Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
Included In This Lesson
Study Tools For Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
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
Transcript
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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 International, 115(45), 757