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    Archer Shock

    Uploaded by

    Joanna Ephraim Cruz

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Archer Shock

    Uploaded by

    Joanna Ephraim Cruz
    6 views11 pages

    Original Title

    ARCHER SHOCK

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    6 views11 pages

    Archer Shock

    Uploaded by

    Joanna Ephraim Cruz

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 11

    Shock

    © USMLE Galaxy LLC

    What is shock??
    ● A state where the vital organs are not receiving adequate oxygenation
    ● This lack of oxygenation causes organ damage and forces the cells to use
    anaerobic metabolism to create energy….producing lactate
    ● Cardiovascular system is composed of:
    ○ The blood
    ○ The vasculature
    ○ The heart
    ● A disruption in any of these three components can cause a lack of oxygen
    delivery to the organs, causing shock
    ● Which component is ‘broken’ determines the type of shock

    1
    2
    Hypovolemic Shock

    Pathophysiology
    ● Low blood flow
    ● There is a loss of the circulating volume
    ● Not enough blood to enter the heart (preload), which decreases cardiac
    output
    ● The body will vasoconstrict to compensate

    3
    Causes
    ● Hemorrhage
    ● Traumatic injury
    ● Dehydration
    ○ Vomiting
    ○ Diarrhea
    ● Burns

    4
    Assessment
    ○ Weak
    ○ Pale
    ○ Tachycardic
    ○ Anxious
    ○ Hypotension
    ○ Decreased LOC
    ○ Pale
    ○ Cool
    ○ Clammy
    ○ Decreased UOP

    Treatment
    ● Fix the cause
    ○ Stop vomiting/diarrhea
    ○ Stop bleeding
    ■ Repair in OR
    ● Replace volume
    ○ Isotonic IVF
    ■ NS
    ■ LR
    ○ Blood products
    ● Support perfusion
    ○ Vasopressors

    5
    Cardiogenic Shock

    Pathophysiology
    ● The heart fails to pump sufficient blood out to the organs
    ● “Pump failure”
    ● Something is stopping the heart itself from getting blood out to the body
    ● Without sufficient blood delivered to the body, there is inadequate
    oxygenation
    ● Lack of oxygen impairs normal cellular metabolism

    6
    Causes
    ● MI
    ● Heart failure
    ● Myocarditis
    ● Endocarditis
    ● Cardiomyopathy
    ● Drug toxicity

    OBSTRUCTIVE Cardiogenic Shock


    ● There is a physical OBSTRUCTION which causes the heart to fail to pump
    sufficient blood out to the organs
    ● Examples:
    ○ Cardiac tamponade
    ○ Pulmonary embolism

    7
    Cardiac Tamponade

    What is it?
    ● Too much fluid fills in the pericardial
    sac
    ● Leads to increased pressure in the
    heart
    ● Client may present with muffled heart
    sounds, jugular vein distention,
    hypotension, and pleural friction rub

    Treatment:
    ● Pericardiocentesis

    Assessment
    ● Decreased perfusion
    ○ Hypotension
    ○ Weak pulses
    ○ Cool, pale, clammy
    ○ Decreased UOP
    ○ Decreased LOC
    ● Volume overload
    ○ JVD
    ○ Crackles
    ○ SOB
    ○ Muffled heart sounds
    ○ S3

    8
    Treatment
    ● TREAT THE CAUSE
    ○ MI
    ■ PCI
    ■ CABG
    ○ PE
    ■ Thrombolytics
    ○ Tamponade
    ■ Pericardiocentesis
    ● Improve contractility
    ○ Dopamine
    ○ Dobutamine
    ● Decrease afterload
    ○ Diuretics
    ○ Dobutamine

    Distributive Shock

    9
    Pathophysiology
    ● Something causes an immune or autonomic response in the body
    ● This alters vascular tone
    ● The result is massive peripheral vasodilation
    ● With so much vasodilation, the blood pressure is inadequate to provide
    blood flow to the vital organs
    ● Without sufficient blood delivered to the body, there is inadequate
    oxygenation
    ● Lack of oxygen impairs normal cellular metabolism

    Causes
    ● Anaphylactic
    ○ Allergic reaction
    ● Neurogenic
    ○ SCI
    ● Septic
    ○ Systemic infection
    ○ Causes release of inflammatory cytokines

    10
    Assessment
    ● Decreased oxygen
    ● Hypotension
    ● Tachycardia
    ● Tachypnea
    ● Warm, flushed skin
    ● Decreased LOC

    Treatment
    ● Anaphylactic
    ○ Epinephrine
    ○ Corticosteroids
    ○ Bronchodilators
    ● Neurogenic
    ○ Cooling
    ○ Supportive care
    ● Septic
    ○ IV antibiotics
    ○ IVF

    11

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