Adult Exam 1 PDF - Nursing Management: Shock & Multisystem Failure
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This document is a chapter on nursing management for shock and multisystem failure. It specifically covers hypovolemic shock, outlining pathophysiology, medical, and nursing interventions. The text includes details such as fluid loss, compensation mechanisms, treatment goals, fluid replacement, and monitoring.
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Unit 15: Nursing Management: Shock and Multisystem Failure- Chapter 53 1. Compare and contrast the pathophysiology, medical and nursing management for the four general categories of shock. Hypovolemic Shock (quickest killer) ○ Patho...
Unit 15: Nursing Management: Shock and Multisystem Failure- Chapter 53 1. Compare and contrast the pathophysiology, medical and nursing management for the four general categories of shock. Hypovolemic Shock (quickest killer) ○ Patho Fluid Loss: Leads to decreased preload and stroke volume. Compensation: Increased heart rate and vasoconstriction (sympathetic nervous system), activation of RAAS. Outcome: Decreased cardiac output (CO) and progressive tissue hypoxia. ○ Med Treatment goals ○ Restore Intravascular Volume ○ Reverse Inadequate Tissue Perfusion ○ Correct Underlying Cause Treatment Steps ○ Stop Bleeding (if hemorrhaging): Apply pressure or perform surgery/procedure. ○ Treat Fluid Loss Causes: Diarrhea/Vomiting: Administer medications. Dehydration: Administer appropriate medications (e.g., insulin for hyperglycemia, desmopressin for diabetes insipidus). ○ Fluid Replacement: Insert at least two large-gauge IV lines. Administer fluids that remain in the intravascular compartment. Use crystalloids for non hemorrhagic shock. Use albumin for decreased colloid osmotic pressure (e.g., cirrhosis). ○ Blood Products (if hemorrhaging): Administer packed red blood cells, plasma, and platelets as needed. Monitor vital signs, blood gas values, and clinical appearance to determine transfusion needs. Monitoring and Support Monitor Patient Condition: ○ Vital signs, blood gas values, and clinical appearance. Research and Alternatives: ○ Synthetic blood development is ongoing. Risks: ○ Be aware of transfusion reactions. ○ Nursing Preventing Hypovolemic Shock Monitoring At-Risk Patients: ○ Track intake & output (I&O) and daily weights. ○ Assist with fluid replacement early. Signs of Decreased Volume: ○ Low urine output (
