Please enable JavaScript.
Coggle requires JavaScript to display documents.
Shock (Oxygenation&Perfusion) - Coggle Diagram
Shock (Oxygenation&Perfusion)
Patho/Etiology
Inadequate perfusion (BP) leads to hypoxia and cell damage
Distributive - global vessel dilation creates to large a space for fluid to fill and maintain BP
Hypovolemic - fluid volume is inadequate to maintain BP
Obstructive - A large embolism causes a profound vessel obstruction leading to insufficient blood return to maintain BP
Cardiogenic - Ventricular dysfunction does not allow adequate CO to maintain BP
Hypoxic cells enter a state of anaerobic metabolism causing a drop in pH leading to acidosis
Cell membrane dysfunction leads to failure of sodium pump
Cells release digestive enzymes which damage the cell and enter the bloodstream causing capillary endothelial damage and cell destruction and death
Temporary compensatory actions
SNS stimulates alpha and beta cells (increase HR,RR, vasoconstriction/ shunting) in an attempt to increase CO and BP and oxygenation
Inadequate renal perfusion activates RAAS to retain sodium and water in an attempt to maintain BP
Complications
Inadequate perfusion leads to end organ damage
Renal damage
GI damage
Neuro damage
cardiac damage
Compensatory mechanisms will eventually exacerbate condition
long term vasoconstriction exacerbates cell damage and release of toxins
death
S&S
Low BP
High HR, RR
cyanosis
cool/ mottled skin
altered mental status
thirst
fever (sepsis)
N/V/A
hemorrhage
Collaborative Treatment
Hypovolemic
Stop loss of fluid if possible
replenish fluids
educate PT about hydration if applicable
Cardiogenic
Correct ventricular dysfunction
Distributive
Fluid
Treat sepsis
Identify possible toxins
Obstructive
Clot busters
stint
Surgery
Labs/ diagnostics
Hypovolemic
BP
Central Venous Pressure - preload
CO
Systemic Vascular Resistance - afterload
HR
Cardiogenic
ECG
cardiac enzymes
CBC
echo
Distributive
CBC
Blood culture
Tox screen
cranial radiography
Obstructive
CBC
ultrasound
radiography
Risk Factors
Hypovolemic
Injury (bleeding)
dehydration
illness (N/V/A)
heat
Bleeding disorder
Cardiogenic
MI
HF
Trauma
Arrhythmia
Distributive
Sepsis
Brain injury
toxin exposure
Obstructive
Foreign body
clotting disorder