med surg ch 12-shock

different tyoes of shock

Cardiogenic

hypovolemic

distructive

obsuctive

lab values

various lab studies

• hemogram

• serum chemistry

• coagulation studies

Serum lactae level

• measure of overall state of shock

• indicator of adequacy of resuscitation

cardigenic shock

heart fails to act as an effective pump

heart cant pump easily

hypovolemic shock

inadequate circulating volume

obstructive

physical impairment to adequate circulating blood flow

something blocking the ciruclation blood flow

distributive shock

widespread vasodilation and decreased vascular tone resulting in a relative

• neurogenic

• septic

• anaphylactic

neurogenic - distributive

affects to the sympatheic nervous system impluse transmisson

anaphylatic - distributive shock

introduction of an antigen into a sentive indiviual

like release histamine

caused by allergic reation

septic - distributive

follows invasion of host by microorganism

cause by immunosuppression

significant bacteremia

organ dysfunction clinical manifestation

tachycardia

abdominal distention

jaundice

oiliguria

tachpnea/hypoxemia

petechiae/bleeding

hypotension

LOC

assessement in central nervous system

BP

early stage - slightly elevated , narrow pulse pressue

late stage - pulses, jugular vein assessement , cap refill, fluid responsiveness

cardiovascular assessement

the initial/most sensitive to early change during shock

anxiety/restlessness

last stage - confused, lethargic , unresponsive

pulmonary assessement

early sign - rapid and deep

late sign- shallow and poor gas exchange

renal assessment

RAAS is activated

GF is down

oilguria

sodium retention

water reabsorption

heptaic assessement

altered liver enzymes

clotting disorder

increased chance of infection

GI assessement

everything is slow

slow bowel movements/sound

nausea

constipation

abdominal distention

skin assessement

skin tugor

skin color, temp , texture

cyanosis - late sign

hematological assessement

increased clotting/ decreased fibrinolysis

like clotting is happening and the thing to stop clotting is not happening lol

low clotting factors

clotting in the microcirulation

ex- DIC