Ventricular ischemia Structural Problems Dysrhythimias

Chest Pain or Ineffective ventricular

Tightness emptying

Decreased systemic Heart becomes an

volume ineffective pump

Decreased cardiac Decreased

Tachycardia output pulmonary
develops pressure

Pulmonary edema Crackles and diffuse

rales can be heard
Risk:

Acute myocardial infarction Dysrhytmias Decreased Oxygen

Atrial thrombus Myocarditis Dark colored nails and
Cardiac Contusion Open heart surgery mucous membrane
Cardiac tampode Pneumothorax Tissue Hypoxia
Cardiac tumor Pulmonary embolus
Cardiomyopathic conditions Valvular dysfunction
Cardiopulmonary arrest Ventricular aneurysm Impaired
cellular
metabolism
Cardiogenic shock Decreased Anxiety, confusion,
urine output lethargy and coma
 Decreased intravascular volume
Absolute and Direct losses

GI status (diarrhea, vomiting, GI

suction, ostomies, fistusals) Decrease cardiac
output
Hemorrhage (trauma, surgery, GI
bleeding, thrombocytopnenia,
hemophilia) Antidiuretic hormone, Shift of interstitial fluid
Catecholamine
aldosterone secretion
Plasmalosses (thermal injuries,
decreased oral fluid intake)

Renal losses (massive dieresis,

Increased volume Increased heart reate, Increased systemic
hyperglycemic osmotic dieresis,
diabetes insipidus) force of contraction vascular resistance

Compensatory
Relative and Indirect losses mechanism Increased cardiac
begins to fail output
Hemoperitoneum or hemorrhagic
pancreatitis

Hemothorax Continued Decreased systemic Decreased Pulmonary

volume loss pressure pressure
Increase capillary membrane

Laceration great vessels

Decreased cardiac
Long bone fractures, pelvic fractures output
Loss of intravascular integrity
Decreased
Rupture of spleen and liver tissue perfusion

Hypovolemic shock Impaired cellular

metabolism
 Disruption of sympathetic nervous system

Loss of sympathetic tone Bradycardia

Venous and arterial vasodilation Decreased cardiac output

Decreased venous return Decreased cellular oxygen supply

Decreased stroke volume Impaired tissue perfusion

Decreased cardiac output Impaired cellular metabolism

Decreased cellular oxygen supply

Impaired tissue perfusion

Impaired cellular metabolism

Neurogenic shock
 Microbial Infection

Toxins released

Mediator released

Vasodilation, edema, Leukocytosis, coagulation

Fever, Hypotension, pulomonary edema, decreased

coronary output, dcreased renal perfusion

Multiple organ failure

Death

Septic shock
 Initial exposure to allergens

Formation of IgE

Anti-bodies accumulate and attach to membrane of mast cells

Mast cells and basophils disperse

IgE interacts antigens to trigger rupture of mast cells

Substance causes vasodilation, increased capillary

permeability and smooth muscle contractions

Symptomatic clinical changes

Anaphylactic shock precipitates

Anaphylactic shock