emergency.docx - Types of shock are classified according to...

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Types of shock are classified according to etiology: CHANS C ardiogenic - caused by inability of the heart to pump blood effectively (due to heart attack or heart failure) H ypovolemic - caused by inadequate blood volume (due to bleeding or dehydration) A naphylactic - caused by allergic reaction N eurogenic - caused by damage to nervous system (due to extreme emotional upset due to personal tragedy or disaster) S eptic - caused by systemic infection Shock - Medical RN Lesson 8-I Emergency Management - objective is to correct underlying cause and prevent progression o Many treatments listed are used for all shock syndromes, e.g., vasopressors, positive inotropic support, oxygen therapy (intubation), fluid replacement o Cardiogenic shock - early revascularization in patients with myocardial infarction and intervention in clients with structural heart disease pharmacologic treatments positive inotropic agents - increase myocardial contractility and improve systolic ejection, e.g., dobutamine, amrinone vasodilators - improve heart's pumping action by reducing its workload; e.g., nitroglycerin, nitroprusside sodium; usually limited to clients with failing ventricular function vasopressors - increase peripheral vascular resistance and elevate blood pressure, e.g., norepinephrine, dopamine diuretics and digoxin - may be given if the client shows heart failure
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antidysrhythmic agents - may be given to regulate the client's heart rhythm oxygen therapy - titrated based on ABG analysis and respiratory effort supportive treatments - to assist with blood circulation intra-aortic balloon pump (counterpulsation) left and right ventricular assist pumping o Hypovolemic shock - rapid fluid replacement therapy to replace lost volume; usually given in a 3:1 ratio (300 mL fluid for every 100 mL of fluid loss) crystalloids - 2/3 moves out of vascular space, e.g. 0.9% normal saline or ringers lactate colloids (not for sepsis or burn) - 1/3 to 1/2 moves out of vascular space, e.g. albumin, dextrans & hydroxyethylstarches hemoglobin-based oxygen carriers blood and blood products whole blood (autotransfusion an option if they go to surgery/chest tube) packed red blood cells - increase the oxygen carrying capacity of blood platelets
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