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Saturday, February 6, 2021

Major Types of Shock by nursesnote


ANAPHYLACTIC (allergic) shock-severe, life-threatening reaction to substance to which the client is sensitive or allergic.

CARDIOGENIC (cardiac) shock-primarily failure of the heart adequately pump. The heart is severely compromised. Possible causes include: failure or stenosis (narrowing) of heart valves, cardiomyopathy (primary heart disease), or rhythm disturbances. Low cardiac output often result from an acute MI (heart attack) or heart failure. Cardiogenic shock may also occur in high cardiac output and is approximately 80% fatal.

ELECTRIC SHOCK-occurs after passage of electric current through the body. This usually results from accidental contact with electric circuits or wires, but may be caused by lightning. Damage depends on the pathway of the current, amount  of current, and the skin"s resistance. Symptoms include unconsciousness, respiratory paralysis, tetanic muscle contractions (continuous tonic spasm), bone fractures, abd cardiac standstill (cardiac arrest). Immediate defibrillation is often necessary.

HYPOGLYCEMIC SHOCK- (insulin shock, wet shock, diabetic shock)- secondary to low blood sugar (<40mg/dL). It may be a result of insulin overdose, a skipped meal, or strenuous exercise in a person with IDDM ( insulin dependent diabetes mellitus) or may be caused by an insulin-secreting pancreatic tumor. Symptoms are related to deficient sugar (fuel) in the brain. Treatment includes administration of sugar (glucose) and supporting blood pressure.

HYPOVOLEMIC SHOCK (hematogenic shock, hemorrhagic shock, oligemic shock)- most often a result of hemorrhage. The body has insufficient blood volume to maintain adequate cardiac output, blood pressure, and tissue perfusion (circulation). Oxygen is not delivered to tissues; wastes are not removed. Symptoms include physical collapse and prostration.

IRREVERSIBLE SHOCK-changes produced cannot be corrected by treatment; death is inevitable.

LUNG SHOCK (shock lung, ARDS- pulmonary damage occurring early in shock. Symptoms include acute respiratory distress and pulmonary edema. Pulmonary vessels may plug with blood cells and platelets, leading to anoxia, damage to alveoli and capillaries, and generalized tissue hypoxia. Decreased surfactant (lubricating substance allowing lung expansion) may lead to atelectasis ( collapsed lung).

NEUROGENIC SHOCK- vasodilation (blood vessel enlargement) secondary to cerebral trauma, spinal cord injury, very deep general or spinal anesthesia, or central nervous system (CNS) depression caused by toxins or drugs, such as "downers" The major mechanism is decreased peripheral vascular resistance.

SEPTIC SHOCK (endotoxic shock, endotoxin shock, toxic shock)- results from overwhelming infection throughout the body, secondary to release of toxins, usually by gram negative bacteria (particularly E. coli) and by cytokines. Viruses can also cause septic shock. Endotoxins, stimulated by infection, act on the vascular system, causing excess blood to be held in capillaries and veins and, therefore, to not be available to the general circulation; dangerous hypotension results. Other symptoms include chills, fever, warm and flushed skin, increased cardiac output, and less hypotension than in hypovolemic shock. If therapy is ineffective, symptoms will be similar similar to those of hypovolemic shock. Septic or toxic shock is one stage in the systemic inflammatory response syndrome (SIRS), most common in newborn or people over age 50, and in persons with diabetes, cirrhosis of the liver, or compromised immune systems ( e.g. due to AIDS, cancer chemotherapy, bone marrow transplant).

TOXIC SHOCK SYNDROME- shock caused by infection, usually by a staphylococcus organism ( often associated with tampon use) can progress to untreatable ( irreversible ) shock. Bacteria produce a toxin that enters the bloodstream, causing a septic condition. Treatment involves removal of the tampon and antibiotic administration.

SPINAL SHOCK- loss of spinal reflexes after acute transverse spinal cord injury. Flaccid paralysis below the level of injury and loss of reflexes and sensation occur. Arterial hypotension is possible.

TRAUMATIC SHOCK-any shock caused by trauma, injury, or surgery, or heart damage following a myocardial infarction (MI); intestinal obstruction; perforation or rupture of viscera; strangulated hernia; or torsion of viscera (including ovary or testicle)


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