hypovolemic shock week 5 Flashcards
shock
tissue perfusion is inadequate to deliver oxygen and nutrients
affects all body systems
can develop slowly or rapidly
hypovolemic shock
results from decreased intravascular volume 2/2 volume loss
most common type of shock
stages of shock
initial: not observable
compensatory: measures needed to increase cardiac output
progressive: compensatory mechanisms fail
refractory: irreversible; total body failure
sequence of events
- decrease in intravascular volume
- decreased venous return/ventricular filling
- decreased stroke volume
- decreased cardiac output
- decreased tissue perfusion
medical mgmt
fluid/blood replacement
medication
redistribute blood volume
treat underlying cause
fluid + blood replacement
multiple IV lines
crystalloids (LR, 0.9% NaCl)
colloids (albumin 5%, 25%)
blood products (plasma, packed RBC, platelets)
redistribution of fluid
position pt in modified Trandelenburg
lower legs elevated 20 deg
knees straight
trunk horizontal
head slightly elevated
treatment of cause
if hemorrhage, control bleeding
if v/d give meds
if dehydration is 2/2 hyperglycemia, give insulin
nursing mgmt
monitor airway/vitals
safe admin of fluids/meds
monitor for side effects
have resuscitation gear available
administer blood/fluids
baseline CBC cross-match monitor closely vitals HGB/HCT
crystalloids
LR
0.9% NaCl
colloids
albumin 5%, 25%
albumin is synthesized from human plasma and is expensive to produce
compensatory stage
homeostatic measures are activated to increase cardiac output
progressive stage
compensatory mechanisms fail; vital organs may be compromised
refractory/irreversible stage
total body failure
shock is unresponsive to therapy
fatal
