What are the nursing interventions for shock?

Treatment and interventions are usually based on the cause of the shock. Most of them are caused by either vasodialation or fluid loss that causes lowered Cardiac Output.



For Hypovolemic, you would want to focus on increasing Cardiac Output by giving positive inotropes like dobutamine, dopamine, and also replacing fluids (Using only NS and LR; never D5W; it will only exacerbate the possible lactic acidosis). Also, you would replace what the patient lost (plasma, RBC, etc.)



For neurogenic, it is a wide-spread loss of sympathetic nervous system tone, so you would focus on vasoconstriction with medications like Norepinepherine and Dopamine.



With anaphylatic shock, epinepherine is the choice drug and removing exposure to the allergen.


Cardiogenic is slightly different. It is caused from a mechanical problem in the heart. Causes could by an acute MI, cardiomyopathies, and dysrrhythmias. Treatment is focused on treating the underlying cause. You would give dopamine to correct the decreased Cardiac Output. With cardiogenic shock, however, there is increased Left Ventricular work-load. The focus would also be in correcting this by decreasing the work-load; Nitroglyerine or Nitroprusside is given along with the positive inotrope.