Shock

Shock can be best be defined as a complex
life threatening condition characterised by
inadequate blood supply to the tissues and cell
body .
[BRUNNER&SUDDARTH]

1. WELCOME MAY GOD BLESS YOU WELCOME MAY GOD BLESS YOU…

2. SHOCK Mrs. Gayathri R First year MSc Nursing Upasana College Of Nursing

3. Shock can be best be defined as a complex life threatening condition characterised by inadequate blood supply to the tissues and cell body . [BRUNNER&SUDDARTH] DEFINITION

4. Sudden malfunction of heart. Deficient oxygenation of blood in lungs. Reduction in blood volume. Miscellaneous. *Faintness *Acute anaphylaxis *Over dosage of drugs *Addisons disease CAUSES OF CIRCULATORY FAILURE

5. POSTURE CONTRACTION OF SKIN VESSELS INTENSITIVITY URINARY SECRETIONS HEART RATE ACCELERATES SUBNORMAL TEMPERATURE COMPENSATORY MECHANISMS

6. INITIAL STAGE COMPENSATORY STAGE PROGRESSIVE STAGE IRREVERSIBLE STAGE STAGES OF SHOCK

7. HYPOVOLEMIC SHOCK CARDIOGENIC SHOCK CIRCULATORY SHOCK *Septic shock *Obstructive shock *Neurogenic shock *Anaphylatic shock CLASSIFICATION OF SHOCK

8. THE MOST COMMON TYPE OF SHOCK IS CHARACTERISED BY A DECREASED INTRAVASCULAR VOLUME. HYPOVOLEMIC SHOCK

9. EXTERNAL ( Fluid loss ) *Trauma *Surgery *Vomiting *Diarrhoea *Diabetes incipidus RISK FACTORS

10. INTERNAL ( Fluid shift ) *Haemorrhage *Burns *Ascites *Peritonitis *Dehydration RISK FACTORS

11. Redistribute fluid volume. Restore intravascular volume. Correct underlying cause. Fluid & blood replacement. Pharmacologic therapy. MEDICAL MANAGEMENT

12. Close monitoring. Fluid replacement. Oxygen administration. Monitor signs & complication. NURSING MANAGEMENT

13. SHOCK OCCURS WHEN HEARTS ABILITY TO PUMP BLOOD IS IMPAIRED & THE SUPPLY OF OXYGEN IS INADEQUATE FOR THE HEART & TISSUE. CARDIOGENIC SHOCK

14. PAIN DYSARRHYTHMIA HEMODYNAMIC INSTABILITY CLINICAL MANIFESTATION

15. Preserve healthy myocardium. Improve cardiac functions. Pharmacological management. Mechanical assistive devices. MEDICAL MANAGEMENT

16. Preventing cardiogenic shock. Monitor hemodynamic status. Administer medications & IV fluids. Enhancing safety & comfort. NURSING MANAGEMENT

17. OCCURS WHEN BLOOD VOLUME IS ABNORMALLY DISPLACED FROM THE VASCULATURE. CIRCULATORY SHOCK

18. SEPTIC SHOCK OBSTRUCTIVE SHOCK NEUROGENIC SHOCK ANAPHYLATIC SHOCK TYPES

19. DUE TO WIDE SPREAD OF INFECTION. MEDICAL MANAGEMENT * Antibiotic therapy. * Fluid replacement. * Laboratory investigation SEPTIC SHOCK

20. Aseptic technique. Monitor signs of infection. Identify risk group. Monitor vitals . Monitor lab values. Administer prescribed medications. NURSING MANAGEMENT

21. IT RESULTS FROM EITHER A CRITICAL DECREASE IN PRELOAD OR AN INCREASE IN LEFT VENTRICLE OUT FLOW OBSTRUCTION. OBSTRUCTIVE SHOCK

22. IN NEUROGENIC SHOCK VASODIALATION OCCURS AS A RESULT OF A LOSS OF BALANCE BETWEEN PARASYMPATHETIC & SYMPATHETIC STIMULATION. NEUROGENIC SHOCK

23. IT OCCURS IN PATIENTS ALREADY EXPOSED TO AN ANTIGEN ANTIBODY REACTION. ANAPHYLATIC SHOCK

24. DUE TO ANTIBODY RESPONSE RELEASE OF HISTAMINE VASODIALATION INCREASED CAPILLARY PERMEABILITY SEVERE BRONCHO CONSTRICTION DECREASED OXYGEN SUPPLY INADEQUATE TISSUE PERFUSION PATHOPHYSIOLOGY

25. History Physical examination Monitoring the patient Check urine out put Proper documentation Oxygen administration NURSING MANAGEMENT

26. Re - assure the casualty. Comfortable position. Loosen the clothing. Keep the casualty warm. Arrest haemorrhage if any. Check vitals. Transport to hospital immediately. FIRST AID IN SHOCK

27. FLUID VOLUME DEFICIT RELATED TO HAEMORRHAGE. DECREASED CARDIAC OUTPUT RELATED TO IN EFFECTIVE CARDIAC FUNCTION. RISK FOR INFECTION RELATED TO INTERRUPTION OF SKIN INTEGRITY FROM INVASIVE PROCEDURES. ALTERED NUTRITION LESS THAN BODY REQUIREMENT RELATED TO DECREASED ORAL INTAKE. NURSING DIAGNOSIS

28. PRE – OPERATIVE MEASURES. POST – OPERATIVE MEASURES. PROMOTING HOME & COMMUNITY BASED CARE. PREVENTION OF SHOCK

29. ACUTE RESPIRATORY DISTRESS SYNDROME. MULTIPLE ORGAN DYSFUNCTION SYNDROME. COMPLICATIONS

30. CONCLUSION

31. THANK YOU…