Hypovolaemic Shock Flashcards
What is hypovolaemic shock?
- The depletion of intravascular fluid volume through loss of blood or circulating plasma
- Normal blood volume increased in pregnancy
- Fluid lost from intravascular compartment
. heamorrhage
. fluid loss from GI tract; dehydration
. mass movement of fluid into another compartment
What are the three stages of shock?
- Compensation
- Progressive
- Decompensated
Explain the compensation stage of shock
Triggering the body’s natural mechanisms in an attempt to maintain adequate BP and tissue perfusion
Explain the progressive stage of shock
Should the cause of the crisis not be successfully treated the shock will proceed the progressive stage and compensatory mechanisms begin to fail
Explain the decompensated stage of shock
At this stage the vital organs have failed and the shock can no longer be reversed - death
What are the signs of hypolvolaemic shock?
- Tachycardia due to pain, activity, stress of pregnancy and labour
- Weak pulse due to decreased stroke volume
- Increased diastolic BP and cool periphery due to vasoconstriction
- Low urine output due to diversion of renal blood flow
- Concentrated urine due to increased sodium = water reabsorption
- Increased RR due to chemoreceptors response to hypoxia
- Nausea due to blood diverted from GI tract
- Sweating due to catechlomines
- Increased BG level due to stress response
Vital signs may remain normal until > 35% BV is lost
What is the management of hypovolaemic shock?
- Resps
- Temp
- Peripheral O2 sats
- BP
- Urine output and urinalysis
What are the medical investigations into hypovolaemic shock?
- CVP to monitor body fluid volume and evaluate effectiveness of fluid replacement therapy
- Arterial blood gas analysis
- Blood tests - FBC, U&E’s, glucose, clotting screen
- ECG to monitor heart condition
What is the treatment of hypovolaemic shock?
- Communication with client
- Assist oxygenation of tissue/ organs (give O2)
- Cannulate
- Fluid replacement
- Blood products
- Oxytocics (to make uterus contract to prevent anymore blood loss)
- Treat cause AIM = to restore cellular and organ perfusion with adequately oxygenated blood
What do colloids and crystalloids do?
Work to restore intravascular volume by increased oncotic pressure in intravascular space
Explain colloids
- Mainly used as PV expanders to restore vascular volume
- ADVS - good at expanding circulatory volume
- DIS - ADVS - excessive use can cause anaphylactic shock
Explain crystalloids
- Balanced salt solution- water and electrolytes e.g normal saline + Hartmans
- 1/2 30-60 secs
- DIS ADVS- excessive use will cause peripheral and pulmonary oedema
