Hypovolemic Shock Patho

PATHOPHYSIOLOGY OF HYPOVOLEMIC SHOCK

Risk Factors: Non- Modifiable Modifiable such as: Fluid Losses: Internal Losses: - trauma - hemorrhage - surgery - burns - vomiting - ascites - diarrhea - peritonitis - diuresis - dehydration - diabetis Insipidus/mellitus

CIRCULATORY SYSTEM

ETIOLOGY/CAUSE: Loss of Blood Volume external blood loss internal blood loss Loss of plasma Volume GI losses Renal losses Transcutaneous Losses Internal losses (a.k.a. third-spacing)

↓ Intravascular Volume

↓ Cardiac Output

Compensatory Mechanisms

Molecular Changes: Kidneys releases Aldosterone ADH ( posterior pituary gland ) Cathecholamine released by the Adrenal Gland (norepinephrine,adrenaline, dopamine) - ↑ SVR ↓ tissue perfusion ↑ Oxygen requirement ↓ BP ↑ Oxygen demand Splenic discharge( disgorging stored RBC and Plasma )

-

if compensation fails great losses

Gross/Anatomical Physical Changes: ↑ Sodium/water retention ↑ Heart Rate/Contractility ↑ Volume ↑ Cardiac Volume

Complications: • •

Multiple Organ Failure Death

Clinical Pathophysiologic Manifestations Manifestation ( S/S ) :SHOCK on HYPOVOLEMIC Effect on Bodily Function: • poor skin turgor • ↓ cardiac output • thirst • ↓ cardiac ejection • oliguria • ↓ impaired • thready pulse cellular metabolism • ↓ BP • cool clammy skin • • •

weakness pale skin mental status deterioration (mental confusion/loss of

• •

If Compensatory Failed Great losses took place

Laboratory Exams: • • • • • •

CBC CT Scan or X-Ray of suspected area Endoscopy Echocardiogram Right Heart Catheterization ( Swan-Ganz) Urine Specific Gravity