Question

Read chapter 65-66 Medsurge II, Draw a table that include etiology, clinical manifestation and more relevant nursing management measure for the differents type of shok [cardiogenic, hypovolemic, anaphylactic and obstructive}

Answer 1

ANSWER:

Types of shock	Etiology	Clinical manifestation	Nursing management
Cardiogenic	The most common causes are serious heart conditions. Direct pump failure MI, Cardiac Arrest Ventricular Dysrhythmia	Tachycardia, hypotension, urine output much less than usual or not at all, tachypnea, cold clammy skin, pulmonary congestion, Loss of consciousness	Prevent recurrence. Identifying at-risk patients early, promoting adequate oxygenation of the heart muscle, and decreasing cardiac workload can prevent cardiogenic shock. Hemodynamic status. Arterial lines and ECG monitoring equipment must be well maintained and functioning Fluids. IV infusions must be observed closely because tissue necrosis and sloughing may occur if vasopressor medications infiltrate the tissues, and it is also necessary to monitor the intake and output. Enhance safety and comfort.
Hypovolemic	Body fluid depletion- Haemorrhage internal external dehydration	Hypotension.Cognitive: The patient experiences decreased sensorium. Tachycardia: The body compensates for the decreased cardiac output by pumping faster than normal, resulting in tachycardia. Rapid, shallow respirations. Oliguria. Clammy skin.	Safe administration of blood. It is important to acquire blood specimens quickly, to obtain baseline complete blood count, and to type and crossmatch the blood in anticipation of blood transfusions. Safe administration of fluids. The nurse should monitor the patient closely for cardiovascular overload, signs of difficulty of breathing, pulmonary edema, jugular vein distention, and laboratory results. Monitor weight. Monitor daily weight for sudden decreases, especially in the presence of decreasing urine output or active fluid loss. Monitor vital signs. Monitor vital signs of patients with deficient fluid volume every 15 minutes to 1 hour for the unstable patient, and every 4 hours for the stable patient. Oxygen administration. Oxygen is administered to increase the amount of oxygen carried by available haemoglobin in the blood.
Anaphylactic	Food allergies. Medication allergies: Example antibiotics, aspirin and other over-the-counter pain relievers Insect allergies: Stings from bees, yellow jackets, wasps, hornets and fire ants. Latex allergy	Anxiety. The first symptoms usually include a feeling of impending doom or fright. Skin reactions. Such as hives, itching, and flushed or pale skin follow. Shortness of breath. Hypotension Tachycardia. Dizziness.	Monitor client’s airway Monitor the oxygenation status. Focus breathing: Breath slowly and deeply Positioning. Position the client upright as this position provides oxygenation by promoting maximum chest expansion Activity. Encourage adequate rest and limit activities to within client’s tolerance. Hemodynamic parameters. Monitor the client’s central venous pressure (CVP), pulmonary artery diastolic pressure (PADP), pulmonary capillary wedge pressure, and cardiac output/cardiac index. Monitor urine output.
Obstructive	Indirect pump failure Cardiac temponade Pulmonary ambolus	It is an emergency condition because they can lead to organ failure, tissue death, and death. Confusion, loss of consciousness, Chest pain, light-headedness, and a sudden increase in heart rate along with a faint pulse. Shortness of breath,sweating, decreased urine output, clammy skin, pallor, and cold hands and feet.	Assess the client’s respiratory rate, rhythm, and depth. Assess client’s heart rate and blood pressure. Assess for any signs of changes in the level of consciousness. Assess for cyanosis or pallor by examining the skin, nail beds, and mucous membranes. Monitor oxygen saturation using pulse oximetry. Monitor arterial blood gasses. Administer IV fluids as ordered. Monitor urine output, observe its color and amount. Assess fluid balance and weight gain.