Lecture on Shock

Introduction

• Presented by Cathy from Level Up RN
• Focus on different types of shock
• Includes quiz at the end
• Recommended use of Level Up RN medical-surgical nursing flashcards

Definition of Shock

• Insufficient blood flow leading to lack of perfusion to organs
• Organs do not receive necessary oxygen and nutrients

Types of Shock

Hypovolemic Shock

• Caused by:
  • Blood loss from trauma or surgery
  • Excessive GI losses (vomiting/diarrhea)
  • Excessive fluid loss (e.g., diuresis)

Cardiogenic Shock

• Caused by heart pump failure
  • Myocardial Infarction (MI)
  • Heart failure
  • Valve/structural heart problems
  • Dysrhythmias

Obstructive Shock

• Blockage of great vessels or heart
  • Pulmonary embolism (PE)
  • Tension pneumothorax
  • Cardiac tamponade

Distributive Shock

• Extreme systemic vasodilation
• Types:
  • Septic Shock: Endotoxins in bloodstream from infection
  • Neurogenic Shock: Dysfunction of sympathetic nervous system (e.g., spinal cord injury)
  • Anaphylactic Shock: Reaction to allergen causing airway closure and systemic vasodilation

Common Signs and Symptoms

• Hypotension
• Tachycardia
• Tachypnea
• Weak pulses
• Decreased urine output (<30 ml/hr)
• Anaphylactic shock may include wheezing and angioedema

Laboratory Findings

• Increased serum lactate
• Abnormal arterial blood gases (ABGs)
• Cardiogenic Shock: Increased cardiac enzymes
• Hypovolemic Shock: Decreased hemoglobin and hematocrit
• Septic Shock: Positive blood cultures

Treatment and Management

• Address underlying condition
• Administer IV fluids, blood products, colloids
• Use vasopressors (e.g., epinephrine, norepinephrine)
  • Correct hypovolemia before administering vasopressors
• Administer antibiotics in septic shock

Nursing Care

• Administer oxygen as ordered
• Maintain airway; prepare for intubation if necessary
• Place patient in shock position (supine with legs elevated, modified Trendelenburg)
• Monitor vital signs, consciousness, urine output
• Watch for complications:
  • Multiple Organ Dysfunction Syndrome (MODS)
  • Disseminated Intravascular Coagulation (DIC)
    • Micro clots lead to ischemia, risk of bleeding due to used clotting factors

Quiz Questions

1. True or False: A urine output under 30 ml/hr may indicate shock? - True
2. What type of shock is caused by heart pump failure? - Cardiogenic Shock
3. Hypotension is a key symptom with which type of shock? - All of them

Conclusion

• Encouragement to study and subscribe
• Engagement through likes and comments on the video