2 Nursing Interventions for Shock

Shock is a life-threatening medical condition in which the body suffers from insufficient blood flow throughout the body. Shock often accompanies severe injury or illness. Medical shock is a medical emergency and can lead to other conditions such as lack of oxygen in body tissues (hypoxia), heart attack (cardiac arrest) or organ damage. It requires immediate treatment because the symptoms can worsen quickly.

Medical shock is a shock is different than emotional or psychological shock that can occur after a traumatic emotional event or scary.



Etiology

1. Hypovolemic shock

• Bleeding
• Loss of fluid volume
• Displacement of fluid from the vascular to the interstitial cells

2. Cardiogenic shock

• Impaired the ability of the heart pump (cardiac arrest, arrhythmia, valve disease, myocardial degeneration, systemic infection drugs.

3. Vasogenic shock

• Decrease simpatic tone, vasodilatation, increased capillary permeability

neurogenic, or chemicals (anaphylactic), severe pain, psychological stress, neurological damage, cholinergic drugs, alpha adrenergic blocker agent.

4. Septic shock

• Cause of gram-negative organisms (P. aerogenosa, Escherichia coli, Klebseilla pneomoni, Staphylococcus, Streptococcus).
• Predisiposisi: malnutrition, large open wounds, ischemia of the gastrointestinal tract (GI), immunosuppression.
• Host interactions - toxin stimulates systemic complement activity - changes in organ microcirculation, increased capillary permeability, cell injury, increased cell metabolism.

Signs of shock :

• General state: weak.
• Perfusion: pale skin, cold, wet.
• Tachycardia.
• Peripheral vein is not visible.
• Decreased blood pressure, systolic less than 90 mmHg or a fall of more than 50 mm Hg of pressure before.
• Hyperventilation.
• Peripheral cyanosis.
• Restlessness, decreased consciousness.
• Decreased urine production.

2 Nursing Interventions for Shock

1. Fluid Volume Deficit
a. Intravenous therapy (according to type of shock):
Crystalloid (to restore the liquid electrolyte).

b. Colloid (to restore plasma volume and restore the osmotic pressure): WB, PRC, plasma.

2. Decrease Cardiac Output
Goal:

• Increase the vascular fluid.
• Support the compensatory mechanisms.
• Prevent ischemic complications.

Drug therapy:

• Improve venous return.
• Improve myocardial contraction.
• Ensure adequate myocardial perfusion:
• Vasoconstrictor agents.
• Agents that increase myocardial contraction.
• Myocardial perfusion agent adds.