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AMNSG4330
1:58:15
AMNSG4330
AMNSG4330
- Lecture
- Lecture
9 - -Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
Lecture
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
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NSG4330 - Lecture 9 - Shock
T or F - Shock is a syndrome T
Inadequate tissue perfusion
What is the definition of shock? This is caused when oxygen supply does not meet oxygen demand
- decreased cardiac output
- decreased hemoglobin
What causes decreased oxygen delivery? - decreased arterial oxygen saturation
- increased fraction of inspired oxygen (FiO2)
- administration of blood products
What causes increased oxygen delivery? - increased cardiac output
- seizures
- shivering
- pain
What causes increased oxygen demands? - hyperthermia
- increased activity levels
- hypothermia
- anesthesia
What causes decreased oxygen demands? - relief of pain
anaerobic metabolism
What kind of metabolism does a cell do
when there is no oxygen available? (aerobic metabolism = oxygen available)
- Presence of oxygen
- Large amount of energy
What is aerobic respiration? - produce CO2 and water
- Completely break down of glucose
- Absence of oxygen
- Less energy
- Produce lactic acid or ethanol
- glucose not completely broken down
What is anaerobic respiration?
- lactic acid in high levels can be toxic
- when glucose onset completely broken down, not enough goes to the brain
T
T or F - Body cells require a constant
supply of oxygen and nutrients
- a properly beating heart
What four things are required for the - adequate transport medium (fluid): blood and hemoglobin
delivery of O2 and nutrients and the - an intact functioning vessel system (container)
elimination of CO2? - a functioning respiratory system
MAP is the average arterial pressure in a cardiac cycle
- MAP > 60 indicated perfusion to organs
- Normal MAP = 70-100
What is MAP?
S+D+D / 3
ge 1Page
of 710/13/2026,
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Lecture
1:58:15
AMNSG4330
9 - Shock.pdfPage
AMNSG4330
- Lecture
1- of
Lecture
9710/13/2026,
- Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
1:58:15 AMNSG4330 - Lecture 9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
(&*$ **F
(&*$
VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
**F VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
(&*$ **F VJyv
,ge 2Page
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1:58:15
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AMNSG4330
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AMNSG4330
AMNSG4330
- Lecture
- Lecture
9 - -Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
Lecture
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
(&*$ **F
(&*$
VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
**F
(&*$
VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
**F VJyvhjbnoP+_IREOLKDJ(UWRORWU
NSG4330 - Lecture 9 - Shock
Low Blood Flow
- Hypovolemic
- Cardiogenic
Maldistribution of Blood Flow
- Neurogenic
- Anaphylactic
What are the classifications of shock? - Septic
Obstructive Shock
- loss of intravascular fluid volume
What is hypovolemic shock? - volume in inadequate to fill the vascular space
- hemorrhage
- vomiting, diarrhea
- diuresis
What causes hypovolemic shock? - diabetes insipidus
- third spacing (peritoneal, pleural)
What is absolute hypovolemia? The loss of fluid has completely left the body
What is relative hypovolemia? Fluid moves out of the vascular space but doesn't leave the body (ascites)
Mental status
- anxiety, lethargy, sleepy, combative
Skin
- clammy, pale, mottling, central and peripheral cyanosis
Cardiovascular
- BP begins to fall, capillary refill is delayed
- pulse rapid and weak
What are signs and symptoms of Respiratory
hypovolemic shock? - respirations rapid and shallow
GU
- decreased urine output
The most severe form of heart failure
Systolic or diastolic dysfunction
What is cardiogenic shock?
Compromised cardiac output
-Myocardial infarction
- cardiomyopathy
- blunt cardiac injury
What are causes of cardiogenic shock? - severe systemic or pulmonary hypertension
- cardiac tamponade
- tachycardia
- hypotension
What are early manifestations of - pulmonary congestion
cardiogenic shock? - narrowed pulse pressure
The difference between systolic and diastolic blood pressure
- Normal range = 40-60 mmHg
- wider pulse pressure = compliance decreases as person ages (stiffer) - higher with
What is pulse pressure? kidney/diabetes/cardiovascular disease
- narrow pulse pressure = heart failure/hypovolemia
ge 2Page
of 710/13/2026,
2NSG4330
of 710/13/2026,
- 1:58:15
Lecture
1:58:15
AMNSG4330
9 - Shock.pdfPage
AMNSG4330
- Lecture
2- of
Lecture
9710/13/2026,
- Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
1:58:15 AMNSG4330 - Lecture 9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
(&*$ **F
(&*$
VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
**F VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
(&*$ **F VJyv
of 710/13/2026,
1Page
of 710/13/2026,
1 of 710/13/2026,
1:58:15
1:58:15
AMNSG4330
1:58:15
AMNSG4330
AMNSG4330
- Lecture
- Lecture
9 - -Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
Lecture
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
(&*$ **F
(&*$
VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
**F
(&*$
VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
**F VJyvhjbnoP+_IREOLKDJ(UWRORWU
NSG4330 - Lecture 9 - Shock
T or F - Shock is a syndrome T
Inadequate tissue perfusion
What is the definition of shock? This is caused when oxygen supply does not meet oxygen demand
- decreased cardiac output
- decreased hemoglobin
What causes decreased oxygen delivery? - decreased arterial oxygen saturation
- increased fraction of inspired oxygen (FiO2)
- administration of blood products
What causes increased oxygen delivery? - increased cardiac output
- seizures
- shivering
- pain
What causes increased oxygen demands? - hyperthermia
- increased activity levels
- hypothermia
- anesthesia
What causes decreased oxygen demands? - relief of pain
anaerobic metabolism
What kind of metabolism does a cell do
when there is no oxygen available? (aerobic metabolism = oxygen available)
- Presence of oxygen
- Large amount of energy
What is aerobic respiration? - produce CO2 and water
- Completely break down of glucose
- Absence of oxygen
- Less energy
- Produce lactic acid or ethanol
- glucose not completely broken down
What is anaerobic respiration?
- lactic acid in high levels can be toxic
- when glucose onset completely broken down, not enough goes to the brain
T
T or F - Body cells require a constant
supply of oxygen and nutrients
- a properly beating heart
What four things are required for the - adequate transport medium (fluid): blood and hemoglobin
delivery of O2 and nutrients and the - an intact functioning vessel system (container)
elimination of CO2? - a functioning respiratory system
MAP is the average arterial pressure in a cardiac cycle
- MAP > 60 indicated perfusion to organs
- Normal MAP = 70-100
What is MAP?
S+D+D / 3
ge 1Page
of 710/13/2026,
1NSG4330
of 710/13/2026,
- 1:58:15
Lecture
1:58:15
AMNSG4330
9 - Shock.pdfPage
AMNSG4330
- Lecture
1- of
Lecture
9710/13/2026,
- Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
1:58:15 AMNSG4330 - Lecture 9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
(&*$ **F
(&*$
VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
**F VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
(&*$ **F VJyv
,ge 2Page
of 710/13/2026,
2Page
of 710/13/2026,
2 of 710/13/2026,
1:58:15
1:58:15
AMNSG4330
1:58:15
AMNSG4330
AMNSG4330
- Lecture
- Lecture
9 - -Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
Lecture
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
(&*$ **F
(&*$
VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
**F
(&*$
VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
**F VJyvhjbnoP+_IREOLKDJ(UWRORWU
NSG4330 - Lecture 9 - Shock
Low Blood Flow
- Hypovolemic
- Cardiogenic
Maldistribution of Blood Flow
- Neurogenic
- Anaphylactic
What are the classifications of shock? - Septic
Obstructive Shock
- loss of intravascular fluid volume
What is hypovolemic shock? - volume in inadequate to fill the vascular space
- hemorrhage
- vomiting, diarrhea
- diuresis
What causes hypovolemic shock? - diabetes insipidus
- third spacing (peritoneal, pleural)
What is absolute hypovolemia? The loss of fluid has completely left the body
What is relative hypovolemia? Fluid moves out of the vascular space but doesn't leave the body (ascites)
Mental status
- anxiety, lethargy, sleepy, combative
Skin
- clammy, pale, mottling, central and peripheral cyanosis
Cardiovascular
- BP begins to fall, capillary refill is delayed
- pulse rapid and weak
What are signs and symptoms of Respiratory
hypovolemic shock? - respirations rapid and shallow
GU
- decreased urine output
The most severe form of heart failure
Systolic or diastolic dysfunction
What is cardiogenic shock?
Compromised cardiac output
-Myocardial infarction
- cardiomyopathy
- blunt cardiac injury
What are causes of cardiogenic shock? - severe systemic or pulmonary hypertension
- cardiac tamponade
- tachycardia
- hypotension
What are early manifestations of - pulmonary congestion
cardiogenic shock? - narrowed pulse pressure
The difference between systolic and diastolic blood pressure
- Normal range = 40-60 mmHg
- wider pulse pressure = compliance decreases as person ages (stiffer) - higher with
What is pulse pressure? kidney/diabetes/cardiovascular disease
- narrow pulse pressure = heart failure/hypovolemia
ge 2Page
of 710/13/2026,
2NSG4330
of 710/13/2026,
- 1:58:15
Lecture
1:58:15
AMNSG4330
9 - Shock.pdfPage
AMNSG4330
- Lecture
2- of
Lecture
9710/13/2026,
- Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
1:58:15 AMNSG4330 - Lecture 9 - Shock(*((&#*!(*#*($$(*($(*$Y(&*&$(*)&*)((&$*^$&*&$
(&*$ **F
(&*$
VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
**F VJyvhjbnoP+_IREOLKDJ(UWRORWUOI
(&*$ **F VJyv
