shock Flashcards
shock
inability of circulatory system to supply cells with oxygen
initial stage of shock
subtle vitals changes: decreased MAP
cellular damage 2/2 lack of perfusion
reversible
compensatory stage of shock
increased HR, RR to get more oxygen to cells
decreased BP
constriction of peripheral circulation causes pale, cool skin
treated with IV fluid replacement and meds
progressive stage of shock
SBP 80-90 HR > 50 bpm rapid, shallow RR with crackles cool, pale, mottled skin with petechiae UO < 30 mL/hr metabolic acidosis AMS
refractory/irreversible stage of shock
perfusion to organs cannot be restored unresponsive to tx HR erratic or asystolic mechanical ventilation jaundiced skin anuria, dialysis altered LOC profound acidosis
inotropic drugs
dobutamine
dopamine
epinepherine
vasodilators
ntg
nitroprusside
vasopressors
norepinepherine
dopamine
phenylepherine
vasopressin
interventions to maintain renal perfusion
foley
low dose dopamine
interventions to maintain nutrition status
enteral feeding
monitor electrolytes, BUN, Cr
prevent injury 2/2 decreased perfusion
limit sedatives, CNS depressants
IV route only for meds
hypovolemic shock
most common type of shock usually 2/2 bleeding decreased circulating volume decreased BP, CO less oxygenation and decreased perfusion
causes of hypovolemic shock
bleeding, surgery, trauma
diuresis, 3rd spacing, dehydration
peritonitis, pancreatitis, diarrhea, ascites
hypovolemic shock collaborative care
stop fluid loss
large bore IV or CVC or SWAN
O2
vasoconstrictors, dopamine
hemorrhage fluid replacement
PRBCs
