by Celine Bernadette Francisco

Created on: August 09, 2009

Shock can be life-threatening and affect someone who is afflicted by it. Yet, even if we are constantly hearing people talk about it, what really is this condition that entails the whole life of a person - leading to the possibility of death?

Shock is a condition wherein the systemic blood pressure turns out to be insufficient to bring oxygen and nutrients to the vital organs as well as to back up cellular function. To be able to have enough flow of blood to the tissues and cells, there has got to be such factors: enough cardiac pump, efficient vasculature of circulatory system, as well as enough volume of blood. Thus, once one of these has been impaired, the blood flow to the tissues is now threatened. And when not treated, there will be poor delivery of oxygen and nutrients into the cells, starvation of cells, death of the cells, dysfunction of the organs leading to failure, and eventually, death.

Depending on the cause, shock can develop as fast or as slow as possible. Hence, when this condition sets foot, the body will aim to strive and call on the homeostatic mechanisms to maintain balance despite the frail condition.

Nevertheless, there are three main classifications of shock: hypovolemic, cardiogenic, and circulatory or distributive shock. But sometimes, a fourth one is considered, pertaining to obstructive shock, being an outcome of the illnesses that result to mechanical obstruction to the flow of blood along the central circulatory system amidst the normal myocardial function and intravascular volume. Such illnesses include pulmonary embolism, cardiac tamponade, tension pneumothorax, and dissecting aortic aneurysm.

Various clinical manifestations can be noted in a person with shock. Usually, there will be increased respiratory rate due to metabolic acidosis, together with changes in the mental status such as confusion or combativeness. But when detected during this primary stage, the prognosis can be good.

However, when it progresses, there will be rapid and shallow respirations, crackles being heard through the stethoscope, complains of chest pain, increased lethargy and losing of consciousness, together with decreased urinary output, jaundice (yellowish skin), stress ulcers and other effects to the blood flow.

When it comes to the treatment of this condition, it also relies upon the cause and the type. But nevertheless, basic principles that are utilized include: optimizing the intravascular volume, aiding the pumping action of the heart, as well as improving the efficiency of the vascular system.

Meanwhile, nursing actions to follow takes into consideration the hemodynamic status, monitoring of the electrocardiogram rates, arterial blood gases, serum electrolyte levels, intravenous fluid administration, mechanical ventilation, and many others based on the client's needs.

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