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Nursing Management: Shock and Multiple Organ Dysfunction
Syndrome
Chapter 67 Overview
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
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Fig. 67-1. Relationship of shock, systemic inflammatory response syndrome, andmultiple organ dysfunction syndrome. CNS, Central nervous system.
Shock
Classification of Shock Cardiogenic shock
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Shock
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Fig. 67-2. The pathophysiology of cardiogenic shock.
Shock
Classification of Shock, continued Hypovolemic shock
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Shock
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Fig. 67-3. The pathophysiology of hypovolemic shock.
Shock
Classification of Shock, continued Distributive shock
Neurogenic shock
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Shock
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Fig. 67-4. The pathophysiology of neurogenic shock. BP, Blood pressure.
Shock
Classification of Shock Distributive shock, continued
Anaphylactic shock Septic shock
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Shock
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Fig. 67-5. The pathophysiology of septic shock. CNS, Central nervous system.
Shock
Classification of Shock, continued Obstructive shock
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Shock
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Fig. 67-6. The pathophysiology of obstructive shock.
Shock
Stages of Shock Compensatory stage
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Shock
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Fig. 67-7. Compensatory stage: reversible stage during which compensatory mechanismsare effective and homeostasis is maintained.
Shock
Stages of Shock, continued Progressive stage
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Shock
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Fig. 67-8. Progressive stage: compensatory mechanisms are becoming ineffective andfail to maintain perfusion to vital organs.
Shock
Stages of Shock, continued Irreversible stage
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Shock
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Fig. 67-9. Irreversible or refractory stage: compensatory mechanisms are not functioningor are totally ineffective, leading to multiple organ dysfunction syndrome.
Shock
Diagnostic Studies
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Shock
Collaborative Care: General Measures Oxygen and ventilation Fluid resuscitation Drug therapy
Sympathomimetic drugs Vasodilator drugs
Nutritional therapy
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Shock
Collaborative Care: Specific Measures Cardiogenic shock Hypovolemic shock Septic shock Neurogenic shock Anaphylactic shock Obstructive shock
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Nursing Management:Shock
Nursing Assessment Nursing Diagnoses Planning Nursing Implementation
Health promotion Acute intervention
Neurologic status Cardiovascular status Respiratory status
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Nursing Management:Shock
Nursing Implementation Acute intervention, continued
Renal status Body temperature and skin changes
Gastrointestinal status Personal hygiene Emotional support and comfort
Ambulatory and home care Evaluation
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Systemic Inflammatory Response Syndrome (SIRS) and
Multiple Organ Dysfunction Syndrome (MODS) Etiology and
Pathophysiology Organ and metabolic
dysfunction Clinical Manifestations of
SIRS and MODS
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Nursing and Collaborative Management:
SIRS and MODS Prevention and Treatment
of Infection Maintenance of Tissue
Oxygenation Nutritional and Metabolic
Needs Support of Failing Organs
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