BSN Notes: Common Signs And Symptoms: Shock- Types of Shock,Hypovolemic shock

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Types of Shock
1.       Cardiogenic
2.       Hypovolemic
3.       Distributive shock
·         Septic
·         Neurogenic
·         Anaphylactic
Type
Cause
Cardiogenic
Impaired ability of the heart to pump
Hypovolemic
Loss of circulating intravascular volume.
Distributive shock
Misdistribution of circulating blood volume.
  • ·         Septic
  • ·         Neurogenic
  • ·         Anaphylactic

Result of microorganisms entering the body
Result of loss of sympathetic tone
Result of antigen antibody reaction
.


Hypovolemic shock
Result of intravascular blood volume depletion ie. Lack of circulating blood volume.
Common causes:  
·         Haemorrhage
·         GI ulcer
·         Vomiting
·         NG suction
·         Diarrhoea
·         Diuretic therapy
·         Diabetes insipidus
·         HyperGIycaemia
·         Liver diseases
·         Malnutrition
·         Blood coagulopathies
·         Bone marrow suppression
·         Haemophilia
·         Dehydration
·         Blood loss during major operations
 Pathophysiology:
Relative or absolute hypovolemia
Decreased circulatory volume
Decreased venous return to the heart
↓in stroke volume and CO
↓in tissue perfusion
O2 and nutrients supply to peripheral tissue
Impaired cellular metabolism
Death


Clinical  features:
·         Initially diaphoresis
·         Anxiety , restlessness , altered mental state, hypotension , rapid , weak , thready pulse
·         Cool clammy skin, cyanosis
·         Rapid and shallow inspiration
·         Hypothermia         
·         Thirst and dry mouth
·         Fatigue
·         Cold and mottled skin
Management
·         Correct underlying cause
·         Redistribute the blood volume by use of devices as pneumatic antishock stockings
·         Crystalloids NaCI (0.9%) or lactated ringers
·         Colloids Hydroxyethyl Starch (Voluven, Hetastarch), Polysaccharides (dextran), Polygeline (Haemaccel).
·         Combination of crystalloid and colloid solution  
·         Blood transfusion.
·         Vasoactive medications to restore vasomotor tone and improve cardiac function

·         Nutritional support to meet the metabolic requirements

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notes.nursium.com: BSN Notes: Common Signs And Symptoms: Shock- Types of Shock,Hypovolemic shock
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