Shock is a life-threatening condition where the body's tissues do not receive enough blood flow and oxygen. There are several types of shock including cardiogenic, hypovolemic, obstructive, and distributive shock. Distributive shock includes anaphylactic, septic, and neurogenic shock. Shock progresses through initial, progressive, and irreversible stages characterized by worsening signs and symptoms as compensatory mechanisms fail. Treatment depends on the underlying cause but aims to restore adequate blood flow and oxygen delivery to tissues.

1. 

2. Presented By…
. Saurabh Kumar
BSc(N) 2nd Year Student

3. Content
1.Introduction
2.Definition
3.Types
4.Pathophysiology
5.Stage
6.Clinical feature
7.Management

4. 1. Introduction
Cell need two things to function; Oxygen and
glucose. This allows the cell to generate
energy and do their specific jobs. When cell’s
don’t receive either of them or both ,they stop
function.
 shock can best be defined as a clinical
syndrome that result from inadequate tissue
perfusion , creating an imbalance b/w the
delivery of oxygen and nutrients needed to
support cellular function.

5. Adequate blood flow to the tissue and cells
requires an effective cardiac pump, circulatory
system and sufficient blood volume.
 If one of these components is impaired
perfusion to the tissue is threatened or
compromised. Without treatment, inadequate
blood flow to the cells results in poor delivery of
oxygen and nutrients , cellular hypoxia , and cell
death that progresses to organ dysfunction and
eventually death .

6. Definition
Shock is a life threatening medical condition in which
body suffer from insufficient blood flow throughout
the body .
It is characterized by inadequate tissue perfusion in
which there is insufficient delivery of oxygen and
nutrients to the body tissue and inadequate removal
of waste product from the tissue , If untreated results
in cell death.

8. 3. Types of Shock
1. Cardiogenic Shock
2. Hypovolemic Shock
3. Obstructive Shock
4. Distributive Shock

9. Distributive Shock further
classified
1.Anaphylactic Shock
2.Septic shock
3.Neurogenic shock

13. 1. Cardiogenic Shock
This type of Shock occur‘s when pumping action of heart
diminished and heart fails to pump blood in the body result
in decreased cardiac outputs.
In cardiogenic Shock ,the left ventricle has been injured in
some way , leading to impaired pumping.
CAUSE…
 CAD, MI, Heart Failure..etc

14. Cardiogenic shock signs and symptoms
include:
Rapid breathing
Severe shortness of breath
Sudden, rapid heartbeat (tachycardia)
Loss of consciousness
Weak pulse
Low blood pressure (hypotension)
Sweating
Pale skin
Cold hands or feet
Urinating less than normal or not at all

16. Medical Management
Anti-arrhythmia medicines to restore a
regular heartbeat.
Blood thinners or antiplatelet medicines to
dissolve blood clots and
reduce platelets that may be blocking the
coronary arteries.
Vasopressors and inotropes, such as
norepinephrine and dobutamine, to
increase blood pressure and blood flow out
of the heart.

17. Nursing Management
Preventing Cardiogenic Shock
Monitoring Hemodynamic
Status
Administering Medication
And Intravenous Fluid.

19. Hypovolemic shock is an
emergency condition in which
severe blood or other fluid loss
makes the heart unable to pump
enough blood to the body. This
type of shock can cause many
organs to stop working.

20. Causes
Losing about one fifth or more of the
normal amount of blood in your body
causes hypovolemic shock.
Blood loss can be due to:
Bleeding from cuts
Bleeding from other injuries
Internal bleeding, such as in the
gastrointestinal tract

21. The amount of circulating blood in
your body also may drop when you
lose too much body fluid from other
causes. This can be due to:
Burns
Diarrhea
Excessive perspiration
Vomiting

23. Symptoms
Anxiety or agitation
Cool, clammy skin
Confusion
Decreased or no urine output
Generalized weakness
Pale skin color (pallor)
Rapid breathing
Sweating, moist skin
Unconsciousness (lack of
responsiveness)

24. Pathophysiology

26. Medical management
1.Treatment of the underlying cause
2.Fluid and blood replacement
3.Redistribution Of fluid

27. Nursing Management
1. Administering Blood and
Fluids Safely
2. Implementing Other Cause

28. 3.

29. Obstructive Shock occur’s
when there is a blockage of
blood flow in the
Cardiovascular circuit
outside the heart.

30. Obstructive shock is a medical emergency.
It happens when there is a decrease in
diastolic filling of the heart, which then
decreases cardiac output. This means
that the heart is not getting enough blood to
pump out to the rest of the body.

31. Shock then occurs due to
the lack of blood getting
to the organs and
decreasing their
functioning capacity.

32. Causes of Obstructive Shock
Several diseases or disorders can cause
obstructive shock, such as:
Aortic dissection: the large
blood vessel attached to the heart
tears and cannot transport blood to
and from the heart effectively.
Tension pneumothorax: air
leaks out of the lungs due to trauma.

33. Vena cava syndrome: a major vein in
the body becomes blocked and cannot carry
blood from the body to the heart
High blood pressure: pulmonary
or systemic hypertension
Pulmonary embolism: blood clot
in the lungs

34. Heart lesions: obstruct the flow
of blood from the heart
Cardiac tamponade: a pressure
on the heart that keeps it from filling,
which decreases blood pressure

35. Symptoms of Obstructive
Shock…..
1.Symptoms that are associated with
neurological function include, confusion,
loss of consciousness, and inability to
concentrate.

36. The symptoms that are
related to the heart and its
function are chest pain,
lightheadedness, and a sudden
increase in heart rate along with a
faint pulse.
Respiratory symptoms.
consist of shortness of breath and
fast but shallow breathing.

37. Other symptoms
include sweating,
decreased urine output,
clammy skin, pallor, and
cold hands and feet.

38. Nursing Management
---Common interventions include adequate
oxygen, fluid and/or drug therapy. In all cases
the nurse needs to provide a safe environment
for the patient who may be at risk due to a
reducing level of consciousness and
deteriorating vital signs.

41. It’s occur when Peripheral
Vascular Resistance is lost
because of Vasodilation of
Peripheral circulation.

42. 3 Types of Distributive
Shock.
1. Anaphylactic Shock
2. Septic Shock
3. Neurogenic shock

43. 1. Anaphylactic Shock
Anaphylactic shock is a rare but
severe allergic reaction that can be
deadly if you don't treat it right
away. It's most often caused by an
allergy to food, insect bites, or
certain medications.

44. Shock is when your blood
pressure drops so low that
your cells (and organs)
don't get enough oxygen.

45. Most common causes of an
anaphylactic reaction include:
Foods, especially nuts and
shellfish
Latex, found in many disposable
gloves, syringes, and adhesive
tapes
Medications, including penicillin

46. Some typical symptoms
include:
Swelling of your mouth
Tight feeling in your throat and
difficulty breathing
Hives
Vomiting
Dizziness
Fainting
Rapid heartbeat

47. Management
1 .put a shot of epinephrine under
muscle or vein.
2. steroids, and antihistamines (drugs used
to treat allergic reactions)
3. Other possible treatments include a
breathing tube and medications to help you
breathe better, and a corticosteroid (a
powerful anti-inflammatory drug) to keep
symptoms from coming back hours later.

49. Septic shock is most often caused
by bacterial infections, but almost
any infection can cause septic Shock.
There’s a significant drop in blood
pressure that can lead to respiratory
or heart failure, stroke, dysfunction of
other organs, and possibly death.

50. Symptoms.
high fever or chills
intense body pain
fast heart rate
rapid breathing
rash

51. Management.
use a number of medications to treat
septic shock, including:
intravenous antibiotics to fight
infection
vasopressor medications, which are
drugs that constrict blood vessels and
help increase blood pressure
insulin for blood sugar stability
corticosteroids

53. Neurogenic shock is a life-
threatening condition caused
by irregular blood
circulation in the
body. Trauma or injury to
the spine can cause this
disruption.

54. Neurogenic shock is extremely
dangerous because it can cause
your blood pressure to
drop drastically and suddenly, and
can leave irreversible damage to
your body tissues. If left untreated,
neurogenic shock can be fatal.

55. Neurogenic shock symptoms.
dizziness
nausea
vomiting
blank stares
fainting
increased sweating
anxiety
pale skin

56. In more severe cases of neurogenic
shock, you may experience:
difficulty breathing
chest pain
weakness from irregular blood circulation
bradycardia, or a slower heart rhythm
faint pulse
cyanosis, or discolored lips and fingers
hypothermia, or decreased body temperature

57. If left untreated,
neurogenic shock can
cause irreversible tissue
damage and death.

58. causes of neurogenic
shock include
car accidents that cause central
nervous system damage or spinal
cord injury
sport injuries causing trauma to the
spine
gunshot wounds to the spine

59. medications that affect the
autonomic nervous system,
which regulates breathing and
other automatic bodily
functions.
improper administration of
anesthesia to the spinal cord.

60. Medical Treatment of
neurogenic shock
norepinephrine
epinephrine
dopamine
vasopressin
Atropine(medication will help to
keep your heartbeat normal.)

62. STAGES OF SHOCK
Shock is progressive
disorder that if
uncorrected leads to
death.

63. Shock evolves through 3
phases
1.Initial non-progressive
phase
2.Progressive phase
3.Irreversible stage

64. 1.Initial non-progressive phase
Compensatory mechanism to
maintain the homeostasis so that
blood supply to vital organs is
maintained
By neuro humoral mechanism which
maintains blood pressure and cardiac
output
Widespread vasoconstriction of
vessels except coronary and
cerebral vessels

66. 2.Progressive phase
As the stage advances there is failure
of compensatory mechanism, dilatation
of arterioles, veinules and capillary bed
Because of this fluid leaks out of
capillaries into interstitium and there is
sludging of blood
This reduces the tissue
perfusion leading to hypoxia
Initially body tissue except brain and
heart suffers from hypoxia

68. 3.IRREVERSIBLE PHASE
(DECOMPENSATED STAGE)
Cellular injury and tissue injury is so severe that
condition does not revert back to normal even
after correcting hemodynamic defects
Hypoxic and ischemic cell injury – causes
leakage of lysosomal enzymes which further
aggravates condition
Myocardial infarction and synthesis of NO
further worsens condition
Intestinal ischemia causes microbes from
intestinal flora to enter the circulation which
produces superimposed bacteremic shock

69. Signs and
symptoms in
different phases

70. Compensated phase
15 to 25% of fluid loss from vessels
and there are subtle signs of shock
Mean arterial pressure will be less
than 10-15mm Hg from the baseline
Increased Renin and Anti-diuretic
hormone secretion
Vasoconstriction
Increased heart rate
Decreased pH

71. Progressive phase
(Intermediate phase)
25 to 35% of fluid loss from
vessels and classical signs of
shock appears
Mean arterial pressure is less than
20mmHg from Base line
Tissue hypoxia develops
Decreased urine output (oliguria)
Weak rapid pulse

72. Irreversible phase
>35% of fluid loss from vessels,
body cells die to hypoxia and vital
signs come to bottom.
Anuria.
Excessive organ or tissue damage.
Multi organ failure.
Decreased pH.
Patient lead to death.