First Aid for shockIf you suspect that a person is in shock, call your local emergency number then immediately take the following steps;Lay the person
... [Show More] down and elevate the legs and feet slightly, unless you think this may cause pain or further •injury.Keep the person still and don't move him or her unless necessary.•Begin CPR if the person shows no signs of life, such as not breathing, coughing or moving.•Loosen tight clothing and, if needed, cover the person with a blanket to prevent chilling.•Don't let the person eat or drink anything.•If you suspect that the person is having an allergic reaction, and you have access to an epinephrine •autoinjector, use it according to its instructions.If the person is bleeding, hold pressure over the bleeding area, using a towel or sheet.••If the person vomits or begins bleeding from the mouth, and no spinal injury is suspected, turn him or her onto a side to prevent choking.Reassure the person and encourage them to rest or stay still. Stay with them until the ambulance arrives.
Stages of shockThe syndrome of shock progresses in four stages when the conditions that cause shock remain uncorrected and poor cellular oxygenation continues. These stages are;Initial stageNon progressive stageProgressive stageRefractory stage
Initial stageDecrease in baseline mean arterial pressure (MAP) of 5-10mm hg.Increased sympathetic stimulation.Mild vasoconstriction.Increased heart rate.
Non progressive stageDecrease in MAP of 10-15mm hg from the patient's baseline value.Continued sympathetic stimulation.Moderate vasoconstriction.Increased heart rate.Decreased pulse pressure.Chemical compensation.Some anaerobic metabolism in nonvital organs.Mild acidosis and hyperkalemia.
Planning and goalsMaintain fluid volume at a functional level.Report understanding of the causative factors of fluid volume deficit.Maintain normal blood pressure, temperature and pulse.Maintain elastic skin turgor, most tongue and mucous membranes, and orientation to person, place and time.Intervention Safe administration of blood.Safe administration of fluids; the nurse should monitor the patient closely for cardiovascular overload, signs of difficulty of breathing, pulmonary edema, jugular vein distention and laboratory results.Monitor weight.Monitor vital signs of patient with deficient fluid volume every 15 minutes to 1 hour for the unstable patient, and every 4 hours for the stable patient.Administer oxygen to increase the amount of oxygen carried by available hemoglobin in the blood.
EvaluationThere was maintained fluid volume at a functional level.Normal blood pressure, temperature and pulse was maintained.Reported understanding of the causative factors of fluid volume deficit.There was maintained elastic turgor, most tongue and mucous membranes, and orientation to person, place and time.
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