated. ii
4.Refractory iistage, iishock iibecomes iiunresponsive iito iitherapy iiand iiis iiconsidered
iiirreversible. iiPoint iiof iino iireturn
, What iiMAP iidefines iishock ii- iiAnswers ii-The iiclient iiwith iia iiMAP iiless iithan ii60 iimm iiHg
iior iiwith iievidence iiof iiglobal iitissue iihypo iiperfusion iiis iiconsidered iito iibe iiin iia iishock
iistate.
What iiis iithe iimost iicommon iitype iiof iishock ii- iiAnswers ii-Hypovolemic iishock iiis iithe
iimost iicommonly iioccurring iiform iiof iishock.
What iishock iitypes iiare iidistributive ii- iiAnswers ii-1.Septic
2.Anaphylactic
3.Neurogenic
Cardiogenic iiShock ii- iiAnswers ii-Cardiogenic iishock iiis iithe iiresult iiof iifailure iiof iithe
iiheart iito iieffectively iipump iiblood iiforward
It iican iioccur iiwith iidysfunction iiof iithe iiright iior iithe iileft iiventricle, iior iiboth
The iilack iiof iiadequate iipumping iifunction iileads iito iidecreased iitissue iiperfusion iiand
iicirculatory iifailure
Cardiogenic iiShock iiSigns iiand iiSymptoms ii- iiAnswers ii-The iipatient iimay iicomplain iiof
iichest iipain. iiTachycardia iidevelops iito iicompensate iifor iithe iidecrease iiin iiCO. iiThe
iirespiratory iirate iiincreases iito iiimprove iioxygenation.
ii
ABG iivalues iiindicate iirespiratory iialkalosis. ii
As iithe iileft iiventricle iifails, iiauscultation iiof iithe iilungs iimay iidisclose iicrackles iiand
iirhonchi, iiindicating iipulmonary iiedema. iiHypoxemia iioccurs.
Cardiogenic iiShock iiCauses ii- iiAnswers ii-MI
Cardiogenic iiShock iiInterventions ii- iiAnswers ii-Preventive iimeasures iiinclude iithe
iiidentification iiof iipatients iiat iirisk, iifacilitation iiof iiearly iireperfusion iitherapy iifor iiacute
iiMI, iiand iifrequent iiassessment iiand iimanagement iiof iithe iipatient's iicardiopulmonary
iistatus. ii
Patients iiwho iirequire iimechanical iidevice iitherapy ii(intra-aortic iiballoon iipump ii[IABP],
iileft iiventricular iiassist iidevice ii[LVAD], iior iiextracorporeal iimembrane iioxygenation
ii[ECMO]) iineed iito iibe iiobserved iifrequently iifor iicomplications, iiwhich iimay iiinclude
iiinfection, iibleeding, iithrombocytopenia, iihemolysis, iiembolus, iistroke, iidevice
iimalfunction, iicirculatory iicompromise iiof iia iicannulated iiextremity, iiSIRS, iiand iisepsis.
Anaphylactic iishock ii- iiAnswers ii-Anaphylactic iishock, iia iitype iiof iidistributive iishock, iiis
iithe iiresult iiof iian iiimmediate iihypersensitivity iireaction. iiIt iiis iia iilife-threatening iievent
iithat iirequires iiprompt iiintervention. iiThe iisevere iiand iisystemic iiresponse iileads iito
iidecreased iitissue iiperfusion iiand iiinitiation iiof iithe iigeneral iishock iiresponse.
Anaphylactic iishock iisigns iiand iisymptoms ii- iiAnswers ii-Massive iivasodilation
Itchy iirash
Low iiBP