DISEASE CAUSE PATHOPHYSIOLOGY SIGNS AND

SYMPTOMS/
COMPLICATIONS
DIAGNOSTIC TEST TREATMENT MEDICAL MGT NURSING MGT
SHOCK

inadequate
tissue perfusion, in
which there is
insufcient delivery of
oxygen and nutrients to
the bodys tissues and
inadequate
removal of waste
products from the tissues

classification:
1) hypovolemic shock
caused by a decrease in
the circulating
blood
volume, (2)
cardiogenic
shock caused by cardiac
failure, (3)
extracardiac
obstructive shock caused
by a
blockage of blood ow in
the cardiovascular circuit
outside
the heart, and (4)
distributive shock
caused by excessive
dilation
of the venules and
arterioles
Tissue perfusion and
blood pressure are
maintained in the
body by three
mechanisms: adequate
blood volume, an
effective
cardiac pump, and
effective blood
vessels. The body
is
able to compensate for
failure of one of these
mechanisms
by
making a change in one
or both of the other two.
Shock
occurs
when compensatory
mechanisms fail and
inadequate
tissue
perfusion occurs.
Common causes include
inadequate
cardiac
output
caused by heart failure, a
sudden loss of
blood volume resulting
from hemorrhage, or a
sudden decrease
in peripheral vascular
resistance caused by
anaphylaxis,
sepsis,
and neurological
alterations.

Tachycardia, tachypnea,
hypotension,
oliguria, cyanosis, and altered
mental
status





COMPLICATION:
Acute respiratory
distress syndrome
(ARDS), disseminated
intravascular coagulation
(DIC), and multisystem
organ
failure are three
especially grave
conditions that may
follow
a prolonged episode of
shock.
Complete blood count, serum
osmolarity,
blood chemistries,
prothrombin time,
partial thromboplastin time,
blood
typing and crossmatch, serum
lactate,
arterial blood gases, cardiac
isoenzymes, urinalysis

Chest x-ray, spinal lms,
computed
tomography, echocardiogram
Electrocardiogram, arterial
pressure
monitor, central venous
pressure
monitor, pulmonary artery
catheter,
gastric pH
Determination and treatment
of causes of shock

Septic shock: antibiotics
Cardiogenic shock: morphine,
diuretics, nitrates
Anaphylactic shock:
epinephrine,
diphenhydramine (Benadryl),
methylprednisolone (Solu-
Medrol),
aminophylline