Learning Goal: I’m working on a nursing practice test / quiz and need an explana
Learning Goal: I'm working on a nursing practice test / quiz and need an explanation and answer to help me learn.Shock—- Syndrome characterized by ↓ tissue perfusion and impaired cellular metabolism resulting in animbalance b/w the supply of and demand for O2 and nutrients (exchange is essential for life).When cells experience hypo tissue perfusion, the demand for O2 and nutrients exceeds thesupply at the microcirculatory level.- Types of Shocko Distributive shocko Hypovolemic shocko Cardiogenic shocko Obstructive shockCardiogenic shock- Occurs when systolic or diastolic dysfunction of the heart’s pumping action results in reducedCOo Most common cause is acute MIo Early clinical presentation can be▪ Tachycardia▪ Hypotension▪ Tachypnea with crackles & cyanosis- Manifestations to includeo Decreased cap refillo Increased Na+ and water retentiono Decreased urine outputo Decreased bowels, N/Vo Increased blood glucoseo Increased BUNHypovolemic Shock- Occurs after a loss of intravascular fluid volumeo Absolute – loss through hemorrhage, GI loss, body drainage, diabetes insipidus ordiuresis▪ Loss of blood, loss of other body fluids through vomiting, diarrhea, GI bleeding,excessive diuresiso Relative – when fluid volume moves out of the vascular space into the extravascularspace▪ fluid shift, internal bleeding, massive vasodilation and pooling of blood or otherbody fluids- Manifestations to includeo Tachypnea leading to the late sign of bradypneao Decreased urine outputo Pallor, cool clammy skino Anxiety, confusion, agitationo Absent bowelso Decreased HCT & HGBo Increased lactateNeurogenic Shock- Can occur within 30 minutes of a spinal cord injury an can last up to 6 weeks- Most important clinical manifestations areAdult Health IIChapter 66 – shock, sepsis & MODSo Hypotensiono Bradycardia- Manifestations to includeo Skin will initially be warm from massive vasodilation, then risk for hypothermia onceheat disperseso Flaccid paralysiso Bladder dysfunctionAnaphylactic Shock- An acute, life threatening hypersensitivity allergic reaction.- Reactions causes massive vasodilation, release of vasoactive mediators (can constrict or dilate)and increased capillary permeability leading to fluid leaks from the vascular space into theinterstitial space- Can lead to respiratory distress- Sudden onset of symptoms includeo Dizzinesso Chest paino Incontinenceo Swelling of lips and tongueo Wheezing and stridoro Flushing skino Pruritus and urticariao Confusiono Septic ShockMetallic taste- Sepsis is defined as a set of symptoms or syndrome in response to an infection- Shock is a subset of sepsis with an increased mortality. It is characterized by persistenthypotension and inadequate tissue perfusion- Manifestations to includeo Hyperventilationo Crackleso Respiratory alkalosis leading to acidosiso Pulmonary HTNo Respiratory failureo Warm & flushed skin leading to the late sign of cool & mottledo Confusion & agitation, can lead to coma (late)o Increase glucoseo Increased lactateo Decreased plateletsSepsis/Shock Continuum» » » » SIRS = initial insult (inflammatory response)Sepsis = SIRS + suspicion or confirmed infectionSevere Sepsis = SIRS + infection + hypoperfusion or organ dysfunctionSeptic Shock = SIRS + infection +organ dysfunction + refractory hypotensiono Invasion of microorganism with an amplified response to the infection▪ Bacteria (most common)▪ Fungus, virus or parasites

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