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Shock

Symptoms

Shock is defined as abnormal metabolism at the cellular level. Since it is not easy to directly measure cellular problems, the symptoms of shock are indirect measurements of cellular function. Shock is the end stage of all diseases, and symptoms will often be dependant on the underlying cause.

Vital signs

As the patient goes through the various stages of shock, vital signs change. In the early stages, the body tries to compensate by moving fluids around from within cells to the blood stream with an attempt to maintain blood pressure in a normal range. However, there may be a slight rise in the heart rate (tachycardia = tachy or fast + cardia or heart). Think of donating blood. A unit of blood (or about 10% of your blood volume) is removed, yet the body compensates well, except for a little lightheadedness, which is often resolved by drinking fluids. Another example is exercising and forgetting to drink enough fluids and feeling a little tired at the end of the day.

As the body loses the ability to compensate, the breathing rate gets faster and the tachycardia increases as the body tries to pack as much oxygen onto the remaining red blood cells as possible and deliver them to the cells. Unfortunately, blood pressure starts to fall (hypotension=hypo or low + tension= pressure) as compensation mechanisms fail.

Body function

Cells don't get enough oxygen and the organs that they comprise start to fail. All organs may be affected.

  • As the brain is affected, the patient may become confused or lose consciousness (coma).
  • There may be chest pain   as the heart itself doesn't get an adequate oxygen supply.
  • Diarrhea   often occurs as the large intestine becomes irritated due to hypotension.
  • Kidneys may fail and the body may stop making urine.
  • The skin becomes clammy and pale.

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Self-Care at Home

If you come upon a person in shock, the initial response should be to call 911 and activate the emergency response system.

Lay the person down in a safe place and try to keep them warm and comfortable.

Follow-up

Patients in shock are critically and will be admitted to an intensive care unit. Depending on the underlying condition, a variety of specialists will be involved with their care. Nurses with advanced training, respiratory therapists, and pharmacists will be added to the team of doctors assigned to one patient.

When the body is in a stressed state, it becomes more susceptible to infection. As well, having tubes in one's body for prolonged periods lead to higher infection risk. While in the hospital, the staff will be vigilant in trying to prevent nosocomial (hospital-borne) infections.

Extended nursing care is often needed if one survives shock  . Rehabilitation may take a prolonged period of time as different organs recover their function. The amount of time the body was in a shock state often determines the extent of organ damage, and full recovery may never be complete. Brain injury can lead to stroke   and thought impairment. Heart   and lung damage   can lead to significant disabilities that may include reduced exercise tolerance.Kidney damage   can lead to the need for dialysis.

Outlook

Shock is a culmination of multiple organ systems in the body that have failed or are in the process of failing. Even with the best of care, there is a significant risk of death.

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