NURS 4183Adult Health II - Shock, Sepsis & MODS.2022 / Adult Health II - Shock, Sepsis and MODS.

Adult Health II Chapter 66 – shock, sepsis & MODS Shock— - Syndrome characterized by ↓ tissue perfusion and impaired cellular metabolism resulting in an imbalance b/w the supply of and demand for O2 and nutrients (exchange is essential for life). When cells experience hypo tissue perfusion, the demand for O2 and nutrients exceeds the supply at the microcirculatory level. - Types of Shock o Distributive shock o Hypovolemic shock o Cardiogenic shock o Obstructive shock Cardiogenic shock - Occurs when systolic or diastolic dysfunction of the heart’s pumping action results in reduced CO o Most common cause is acute MI o Early clinical presentation can be ▪ Tachycardia ▪ Hypotension ▪ Tachypnea with crackles & cyanosis - Manifestations to include o Decreased cap refill o Increased Na+ and water retention o Decreased urine output o Decreased bowels, N/V o Increased blood glucose o Increased BUN Hypovolemic Shock - Occurs after a loss of intravascular fluid volume o Absolute – loss through hemorrhage, GI loss, body drainage, diabetes insipidus or diuresis ▪ Loss of blood, loss of other body fluids through vomiting, diarrhea, GI bleeding, excessive diuresis o Relative – when fluid volume moves out of the vascular space into the extravascular space ▪ fluid shift, inte