Neurogenic Shock

Question 1

Causes

Answer 1

Spinal cord injury
Spinal anesthesia
Brain injury
Medications

Question 2

Info

Answer 2

Disruption of SNS (sympathetic nervous system) stimulation below level of the injury
Least common
Loss of vasomotor tone
Massive vasodilation

Question 3

Cervical spinal cord injury

Answer 3

Account for 20%

Question 4

Spinal cord injury above T5

Answer 4

Lower on the spinal cord and least common

Question 5

Medications

Answer 5

Toxicities that depress the vasomotor center

Question 6

Patho

Answer 6

Sympathetic nervous system is blocked which results in parasympathetic rather than sympathetic response resulting in a decreased BP and Heart rate

Question 7

Results in

Answer 7

Massive vasodilation
Hypotension
Bradycardia
Decreased systemic vascular resistance
Decreased cardiac output
Decreased tissue perfusion
Decreased venous return

Question 8

How do they look

Answer 8

Warm, dry extremities related to vasodilation
May appear flush
Body core is cool

Question 9

Nursing interventions

Answer 9

Identify and treat the cause
Stabilize the pt
Maintain airway
Fluid resuscitation 1st
Prevent/treat hypothermia
Hemodynamic support 2nd
DVT prophylaxis
Passive ROM
Inotropes

Question 10

Stabilize

Answer 10

Maintain positioning of head of bed
Risk for orthostatic hypotension

Question 11

Maintain airway

Answer 11

Ventilator support
(If a question asks, the answer is always ABGs first)

Question 12

Prevent hypothermia

Answer 12

Due to the core of the body being cool although the extremities may be warm and flushed

Question 13

Hemodynamic support

Answer 13

Vasopressors: vasoconstriction
Atropine (bradycardia)
Temporary pacemaker

Question 14

DVT prophylaxis

Answer 14

SCDs