my own powerpoint during my report ! :D

2. What is shock ?
A condition in which widespread perfusion to the cells is
inadequate to deliver oxygen & nutrients to support vital
organs & cellular function.
Adequate blood flow to the tissues & cells requires an
adequate cardiac pump, effective vasculature or
circulatory system, & sufficient blood volume.
Without treatment, inadequate blood flow to the cells
results in poor delivery of O2 & nutrients, cellular hypoxia,
& cell death that progresses to organ dysfunction &
eventually death.

6. BLOOD
VOLUME
VENOUS
RETURN
STROKE
VOLUME
CARDIAC
OUTPUT
TISSUE

7. External : Fluid losses Internal : Fluid Shifts
o Trauma oHemmorhage
o Surgery oBurns
o Vomiting oAscites
o Diarrhea oPeritonitis
o Diuresis oDehydration
o Diabetes insipidus

8. • Medical management:

9. • Nursing Management:
• General Nursing Measure

12. PATHOPHYSIOLOGY

13. • Causes
 Septic shock occurs most often in the very old and the very young. It may
also occur in people with weakened immune systems.
 Any type of bacteria can cause septic shock.
 Fungi and (rarely) viruses may also cause the condition.
 Toxins released by the bacteria or fungi may cause tissue damage. This
may lead to low blood pressure and poor organ function.
 Some researchers think that blood clots in small arteries cause the lack of
blood flow and poor organ function.
 The body has a strong inflammatory response to the toxins that
may contribute to organ damage.
• Risk factors for septic shock include:
• Diabetes
• Diseases of the genitourinary system, biliary system, or
intestinal system
• Diseases that weaken the immune system, such as AIDS
• Indwelling catheters (those that remain in place for extended
periods, especially intravenous lines and urinary catheters and
plastic and metal stents used for drainage)
• Leukemia
• Long-term use of antibiotics

15. Little or no urine
agitation

16. Medical Management;
 Identification source of infection
 Culture;
 Specimens of Blood, sputum, urine, wound drainage, & tips of
invasive catheters.
 Using aseptic technique
 Rapid & effectiverestoration of tissue perfusion
 Evaluation & Tx of Pt.’s immune response & dysregulation of the
coagulation system.

Exams and Tests
 Blood tests may be done to check for:
 Infection around the body
 Low blood oxygen level
 Disturbances in the body's acid-base balance
 Poor organ function or organ failure

17.  A chest x-ray to look for pneumonia or fluid in the lungs
(pulmonary edema)
 A urine sample to look for infection
 Additional studies, such as blood cultures, may not become
positive for several days after the blood has been taken, or
for several days after the shock has developed.
 Treatment
 Septic shock is a medical emergency. In most cases, people are
admitted to the intensive care unit of the hospital.
 Treatment may include:
 Breathing machine (mechanical ventilation)
 Dialysis
 Drugs to treat low blood pressure, infection, or blood clotting
 Fluids given directly into a vein (intravenously)
 Oxygen
 Sedatives
 Surgery
 The pressure in the heart and lungs may be checked. This is
called hemodynamic monitoring. This can only be done with
special equipment and intensive care nursing.

18. Nursing Management;
 Aseptic technique
 Monitored for signs of infection
 (IV lines, arterial & veinous puncture sites, surgical
 incision ,traumatic,wounds,urinary catheter, & pressure ulcer.)
 Identify the pt.who are particular risk for sepsis & septic shock.
 Identify the site & source of sepsis & specific organisms involved.
 Obtains appropriate specimens culture & sensitivity.
 Closely monitors for fever, chills or shivering.
 Administers prescribed IV fluids & medications, including
(Antibiotic agents , & vasoactive medications).
 Monitor Blood levels ( antibiotic agents, BUN, creatinine, WBC,
HgB,Hct, platelet levels, coagulation studies). & reports changes
to physician.
 Monitors the pt. Hemodynamic status, fluid I&O,& nutritional
status.
 Daily wt. & close monitoring serum albumin& prealbumin levels.