Shock Packet

Question 1

Compensated Shock (Reversible)

Answer 1

Change in LOC (anxious appearance)
Increased pulse and respirations
Cool, pale skin

Example sentence: The patient in compensated shock presented with an anxious appearance and increased pulse.

Question 2

Uncompensated Shock (Irreversible)

Answer 2

Decrease in LOC, unconscious
Decrease HR
Decrease respirations

Example sentence: The patient in uncompensated shock had decreased level of consciousness and respiratory rate.

Question 3

Neurogenic Shock (Spinal Cord Injury)

Answer 3

Warm, dry, flushed skin and capillary refill normal
Neurologic deficit (paralysis or loss of sensation)
Change in respiratory pattern (diaphragm breathing)
Hypothermia (late sign)
Hypotension (early sign)
HR normal or bradycardia (early sign)

Example sentence: The patient with neurogenic shock exhibited warm, flushed skin and bradycardia.

Question 4

Anaphylactic Shock (Allergic Reaction)

Answer 4

Itching, Flushing, Hives
Swelling of eyelids, lips and tongue
Tightness in chest (SOB and wheezing)
Severe dyspnea
Normal to slightly increased BP (increase due to initial vasoconstriction)
Cyanosis -decreased perfusion to tissues - lactic acid build up
Hypotension
CERVICAL VERTEBRAE- most commonly fractured (least protected)
Phrenic nerve (C2-C4) controls chest wall
Abdominal cramps
Nausea and Vomiting
Diarrhea
Tachycardia, hypotension
Antigens - injected, inhaled, absorbed thru skin or mucous membranes, ingested
Local reaction - Skin symptoms; treat with Benadryl (Diphenhydramine)
Moderate reaction - Airway symptoms - BP normal - treat with SQ Epinephrine and Benadryl
Severe reaction - Low BP - Epi IV push, Benadryl, Fluid bolus, Steroids ( assess cardiac history prior to IV Epi- caution in elderly)
Antigen causes immunoglobin response which causes histamine release (dilates blood vessels and bronchoconstriction)

Example sentence: The patient experiencing anaphylactic shock had swelling of eyelids and tightness in the chest.

Question 5

Psychogenic Shock

Answer 5

Fainting with no sign of serious injury or illness
SOB, anxious, increased HR, respirations, BR

Example sentence: The patient in psychogenic shock fainted with no visible signs of injury.

Question 6

Septic Shock

Answer 6

Elevated temp initially (source of infection)
Decreased temp late sign
Petechiae
Decreased LOC
Respiratory alkalosis due to hyperventilation
Normal pulse oximetry
Creeping mottling
Tachycardia and hypotensive (vasodilation)
Treatment - Fluids initially then consider Dopamine

Example sentence: The patient with septic shock had an elevated temperature and decreased level of consciousness.

Question 7

Cardiogenic Shock (Heart Failure)

Answer 7

Dyspnea
Rales (wet lung sounds)
Tachycardia, decreased BP (ineffective pump)
Increased respirations, diaphoresis, arrhythmias

Example sentence: The patient with cardiogenic shock had dyspnea and wet lung sounds.

Question 8

Hypovolemic Shock (Bleeding or Dehydration)

Answer 8

Increased HR and respirations
Decreased BP
Cyanosis (lack of O2 to tissues)
Diaphoresis
Internal or external bleeding
LOC changes
Anxious appearance
Hypoxia
Increased blood volume in lungs and liver due to pump failure (CHF)
Treatment - consider Dopamine to increase BP 2-20mcg/kg/min

Example sentence: The patient in hypovolemic shock had increased heart rate and cyanosis.