PN3 EXAM 3 STUDY GUIDE Shock Syndromes:
Shock is a systemic condition where there is an imbalance between the oxygen supply
to the
... [Show More] tissues/organs and the oxygen needs of those tissues/organs. There are different
types of shock. Any situation that decreases vascular volume, blood pressure, or cardiac
function can lead to shock.
Shock can be divided according to the cause. There are three main types of shock.
Distributive shock is further divided into another three categories.
Cardiogenic: pump (heart) failure
Hypovolemic: lack of circulating volume
in the vascular space Distributive:
alteration in the vascular bed size
● Neurogenic: impaired sympathetic nervous system
● Anaphylactic: hypersensitivity response due to antigen-antibody reaction
● Septic: Due to
systemic infection
Complications of each type
● Multiple Organ Dysfunction Syndrome (MODS)
● Disseminated Intravascular Coagulation (DIC)
● Acute respiratory Distress
Syndrome (ARDS) Treatment goals
of each type
● Identify and treat the underlying cause
● Deliver oxygen to the tissues
● Maintain Circulation
● Monitor for complications
● Provide comfort and
emotional support 4 stages of
shock:
● Initial: decreased CO and impaired tissue perfusion
● Compensatory: activation of sympathetic nervous system (SNS)
● Progressive: every system in the body is affected and MOD happens
● Refractory: body will no longer respond to therapy
SIRS is a clinical response to a nonspecific insult. Regardless of the etiology of the insult,
the body responses are similar. If the process cannot be contained by the innate counterinflammatory
response, there is an increased activation of the inflammatory cells,
including release of neutrophils, macrophages, and lymphocytes; and additional
damage to the vascular epithelium, deterioration in distribution of nutrients to the
organs, and subsequent complication of multiple organ dysfunction syndrome
(MODS) or multiple organ failure (MOF). Conditions commonly associated with SIRS
include infection, pancreatitis, ischemia, trauma, hemorrhagic shock, aspiration of
gastric contents, massive transfusions, and host defense deficiencies It is essential that
you assess all patients at risk for SIRS, especially for the cardinal signs of the body’s
inflammatory response. At least two or more of the following findings will be present
in SIRS:
● Change in temperature either higher than 38° C (100.4° F) or lower than 36° C
(96.8° F)
● Pulse greater than 90 beats per minute
● Respiratory rate greater than 20 breaths per minute or a partial pressure of
carbon dioxide (PC02) less than 32 mm Hg
● White blood cell (WBC) count higher than 12 × 103/mm3, or with more than
10% band cells
BOX 65-3: ASSESSMENT AND DIAGNOSIS OF SHOCK
Common clinical manifestations of the shock syndrome will vary according to the
underlying cause, the stage of shock, and the individual person’s response to shock. The
exact course of events can be variable. Each person must be assessed individually prior to
any intervention: [Show Less]