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Shock

Terms in this set (31)

Define shock
acute, widespread process of impaired tissue perfusion

imbalance between cellular oxygen supply

all body organs are affected by shock and either work harder to adapt and compensate for reduced perfusion or fail to function secondary to hypoxia

DECREASED TISSUE PERFFUSION
What do all types of shock involve?
ineffective tissue perfusion and acute circulatory failure
What are the 4 broad stages of shock?
-initial
-compensatory
-progressive
-refractory
Describe the initial phase of shock
-cardiac out decreased = decreased tissue perfusion
-MAP decreased 10 mmHg from baseline
-effective compensation
-increased HR
Describe the compensatory phase of shock
-the body naturally attempts to maintain CO, BP, and perfusion
-MAP decreased 10-15 mmH from baseline
-increased renin
-vasoconstriction
-decreased pulse pressure
-increased HR
-decreased pH
-restless
-apprehensive
Describe the progressive phase of shock
-the body fails to meet tissue needs and compensation is ineffective
-MAP is decreased 20 mmHg from baseline
-tissue/organ hypoxia
-decreased UOP
-weak rapid pulse
-decreased pH
-sensory neural changes
Describe the refractory phase of shock
at this point, the body in the shock state becomes unresponsive to interventions and therapy and the syndrome is considered irreversible (excessive cell/organ damage, multiple system organ failure, decreased pH)
When is a pt that is in shock considered to be in multiple organ dysfunction syndrome (MODS)?
as shock progresses and organ systems (2 or more) begin to fail
What are the overall consequences of shock?
all body organs are affected by shock and either working harder to adapt and compensate for reduced perfusion or fail to function secondary to hypoxia
What are the cardiovascular consequences of shock?
ventricular failure
microvascular thrombosis
What are the neurologic consequences of shock?
-sympathetic nervous system dysfunction
-cardiac and respiratory depression
-thermoregulatory failure
-coma
What are the pulmonary consequences of shock?
acute lung failure
ARDS
What are the renal consequences of shock?
AKI
What are the hematologic consequences of shock?
disseminated intravascular coagulation
What are the GI consequences of shock?
GI tract failure
liver failure
pancreatic failure
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