Causes and Nursing Management of Shock

Definition of Shock:

Shock is an abnormal physiological condition resulting from inadequate proportion of blood to the aorta thus causes inadequate blood flow per-fusing the capillaries of tissues and organs. A shock is a condition of depression of all vital function due to sudden illness, injury, severe hemorrhage.

Nursing management of shock
Fig: Nursing management of shock

Causes of Shock:

Common Causes:

  • Heart conditions (heart attack, heart failure),
  • Heavy internal or external bleeding, such as from a serious injury or rupture of a blood vessel,
  • Dehydration, especially when severe or related to heat illness,
  • Infection (septic shock),
  • Severe allergic reaction (anaphylactic shock),
  • Spinal injuries (neurogenic shock),
  • Burns,
  • Persistent vomiting or diarrhea,
  • Bleeding.

Others Cause:

  • Anaphylaxis,
  • Epidural hematoma,
  • Carbon monoxide poisoning,
  • Abdominal aortic aneurysm,
  • Meningococcemia,
  • Adult respiratory distress syndrome,
  • Hereditary angioedema,
  • Chronic poisoning,
  • Colitis,
  • Kwashiorkor,
  • Caffeine overdose,
  • Anthrax,
  • The plague.

Nursing Management of Shock:

It includes the following:

  1. Rest and reassure the patient.
  2. Keep the person warm and comfortable place.
  3. Loosen any tight clothing, remove belt and shoes and cover them with a blanket.
  4. Check and control ABCDEs:
    A- Airway control,
    B- Breathing and ventilation,
    C- Circulation,
    D- Disability,
    E- Exposure with environmental control.
  5. If necessary, begin rescue breathing and CPR (Cardiac Pulmonary Resources).
  6. If the person is conscious and does NOT have an injury to the head, leg, neck, or spine, place the person in the shock position. Lay the person on the back and elevate the legs about 12 inches (30 centimeters). Do NOT elevate the head. If raising the legs will cause pain or potential harm, leave the person lying flat.
  7. Even if the person is able to breathe on his or her own, continue to check rate of breathing at least every 5 minutes until help arrives.
  8. Do not move a person who has a known or suspected spinal injury.
  9. Open an intravenous (UV) channel in a large vein and give adequate fluid (normal saline, hart sole, dextrose).
  10. If the casualty unconscious and in case of head injury or suspected internal bleeding do not give stimulate.
  11. Do not give fluids by mouth, even if the person complains of thirst. There is a choking risk in the event of sudden loss of consciousness.
  12. Control bleeding by direct pressure should be applied to any wounds that are bleeding significantly.
  13. Give appropriate first aid for any wounds, injuries or illness.
  14. Pain should be relieved as fast as possible.
  15. Transport as soon as possible to hospital.

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