1. Nursing Care of Patients in Shock
Chapter 9
Nursing Care of Patients in Shock

2. Shock
Circulatory Collapse Resulting in Organ Damage and Death Without Immediate Treatment

3. Pathophysiology of Shock
Tissue Perfusion: Adequate Blood Volume, Effective Cardiac Pump, Effective Blood Vessels
Compensation: Change in One or Both of Nonfailing Tissue Perfusion Mechanisms
Shock: Failure in Compensation

4. Metabolic and Hemodynamic Changes in Shock
Sympathetic Nervous System
Tachycardia
Tachypnea
Oliguria
Cool, Clammy Skin with Pallor
Decreased Blood Pressure

5. Effect on Organs Tissue Ischemia and Organ Injury
Kidneys Injured First
Brain Death if Anoxic Over 4 Minutes

6. Complications from Shock
Adult Respiratory Distress Syndrome
Disseminated Intravascular Coagulation
Multisystem Organ Failure

7. Classification of Shock
Hypovolemic Shock
Decreased Circulating Blood Volume
Cardiogenic Shock
Cardiac Failure
Obstructive Shock
Blockage of Blood Flow Outside Heart

8. Classification of Shock (cont’d)
Distributive Shock
Excessive Dilation of Venules/Arterioles

9. Types of Distributive Shock
Anaphylactic Shock
Septic Shock
Neurogenic Shock

10. Therapeutic Interventions for Shock
Maintain Airway/Respiratory Support
Provide Cardiovascular Support
Maintain Circulatory Volume
Control Bleeding
Treat Cause

11. Nursing Diagnoses Ineffective Tissue Perfusion
Decreased Cardiac Output
Fear
Deficient Knowledge

12. Nursing Care Maintain Airway, Oxygenation Monitor Vital Signs
Monitor Intake and Output
Provide Fluids as Ordered
Provide Warmth
Relieve Pain