Shock Part 2 PDF
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Western Sydney University
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Summary
This document provides an overview of the stages of shock, including the initial, compensatory, progressive, and refractory stages. It also details the physiological responses and clinical features observed during each stage. The document contains information on compensatory mechanisms and organ dysfunction associated with shock.
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Health Variations 4 NURS3015 Shock- Part 2 Stages of Shock Initial - anaerobic metabolism and lactic acidosis are evident due to decreased oxygen delivery and increased carbon dioxide retention. Stages of Shock Initial - anaerobic metabolism and lactic acidosis are evident due to decr...
Health Variations 4 NURS3015 Shock- Part 2 Stages of Shock Initial - anaerobic metabolism and lactic acidosis are evident due to decreased oxygen delivery and increased carbon dioxide retention. Stages of Shock Initial - anaerobic metabolism and lactic acidosis are evident due to decreased oxygen delivery and increased carbon dioxide retention. Compensatory (reversible) - the neurochemical responses are triggered, clinical signs and symptoms of shock are present. Stages of Shock Initial - anaerobic metabolism and lactic acidosis are evident due to decreased oxygen delivery and increased carbon dioxide retention. Compensatory (reversible) - the neurochemical responses are triggered, clinical signs and symptoms of shock are present. Progressive - stage occurs when the body’s attempt to return to homeostasis fails Stages of Shock Initial - anaerobic metabolism and lactic acidosis are evident due to decreased oxygen delivery and increased carbon dioxide retention. Compensatory (reversible) - the neurochemical responses are triggered, clinical signs and symptoms of shock are present. Progressive - stage occurs when the body’s attempt to return to homeostasis fails Refractory - is the final stage of shock and is irreversible. At this point, cellular damage leads to necrosis Initial Stage Responsible for compensatory mechanisms. Cardiac Output Stimulates the Sympathetic Stimulates Renin Angiotensin Nervous System (SNS) Aldosterone System (RAAS) Compensatory Stage Mechanisms begin to fail Metabolic and circulatory derangements become more pronounced Inflammatory and immune responses become fully activated Signs of dysfunction in one or more organs may become apparent Progressive Stage Cellular and tissue injury are so severe that the patients’ life is not sustainable even if metabolic circulatory and inflammatory derangements are corrected Full blown multi organ dysfunction syndrome (MODS) may be evident Refractory Stage No response to therapy Death is likely Loss of autoregulation Capillary permeability changes & fluid shifts Venous return & cardiac output almost negligible Reduced cardiac output leads to impaired tissue perfusion. Clinical features in Stages of Shock Clinical features in Stages of Shock 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.
