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Dr. Sherwin Buluran
Christian P. Ureta BSN 2-3
so when perfusion is not occurring properly this is called a hypoperfusional (hypo = below) state. It travels in the blood stream as well. life-threatening medical condition characterized by a decrease in tissue perfusion to a point at which it is inadequate to meet cellular metabolic needs. all with similar outcomes. This allows the cells to generate energy and do their specific jobs.The process of blood entering the tissues is called perfusion. where oxygen molecules cross into the smallest blood vessels.Circulatory shock. As the blood carries oxygen and nutrients around the body. and can stop the tissues from functioning properly. where it is then taken back to the lungs and breathed back into the air. The hemoglobin then picks up carbon dioxide. the capillaries. the waste product of metabolism. whereby the whole cycle starts again. The red blood cells are pushed through the body by the actions of the pumping heart and deliver the oxygen to cells in all the tissues of the body. How the body works Cells need two things to function: oxygen and glucose. and are picked up by red blood cells and attached to hemoglobin molecules. is a serious. and using an insulin molecule that "opens the door. shock may lead to hypoxemia (a lack of oxygen in arterial blood) or cardiac arrest (the heart stopping). Shock can have a variety of effects. but all relate to a problem with the body's circulatory system. Oxygen in the air enters the body through the lungs. Medical shock is a lifethreatening medical emergency and one of the most common causes of death for critically-ill people." it enters the cell to provide energy for cellular metabolism. A circulatory shock should not be confused with the emotional state of shock. . commonly known simply as shock. Glucose is generated in the body from the foods we eat. reduced flow hinders the delivery of these components to the tissues. For example. as the two are not related.
The person doesn't receive enough oxygen in vital organs. It can also be caused by excessive sweating or an inadequate intake of oral fluids. If this situation is not corrected right away. Dehydration may follow severe diarrhea or vomiting. What are the signs and symptoms of the condition? Hypovolemic shock can cause the following: . the person will die. which contains fluid. that is injured\ \the depth of destruction\ \the location of the burn\ . and other particles. When there is a severe decrease in blood or total body fluid. internal bleeding due to an injury. cells.Types of shock • • • • • Hypovolemic Shock Cardiogenic Shock Hemorrhagic Shock Neurogenic Shock Hypoglycemic Shock Hypovolemic Shock Hypovolemic shock is a condition in which the body doesn't have enough blood volume to circulate throughout the body. hypovolemic shock occurs. also called BSA. What are the causes and risks of the condition? Hypovolemic shock is usually caused by massive blood loss or severe dehydration. What is going on in the body? Blood. or severe the amount of body surface area. a hemorrhage. Oxygen is required to keep body tissues alive. Blood loss may be the result of gastrointestinal bleeding. carries oxygen through the body.
pale skin confusion fainting low blood pressure rapid heartbeat reduced urine output Stages of Hypovolemic Shock Most sources state that there are 4 stages of hypovolemic shockhowever a number of other systems exist with as many as 5 stages. 15-30. 40 Stage 1 Up to 15% blood volume loss (750mls) Compensated by constriction of vascular bed Blood pressure maintained Normal respiratory rate . 30-40. The 4 stages are sometimes known as the "Tennis" staging of hypovolemic shock. as the 4 stages of % volume of blood loss mimic the scores in a game of tennis: 15.• • • • • • cold.
Agitation) Sweating with cool. Pallor of the skin Slight anxiety Stage 2 15–30% blood volume loss (750–1500 ml) Cardiac output cannot be maintained by arterial constriction Tachycardia >100bpm Increased respiratory rate Blood pressure maintained Increased diastolic pressure Narrow pulse pressure Sweating from sympathetic stimulation Mildly anxious/Restless Stage 3 30–40% blood volume loss (1500–2000 ml) Systolic BP falls to 100mmHg or less Classic signs of hypovolemic shock Marked tachycardia >120 bpm Marked tachypnea >30 bpm Decreased systolic pressure Alteration in mental status (Anxiety. pale skin Stage 4 Loss greater than 40% (>2000mls) Extreme tachycardia with weak pulse Pronounced tachypnea Significantly decreased systolic blood pressure of 70 mmHg or less Decreased level of consciousness .
A drink that balances essential salts and sugars. It often occurs after an accident or severe illness. hypovolemic shock can lead to irreversible brain and kidney damage. effective treatment. and extremely pale (moribund) Diagnosis & Tests Shock is usually diagnosed based on a person's symptoms and a physical exam. cool. What are the long-term effects of the condition? Without rapid. helps if the vomiting or diarrhea is severe. If the exact cause of shock is not clear. Usually. hypovolemic shock cannot be prevented. Skin is sweaty. and other tests may be done. What are the risks to others? Hypovolemic shock is not contagious. such as a commercial hydration solution. this is done through a . Dehydration can sometimes be prevented by drinking enough fluids. Xrays. What can be done to prevent the condition? In many cases. It can also cause cardiac arrest. and poses no risk to others. and ultimately death. Treatment & Monitoring Emergency treatment for hypovolemic shock includes prompt replacement of fluid and/or blood. blood tests.
and X-rays. People in shock are very ill and may need to be put on a ventilator. blood tests. monitoring may include physical exams. Any bleeding sites must be found so that blood loss can be controlled. or artificial breathing machine.needle in a vein known as an IV. . Any new or worsening symptoms should be reported to the healthcare provider. Surgery may be needed to treat any injuries that are present. Medicines may be needed to support blood pressure or treat other complications. How is the condition monitored? Depending on the person's health status.
mottling. trauma. tachycardia. dysrhythmias. tissue sloughing with extravasation.GENERIC NAME DOPAMINE HYDROCHLORID E (doe'pa-meen) Dopastat. elevated blood pressure. increase in toe temperature. • Monitor therapeutic effectiveness. dilated pupils (high doses). Safe use during pregnancy (category C). signs of peripheral ischemia (pallor. complaints of tenderness. Skin: Necrosis. cyanosis. dyspnea. tachyarrhythmi as or ventricular fibrillation. lactation.and betaadrenergic receptors and on specific dopaminergic receptors in mesenteric and renal vascular beds INDICATION S To correct hemodynamic imbalance in shock syndrome due to MI (cardiogenic shock). ascending tachycardia. pulse. Other: Azotemia. gangrene. adequacy of nail bed capillary filling. pain. CNS: Headache. GI: Nausea. Intropin. CONTRAINDI CATIONS Pheochromocyt oma. or children is not established. peripheral pulses. other indices of adequate dosage and perfusion of vital organs include loss of pallor. less frequent: aberrant conduction. Major cardiovascular effects produced by direct action on alpha. Precise measurements are essential for accurate titration of dosage. numbness. • Report the following indicators promptly to physician for use in decreasing or temporarily suspending dose: Reduced urine flow rate in absence of hypotension. disproportionate rise in diastolic pressure (marked decrease in pulse pressure). NURSING RESPONSIBILITIES Assessment & Drug Effects • Monitor blood pressure. bradycardia. anginal pain. or burning sensation). open heart surgery. palpitation. coldness. ADVERSE REACTIONS CV: Hypotension. Revimine Classifications: AUTONOMIC NERVOUS SYSTEM AGENT. piloerection. and urinary output at intervals prescribed by physician. and reversal of confusion or comatose state. vomiting. In addition to improvement in vital signs and urine flow. and CHF. vasoconstriction (indicated by disproportionate rise in diastolic pressure). ectopic beats. cold extremities. widening of QRS complex. ALPHAAND BETAADRENERGIC AGONIST (SYMPATHOMIMET IC) DOSAGE Shock Adult/Child: IV 2–5 mcg/kg/min increased gradually up to 20–50 mcg/kg/min if necessary Renal Failure Adult: IV 2–5 mcg/kg/min MECHANISM OF ACTION Naturally occurring neurotransmit ter and immediate precursor of norepinephrin e. endotoxic septicemia (septic shock). .
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