It covers the four stages of shock. They include the initial stage, the compensatory stage, the progressive stage, and the refractory stage.
Shock involves ineffective tissue perfusion and acute circulatory failure. The shock syndrome is a pathway involving a variety of pathologic processes that may be categorized as four stages: initial, compensatory, progressive, and refractory (Urden, Stacy, & Lough, 2014).
Shock Stages Nursing NCLEX: Initial, Compensatory, Progressive, Refractory.
The three phases of shock: Irreversible, compensated, and decompsated shock.
The initial stage of shock is characterized by hypoxia and anaerobic cell respiration leading to lactic acidosis. The compensatory stage is characterized by the employment of neural, hormonal, and biochemical mechanisms in the body's attempt to reverse the condition.
In medical terms, shock is the body's response to a sudden drop in blood pressure. At first, the body responds to this life-threatening situation by constricting (narrowing) blood vessels in the extremities (hands and feet). This is called vasoconstriction and it helps conserve blood flow to the vital organs.
Finally, if Stage III of shock is reached, it is termed “irreversible,” as the body can no longer keep up with its attempts to maintain blood flow to its most vital organs. Heart rate and breathing remain high until crashing, while blood pressure finally drops very low.
In Stage III of shock, the length of time that poor perfusion has existed begins to take a permanent toll on the body's organs and tissues. The heart's functioning continues to spiral downward, and the kidneys usually shut down completely.
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do not get enough oxygen and nutrients to function properly. Many organs can be damaged as a result. Shock requires immediate treatment and can get worse very rapidly.
Most common signs are hypotension, tachycardia, tachypnea, and cool skin.
ATLS continues to support the use of a 3-for-1 rule (3 mL of crystalloid should be used as replacement for every 1 mL of blood loss), but also encourages frequent reassessments if large amounts of crystalloid are not providing adequate resuscitation. ATLS also dictates treatment based on the class of hypovolemic shock.
The normal healing and recovery process involves the body coming down out of heightened arousal. The internal alarms can turn off, the high levels of energy subside, and the body can re-set itself to a normal state of balance and equilibrium. Typically, this should occur within approximately one month of the event.
Shock is different for everyone and may last for a couple of days or weeks. Shock may cause some people to react in an unusual way when they first hear the news of a death. It may be that some people laugh hysterically. This is often a result of the shock and not necessarily because they find the situation funny.
Emotional shock is a reaction that you may have to an unexpected event or traumatic incident that upsets you and makes it hard for you to function.
Signs and Symptoms
Altered mental state, including reduced alertness and awareness, confusion, and sleepiness. Cold, moist skin. Hands and feet may be blue or pale. Weak or rapid pulse.
Systolic blood pressure is normal in early shock. In late (decompensated) shock, perfusion is profoundly affected. Signs include low blood pressure, tachypnea, cool/clammy skin, agitation, and altered mental status.
The symptoms of shock include cold and sweaty skin that may be pale or gray, weak but rapid pulse, irritability, thirst, irregular breathing, dizziness, profuse sweating, fatigue, dilated pupils, lackluster eyes, anxiety, confusion, nausea, and reduced urine flow.
As you go into shock, your blood pressure, pulse rate, and breathing rate drop abruptly. Because the body's temperature is not regulated, the skin gets cold and sweaty. A rapid fall in blood pressure reduces the supply of oxygen and nutrients to vital organs in the body.
The treatment of shock includes the administration of endogenous catecholamines (epinephrine, norepinephrine, and dopamine) as well as various vaso-pressor agents that have shown efficacy in the treatment of the various types of shock.