Stages of Shock Flashcards
general management
support respiratory, fluid replacement, vasoactive medication, nutritional support
cellular changes
cellular edema, efflux of K, increased permeability, lysosomal membrane rupture, influx of Na, cell damage and death, mitochondrial damage
vascular responses
autoregulation, cytokine release in response to inflammation
blood pressure regulation
when BP drops catecholamines are released from adrenal medulla, increased HR, retention of sodium and water
Compensatory stage characteristics
BP remains within normal limits, increased HR, CO is maintained, stimulation of sympathetic nervous system
compensatory stage manifestations
tachycardia, RR increased, skin cold and clammy, UO decreased, confusion, respiratory alkalosis
medical management for compensatory stage
identify underlying cause, fluid replacement, O2
what is the key sign of shock
narrowing pulse pressure
T/F: when BP drops the damage is already happening
true
progressive stage characteristics
BP drops, RR rapid and shallow, mottling and petechiae, MAP decreases, lethargy, metabolic acidosis
progressive stage manifestations
rapid shallow breathing, chest pain, lethargy, acute kidney injury, liver failure, GI bleeding, skin changes, abnormal clotting times
medical management for progressive stage
treat underlying cause, fluids, respiratory support, nutritional support, oral care if on ventilator, rest and comfort
irreversible stage characteristics
severe organ damage, unable to maintain BP with treatment, unable to oxygen with ventilator support, unable maintain MAP, multiple organ dysfunction, complete organ failure, profound metabolic acidosis
irreversible stage manifestations
patient unable to respond to treatment, ventilator support, severe hypotension, complete decline in mental status status, anuric
medical and nursing management
treat underlying cause, respiratory support, circulatory support, nutritional support, experimental treatment, support comfort measure, support and educations for the family
