Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
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Rapid Infusion Hypovolemic Shock (Image)
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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 International, 115(45), 757
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DRN 101, Week 6
Concepts Covered:
- Cardiac Disorders
- Renal Disorders
- Disorders of the Thyroid & Parathyroid Glands
- Disorders of the Posterior Pituitary Gland
- Disorders of Pancreas
- Shock
- Noninfectious Respiratory Disorder
- Studying
- Shock
- Immunological Disorders
- Urinary System
- Respiratory System
- Endocrine and Metabolic Disorders
- Circulatory System
- Basics of Chemistry
- Eating Disorders
Study Plan Lessons
Brain Natriuretic Peptide (BNP) Lab Values
Fluid Volume Overload
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypertonic Solutions (IV solutions)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypotonic Solutions (IV solutions)
Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
Metabolic Acidosis (interpretation and nursing diagnosis)
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Sepsis
Nursing Care Plan for Distributive Shock
Nursing Case Study for Cardiogenic Shock
Respiratory Alkalosis
Septic Shock (Sepsis) Case Study (45 min)
Shock
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Shock Module Intro
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Alkalosis and Acidosis Nursing Mnemonic (Kick Up, Drop Down)
ABG Course (Arterial Blood Gas) Introduction
Arterial Blood Gases Nursing Mnemonic (ROME)
Fluid & Electrolytes Course Introduction
Fluid Volume Deficit
Hyperkalemia – Causes Nursing Mnemonic (MACHINE)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypernatremia – Causes Nursing Mnemonic (MODEL)
Increase MAP Nursing Mnemonic (VAK)
Nursing Care Plan (NCP) for Fluid Volume Deficit
Renal (Kidney) Acid-Base Balance
Renal (Kidney) Fluid & Electrolyte Balance
Renin Angiotensin Aldosterone System (RAAS)
Acids & Bases (acid base balance)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)