Sunday, April 15, 2012


Nurses who care for patients in the different stages of shock
must tailor interventions to the type of shock, whether hypovolemic,
cardiogenic, or circulatory shock. Hypovolemic
shock, the most common type of shock, is characterized by
decreased intravascular volume. Body fluid is contained in
the intracellular and extracellular compartments. Intracellular
fluid accounts for about two thirds of the total body
water. The extracellular body fluid is found in one of two
compartments: intravascular (inside blood vessels) or interstitial
(surrounding tissues). The volume of interstitial fluid
is about three to four times that of intravascular fluid. Hypovolemic
shock occurs when there is a reduction in intravascular
volume by 15% to 30%, which represents a loss
of 750 to 1500 mL of blood in a 70-kg (154-lb) person

Medication Desired Action in Shock Disadvantages

Medication                  Desired Action in shock                    Disadvantages
Inotropic Agents

Dobutamine (Dobutrex      Improve contractility, increase stroke             Increase oxygen demand of the heart
Dopamine (Intropin)          volume, increase cardiac output
Epinephrine (Adrenalin)
Milrinone (Primacor)


Nitroglycerin (Tridil)            Reduce preload and afterload, reduce           hypotension
                                        cause oxygen demand of heart 
Nitroprusside (Nipride)       

Vasopressor Agents

Norepinephrine (Levophed)   Increase blood pressure by vasoconstriction      Increase afterload, thereby                           
Dopamine (Intropin)                                                                                   increasing cardiac   
                                                                                                               workload;compromise perfusion to 
                                                                                                               skin, kidneys, lungs, gastrointestinal 

No comments:

Post a Comment