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    Kelompok 3 - Shock

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    Fatimah Azzahra
    Shock is a serious medical condition where there is insufficient blood flow to meet the body's needs. There are several types of shock, including cardiogenic shock (due to heart defects), hypovolemic shock (decreased blood volume), anaphylactic shock (allergic reactions), septic shock (infection), and neurogenic shock (nervous system damage). Nursing assessments for shock include restless or unconscious behavior, pale or bluish skin, rapid or shallow breathing, low blood pressure, and decreased urine output. Nursing care for shock involves monitoring vital signs, assessing the cause of weakness, and treating symptoms while working to restore adequate tissue perfusion.

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    Kelompok 3 - Shock

    Uploaded by

    Fatimah Azzahra
    16 views11 pages
    Shock is a serious medical condition where there is insufficient blood flow to meet the body's needs. There are several types of shock, including cardiogenic shock (due to heart defects), hypovolemic shock (decreased blood volume), anaphylactic shock (allergic reactions), septic shock (infection), and neurogenic shock (nervous system damage). Nursing assessments for shock include restless or unconscious behavior, pale or bluish skin, rapid or shallow breathing, low blood pressure, and decreased urine output. Nursing care for shock involves monitoring vital signs, assessing the cause of weakness, and treating symptoms while working to restore adequate tissue perfusion.

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    KELOMPOK 3_SHOCK

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    Shock is a serious medical condition where there is insufficient blood flow to meet the body's needs. There are several types of shock, including cardiogenic shock (due to heart defects), hypovolemic shock (decreased blood volume), anaphylactic shock (allergic reactions), septic shock (infection), and neurogenic shock (nervous system damage). Nursing assessments for shock include restless or unconscious behavior, pale or bluish skin, rapid or shallow breathing, low blood pressure, and decreased urine output. Nursing care for shock involves monitoring vital signs, assessing the cause of weakness, and treating symptoms while working to restore adequate tissue perfusion.

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    Download as pdf or txt
    16 views11 pages

    Kelompok 3 - Shock

    Uploaded by

    Fatimah Azzahra
    Shock is a serious medical condition where there is insufficient blood flow to meet the body's needs. There are several types of shock, including cardiogenic shock (due to heart defects), hypovolemic shock (decreased blood volume), anaphylactic shock (allergic reactions), septic shock (infection), and neurogenic shock (nervous system damage). Nursing assessments for shock include restless or unconscious behavior, pale or bluish skin, rapid or shallow breathing, low blood pressure, and decreased urine output. Nursing care for shock involves monitoring vital signs, assessing the cause of weakness, and treating symptoms while working to restore adequate tissue perfusion.

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    of 11

    Nursing Managing

    For Client
    With Shock
    Presented by Group 3
    GROUP NAME
    CINDY PUSPITA SARI (PO7132011011)
    FATIMAH AZZAHRA (PO7132011019)
    MARLINA ( PO7132011025)
    VIRA MURTAFIAH (PO7132011046)
    DEFINITION
    Shock is a serious medical condition where the
    tissue perfusion is insufficient to meet demand
    for oxygen and nutrients because the body is
    not getting enough blood flow
    Shock can be classified into several groups:
    1. Cardiogenic shock (associated with heart
    defects)
    2. hypovolemic shock (due to decreased blood
    volume)
    3. Anaphylactic shock (due to allergic reactions)
    4. Septic shock (associated with infection)
    5. Neurogenic shock (due to damage to the
    nervous system
    B . ETIOLOGI
    CA N B E C A U SED BY: 9. THERE ARE SEVERAL MAIN
    SHOC K
    (H Y P OV O LE MIC SHOCK) CAUSES OF SHOCK
    1. HEMORRHAGE IC SHOCK)
    (H YP O VO LE M INCLUDE: • SEVERE ALLERGIC RE
    2. DEHYDRATION ACTION
    D IOGENIC
    3. HEART AT TA CK (C A R • HEART CONDITIONS (HEART (ANAPHYLACTIC SHO
    CK)
    SHOCK)
    ENIC SHOCK) ATTACK, HEART FAILURE) • SPINAL INJURIES
    (C A R D IOG
    4. HEART FAILURE • HEAVY INTERNAL OR EXTERNAL (NEUROGENIC SHOCK
    M A O R SE V E RE INJURY )
    5. TRAU BLEEDING, SUCH AS
    FEC T IO N (SE PT IC SHOCK) • BURNS
    6. IN
    E RG IC R EACTION RUPTURE OF A BLOOD VESSEL • PERSISTENT VOMITIN
    7. AN ALL G OR
    SHOCK) • DEHYDRATION, ESPECIALLY
    (ANAPHYLACTIC DIARRHEA
    L C O R D IN JU RY (NEUROGENIC WHEN SEVERE OR RELATED
    8. SPINA
    SHOCK) TO HEAT ILLNESS.
    PATHOPHYSOLOGY PATHWAY

    INITIAL
    REFRACTORIES
    PROGRESSIVE
    COMPENSATORY
    D. Nursing Assessment
    The symptoms depend on the  Excessive sweating, moist
    etiology and type of shock: skin

     Rapid and shallow pulse
    Restless  Shallow breathing
     Unconscious,
    Lips and fingernails look  Weakness, mental status
    bluish changes
    Clammy skin (anxiety, nausea, thirst, and
    The formation of urine is fear.)
    reduced or  Rapid breathing, shallow and
    irregular
    completely formed urine
     Pale face and cyanosis (blue
    Dizzy lips)
    low blood pressure  Dilated pupil
    E. NURSING DIAGNOSIS
    1. Altered tissue perfusion related to vasoconstriction
    ordecreased myocardial contractility
    2. Impaired gas exchange related to ventilation
    perfusionimbalance.
    3. Decreased cardiac output related to loss of circulating
    bloodvolume (diminished cardiac contractility).
    4. Altered urinary elimination related to decreased
    renalfunction.
    5. Fluid volume deficit related to blood loss.6. Anxiety
    related to severity of condition.
    F. NURSING CARE PLAN
    Diagnosis :
    Activity intolerance related to imbalance of oxygen supply to the
    needs (reduction or limitation of cardiac output)is characterized by
    fatigue, weakness, pale
    Intervention :
    1. Check vital signs before and immediately after the event,
    especiallyif the patient is using a vasodilator, diuretic
    2. Record the cardiopulmonary response to activity, record
    tachycardia,dysrhythmia, dyspnea, sweating, paleness
    3. Assess precipitator or cause weakness, sample treatment, pain
    G. Nursing
    Implementation
    In nursing implementation the nurses apply the
    nursingcarel plan based on what have been
    planned to meet the clientsneed. During the
    nursing implementation phase is done, the
    nursesevaluate the responses of the clients
    toward the nursing care given.And what have
    done by the nurses should be noted as
    nursingdocumentation of all nursing care taken
    and its result.
    H. NURSING EVALUATION
    Evaluation is focused on the nursing care plan that havebeen done
    to meet the patient’s needs and what are the patient’sresponses
    on it and related to their expected outcome. For examplethe
    patient could be performed as follow:
    a. Vital signs are stable, within normal limits.
    b. Alert, oriented,
    c. Urine output > 30 ml/h
    Thank You
    Do you have any questions for us?

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