RNSG 1542 - Concepts of Nursing Practice II

Module 9:  Nursing Care of Individual(s) with Shock



Module Objectives:  

Using clinical reasoning and the nursing process, the student will:

  1. Analyze comprehensive assessment findings by:

            a) Comparing and contrasting the risk factors associated with     

               the following disorders:
                - Hypovolemic shock
                - Cardiogenic shock
                - Septic shock
                - Anaphylactic shock
                - Neurogenic shock

            b) Analyzing the etiology and pathophysiology for the above

                disorders, including:

                - Compensatory changes
                - Pathophysiologic changes
                - Initial insult
                - Compensatory stage
                - Progressive stage
                - Refractory stage
            c) Analyzing the signs and symptoms and complications of
                the above disorders, including:
                - Systemic Inflammatory Response Syndrome (SIRS)
                - Multiple Organ Dysfunction Syndrome (MODS)
                - Disseminated Intravascular Coagulation (DIC)
            d) Analyzing the diagnostic tests and relating these to the

                 etiology, pathophysiology and signs and symptoms for the above

                 disorders, including:
                - Central venous pressure measurements
                - Pulmonary artery pressure measurements
                - Arterial pressure measurements
                - Blood, urine, and electrolyte values

         2. Formulate and prioritize nursing diagnoses that address physical,

             psychosocial and learning needs.

         3. Formulate patient and family centered goals and outcomes guided by

             evidence based practice that facilitate health promotion, maintenance,

             and restoration; and ensure confidentiality.

         4. Utilize evidence based practice to analyze and prioritize, implement, and

             evaluate nursing interventions for the above disorders related to:

             a) Safety; Risk reduction

             b) Medication therapy

             c) Diet therapy

             d) Surgical interventions

             e) Patient teaching; Discharge teaching; Referrals

             f) Therapeutic communication

             g) Delegation

             h) Others

         5. Collaborate with interdisciplinary health care team when providing

             patient-centered care.

         6. Evaluate and revise goals and modify the nursing care plan.

         7. Examine associate issues, trends, and informatics into nursing


             a) Legal issues

             b) Ethical considerations

             c) Quality improvement

             d) Evidence based practice

             e) Complimentary medicine.

Learning Activities:

1. Review module objectives.

2. Learning Resources:

  • Lewis, Heitkemper, Dirksen, O'Brien, and Bucher, Medical-Surgical Nursing: Assessment and Management of Clinical Problems (8th edition), pp. 687-689, 1681-1698, 1717-1743.

3. Complete Critical Thinking Exercises:

4. Supplemental Learning:

  • http://www.ccmtutorials.com/cvs/index.htm (Select Shock and complete the following units: Introduction, What is Shock and Key Points. You may wish to explore the other units to get an in-depth understanding of the pathophysiology of shock)
  • The following two links are from the traditional track and are offered as supplemental learning.  Do not concentrate on neurogenic shock as that will be covered later.
    Powerpoint presentation on Shock
    Notes on shock

5. Review module objectives and check for knowledge gaps.

6. Complete module quiz