Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)

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Study Tools For Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)

Rapid Infusion Hypovolemic Shock (Image)

Outline

Hypovolemic and Distributive Shock

 

Definition/Etiology:

  • Hypovolemic Shock – condition of inadequate organ perfusion caused by acute loss of intravascular volume
  • Distributive Shock – pathological redistribution of intravascular volume.

 

Pathophysiology:

  • Hypovolemic – No volume! Blood loss is the most common cause. No volume = no cardiac preload. HR increases to meet demands, but BP is low because we have no volume
  • Usual causes – hemorrhage/trauma/internal bleeding

 

  • Distributive shock – you have the volume, but your vessels are on the fritz. Expand to the point that your regular volume is no longer enough to maintain an adequate pressure. 
  • Usual causes – sepsis, anaphylaxis

 

Clinical Presentation:

Shock presentation:

  • High HR
  • Low BP 
  • Inadequate oxygenation and organ profusion

 

  • Hypovolemic 
  • Hemorrhage
  • Trauma 

 

  • Distributive 
  • Fever
  • Low oxygen saturations
  • Hives if ampholytic

 

Collaborative Management:

  • Hypovolemic 
  • Stop the bleed
  • Replace the volume
  • CBC
  • BMP
  • Lactic Acid
  • Type & Screen
  • Blood transfusion

 

  • Distributive
  • CBC
  • BMP
  • Lactic Acid
  • Blood cultures

 

  • Fluids 
  • Epinephrine
  • Vasoconstrictors
  • Antibiotics

 

Evaluation | Patient Monitoring | Education:

  • Hemodynamic monitoring
  • Treatment of the cause

 

Linchpins: (Key Points)

  • Hypovolemic = no volume
  • Distributive = volume but no vessels
  • Treat the cause

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

  • Standl, T., Annecke, T., Cascorbi, I., Heller, A. R., Sabashnikov, A., & Teske, W. (2018). The nomenclature, definition and distinction of types of shock. Deutsches Ärzteblatt International115(45), 757

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When you start a FREE trial you gain access to the full outline as well as:

  • SIMCLEX (NCLEX Simulator)
  • 6,500+ Practice NCLEX Questions
  • 2,000+ HD Videos
  • 300+ Nursing Cheatsheets