Shock2013_stu.pptx - SHOCK A pathologic condition rather...

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SHOCK A pathologic condition rather than a disease process.
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Shock Characterized by generalized abnormal cellular metabolism which occurs as a direct result of inadequate delivery of oxygen to body tissues, cells and organs or inadequate usage of oxygen by body tissue. This decrease in perfusion leads to damage within the cells from poor metabolism of lactic acid and the development damaging chemicals such as free radicals.
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Pathophysiology Review Lack of O2 causes anaerobic cellular metabolism creating adverse changes in tissue function and build up of lactic acid. Compensation in an attempt to restore tissue perfusion and O2 begins
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Classifications of Shock Functional Impairment classes Hypovolemic Cardiogenic Distributive Neurogenic Septic Anaphylactic Current classes Site of Origin classes Hypovolemic Cardiogenic Vasogenic Septic
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Hypovolemic Shock Caused by the loss of blood or other body fluids. (20%) Hypovolemic shock is the most common form of serious shock, usually caused by serious bleeding Dehydration due to diarrhea, vomiting or heavy perspiration can also lead to the development of hypovolemic shock. (older adults are more prone)
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Hypovolemic Shock (body fluid depletion) There is a loss of circulating fluid volume from the central vascular space to the extent that MAP decreases and the body's total need for tissue oxygenation is not adequately met. Results in Decreased venous return Decreased cardiac output Reduced arterial BP Inadequate tissue perfusion
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Hypovolemic Shock Causes. Hemorrhage: Internal: ruptured organs, fx long ones, aortic dissection, gi ulcers or bleed, surgery. External: trauma, surgery. Dehydration caused by a condition that decreases fluid intake or increases fluid loss. Diarrhea, NGT drainage, heat stroke, DI, diuresis, ascites, bowel obstruction
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Hypovolemic Shock Clinical manifestations Altered LOC Tachycardia Weak, thready pulse Cool, clammy skin Low urinary output Decreased skin turgor
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Hypovolemic Shock Treat underlying cause, control fluid loss, replace fluid loss. Volume (fluid) replacement and blood Crystalloids Colloids Control bleeding Positioning: modified Trendelenburg (elevate legs, leave trunk flat)
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Nursing Interventions Assess and ensure a patent airway Administer oxygen as needed to maintain oxygen saturation. Start an intravenous (IV) catheter or maintain an established catheter. Two IV Lines are ideal; 1 for fluids and 1 for drug therapy Discontinue any thrombolytic medications if infusing Modified Trendelenburg Assess the patient for overt bleeding sites or cause of fluid loss If bleeding is present, apply direct pressure to the site.
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  • Spring '14
  • Brinkley
  • hypovolemic shock

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