Shock Part 1 PDF

Health Variations 4 NURS3015 Shock- Part 2  Commonwealth of Australia Copyright Act 1968 WARNING This material has been reproduced and communicated to you by or on behalf of...

Health Variations 4 NURS3015 Shock- Part 2  Commonwealth of Australia Copyright Act 1968 WARNING This material has been reproduced and communicated to you by or on behalf of Western Sydney University under Part VB of the Copyright Act 1968 (the Act). The material in this communication may be subject to copyright under the Act. Any further reproduction or communication of this material by you may be the subject of copyright protection under the Act. Do not remove this notice.  Shock Shock is the clinical condition of organ dysfunction resulting from an imbalance between cellular oxygen supply and demand. It can be defined as a level of oxygen delivery that fails to meet the metabolic requirements of the tissues. (Ralston, Stuart. Davidson's Principles and Practice of Medicine, 2018; Harrison's Principles of Internal Medicine, 2018) The organ dysfunction seen in early shock is reversible with restoration of adequate oxygen supply. Left untreated, shock transitions from this reversible phase to an irreversible phase and death from multisystem organ dysfunction. Pathophysiology of Shock Impaired oxygen delivery(states of increased oxygen consumption or impaired oxygen utilization) Insufficient oxygen supply Aerobic Metabolism Anaerobic metabolism Pyruvate metabolised Lactate + much less ATP ( 2 ATP from per mole glucose) Disrupts the cell’s ability to maintain osmotic, ionic, and intracellular pH homeostasis Cell death/organ failure Classification of Shock Harrison's Principles of Internal Medicine, 2018  Types of shock Shock Hypovolemic Cardiogenic Obstructive Distributive Pump failure e.g., tension e.g., MI pneumothorax, Myocarditis massive pulmonary Absolute Relative emboli Septic Anaphylactic Neurogenic Hypovolemia Hypovolemia infection allergens Spinal cord e.g., burns injury e.g., hemorrhage GI loss-vomiting, diarrhea Vasodilation Hypovolemic shock ACCCN's Critical Care Nursing Cardiogenic Shock CHEST 2019 156392-401DOI: (10.1016/j.chest.2019.03.020) Obstructive Shock E.g., Massive pulmonary embolism, tension pneumothorax Right ventricular overload Impairs left ventricular function Decreased Cardiac Output Anaphylactic Shock Buckley et.al., Understanding pathophysiology(2019) Neurogenic Shock Damage to Spinal cord Loss of Sympathetic Tone Parasympathetic nervous system, vagal tone unopposed (Autonomic Blockade) Uncontrolled vasodilation Hypotension Decreased Cardiac Output Buckley et.al., Understanding pathophysiology(2019) References Pierre et al. Reconsidering Vasopressors for Cardiogenic Shock (2019), CHEST, Volume 156, Issue 2, 392 – 401 Brown, D., Edwards, H., Buckley, T., Aitkin, R. (2019). Lewis’s medical surgical nursing (5th Ed.). Chatswood, NSW: Elsevier Australia. Elliot,.D., Aitken, L., & Chaboyer, W. (Eds) (2019). ACCCN's Critical Care Nursing. (3rd.). Chatswood, NSW: Elsevier. Craft, Judy, Gordon, Christopher J., Author, Huether, Sue E, McCance, Kathryn L, Author, and Rote, Neal S. Understanding Pathophysiology. 3e, Australian and New Zealand ed. 2019. Linton, Adrianne Dill, Matteson, Mary Ann. Medical-surgical Nursing. 7th ed. 2020. Jameson, J. Larry, Fauci, Anthony S., Editor, Kasper, Dennis L., Loscalzo, Joseph, and Harrison, Tinsley Randolph. Harrison's Principles of Internal Medicine. 20th ed. 2018. Ralston, Stuart. Davidson's Principles and Practice of Medicine. 23rd ed. Elsevier Health Sciences, 2018.