Shock: syndrome characterized by decreased tissue perfusion & impaired cellular
metabolism
- Imbalance in O2 & nutrients supply & demand
Types of Shock:
Low blood flow:
● Cardiogenic shock: Systolic or diastolic dysfunction, CO is compromised
○ Causes: MI, CM, blunt cardiac injury, severe systemic or pulmonary
HTN, cardiac tamponade, and myocardial depression 2/2 metabolic
issues
○S/S: Tachycardia, hypotension, narrowed pulse pressure, ↑ myocardial
O2 consumption
○Physical Assessment: tachypnea, pallor, cool clammy skin, ↓ cap refill,
anxiety, confusion, irritation, ↓ renal perfusion & urinary output
● Hypovolemic shock: 2 Types
○ Absolute hypovolemia: loss of intravascular fluid volume
■ Causes: hemorrhage, GI loss (V/D), fistula drainage, diabetes
insipidus, hyperglycemia, diuresis
○ Relative hypovolemia: Fluid volume moves out of the vascular space
into the extravascular space (third spacing)
○ S/S: (for both) anxiety, tachypnea, ↑ HR & CO, ↓ stroke volume,
pulmonary arterial wedge pressure (PAWP), & urinary output
■ If loss is >30%, blood volume is replaced
Distributive:
● Neurogenic shock: Hemodynamic phenomenon that can occur in response
to spinal cord injury or spinal anesthesia (occurs at T5 or above)
○ Results in massive vasodilation leading to pooling of blood in vessels,
tissue hypoperfusion, & ultimately impaired cellular metabolism
■ S/S: Hypotension, bradycardia, inability to regulate body
temperature (heat loss), dry skin, poikilothermia (taking on
temperature of environment)
● Anaphylactic shock : Acute, life-threatening allergic reaction
○ Results in massive vasodilation, release of vasoactive mediators, and ↑
capillary permeability
○ S/S: anxiety, confusion, dizziness, sense of impending doom, chest
pain, incontinence, swelling of lips & tongue, angioedema, wheezing,
metabolism
- Imbalance in O2 & nutrients supply & demand
Types of Shock:
Low blood flow:
● Cardiogenic shock: Systolic or diastolic dysfunction, CO is compromised
○ Causes: MI, CM, blunt cardiac injury, severe systemic or pulmonary
HTN, cardiac tamponade, and myocardial depression 2/2 metabolic
issues
○S/S: Tachycardia, hypotension, narrowed pulse pressure, ↑ myocardial
O2 consumption
○Physical Assessment: tachypnea, pallor, cool clammy skin, ↓ cap refill,
anxiety, confusion, irritation, ↓ renal perfusion & urinary output
● Hypovolemic shock: 2 Types
○ Absolute hypovolemia: loss of intravascular fluid volume
■ Causes: hemorrhage, GI loss (V/D), fistula drainage, diabetes
insipidus, hyperglycemia, diuresis
○ Relative hypovolemia: Fluid volume moves out of the vascular space
into the extravascular space (third spacing)
○ S/S: (for both) anxiety, tachypnea, ↑ HR & CO, ↓ stroke volume,
pulmonary arterial wedge pressure (PAWP), & urinary output
■ If loss is >30%, blood volume is replaced
Distributive:
● Neurogenic shock: Hemodynamic phenomenon that can occur in response
to spinal cord injury or spinal anesthesia (occurs at T5 or above)
○ Results in massive vasodilation leading to pooling of blood in vessels,
tissue hypoperfusion, & ultimately impaired cellular metabolism
■ S/S: Hypotension, bradycardia, inability to regulate body
temperature (heat loss), dry skin, poikilothermia (taking on
temperature of environment)
● Anaphylactic shock : Acute, life-threatening allergic reaction
○ Results in massive vasodilation, release of vasoactive mediators, and ↑
capillary permeability
○ S/S: anxiety, confusion, dizziness, sense of impending doom, chest
pain, incontinence, swelling of lips & tongue, angioedema, wheezing,
