Shock PDF Nursing Notes

1 sharing by any means electronic like emailing, WhatsApp, Telegram, Facebook, Instagram and by any mechanical means will be treated as violation of Copyright Act. Any person involved d...

1 sharing by any means electronic like emailing, WhatsApp, Telegram, Facebook, Instagram and by any mechanical means will be treated as violation of Copyright Act. Any person involved directly & indirectly will be punishable & fined. All rights are reserved. These notes are the copyright of Nursing Next Live. Reproduction of these notes by any form or by any means electronic or mechanical including, screenshot, photocopying, printout, scanning, or circulating and SHOCK (0.33) Hypovolemic Shock:/hemorrhagic shock (most common) Class I II III IV % blood volume lost →→ 0-15 % 15-30 % 30-40% >40% Amount lost Approx 500cc 500–1 litre 1-1.5 litre 1.5-2 liter Pulse rate/heart rate Normal ↑HR (earliest change) ↑↑ Non recordable SBP systolic blood Normal Normal ↓↓ Non recordable Respiratory rate Normal ↑/Normal ↑ ↑↑ Urine output Normal Normal/↓ ↓ ANURIA Mental status Normal Thirsty/anxious Confused COMA Management Oral liquids i/v crystalloids (Ringer Crystaccoiosy + Massive blood lactate/normal saline) Colloids transfusion Massive Blood Transfusion (0:0:9:34) Student’s Space →→ >4 units in one hour →→ More than 10 units in 24 hours Complications of Massive Blood Transfusion →→ Hypothermia →→ Hypocalcemia (due to chelation of calcium by citrate) →→ Hypercalcemia/Hypokalemia →→ Coagulopathy (most common cause of death) ∴ PRBC (packed RBC) : FFF (Fresh frozen passive) : PT (Platelet) | : | : | PRBC, FFF and platelets should be given in ratio of | : | : | Fluid Management (13:23) Best indicator to determine Best indicator of fluid amount of fluid required? resuscitation in shock? ↓ ↓ CVP (Central venous pressure) Urine output  2 Shock Index (15:56) sharing by any means electronic like emailing, WhatsApp, Telegram, Facebook, Instagram and by any mechanical means will be treated as violation of Copyright Act. Any person involved directly & indirectly will be punishable & fined. All rights are reserved. These notes are the copyright of Nursing Next Live. Reproduction of these notes by any form or by any means electronic or mechanical including, screenshot, photocopying, printout, scanning, or circulating and Heart rate (HR) Systolic blood pressure (SBP) Modified Shock Index Heart rate (HR) Modified arterial pressure (MAP) Comparison of Different Types of Shock Hypovolemic Cardiogenic Neurogenic Anaphylactic Septic 2x: myocardial Ex: Spinal cord transection Ex: Mismatched transfusion Pulse rate ↑↑ ↓↓/↑↑ ↓ ↑↑ ↑ ↑/↓ Systolic ↓ ↓ ↓ ↓ ↓ ↓ Blood pressure Cardiac output ↑ ↓ ↓ ↓ ↓ ↓ Extremities Cold Cold Cold Cold Warm Cold Bradycardia and hypotension is seen Terms and Definitions →→ SIRS (Systemic inflammatory response syndrome): Body's response to inflammation →→ SEPSIS + SIRS + Known foci of infection →→ SEPTIC shock: Sepsis and hypotension, which does not respond to fluids →→ MODS (Multiple organ dysfunction syndrome): Failure of 2 or more organ systems Table: 30:46: Perioperative red blood cell transfusion criteria Hemoglobin level (g/dL) Indications 8 No indication for transfusion in the absence of other risk factors Student’s Space