Med Surg Final Study Guide
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Stages of shock 
o Initial – Usually not clinically apparent 
 Metabolism changes from aerobic to anaerobic 
 Lactic acid accumulates and must be removed by blood and broken down by liver (increased LA – no 
filter) 
 Process requires unavailable O2 
o Compensatory – body is compensating 
 Clinically apparent 
 Neural 
 Hormonal 
 Biochemical compensatory mechanisms 
 Attempts are aimed at overcoming consequences of anaerobic metabolism and maintaining homeostasis 
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Med Surg Final Study Guide•Med Surg Final Study Guide