Pathophysiology of Shock
Examination of the shock condition allows determining the patient’s health condition more effectively, to identify symptoms and find treatment methods. In this essay, it is analyzed the male dog, nine years old, neutered. Based on the input signals of involuntary vomiting, bloating, anxiety and palpation pain, the stage of the patient’s shock is analyzed, and solutions are proposed. This essay aims to investigate the pathophysiology of shock, to analyze the state of shock and to recommend treatment options.
Shock state includes three stages: compensatory, decompensatory, and late decompensatory. The first stage of shock refers to a situation where the body primarily responds to a lack of oxygen, which leads to increased blood flow into the tissue. Compensatory mechanisms achieve this by increasing HP and reducing blood pressure. To compensate for oxygen deficiency, breathing frequency tends to increase. Also, the mucous membranes become pale, and the capillaries fill up longer due to narrowed arterial lumen.
At the same time, temperature and mentation are reduced. The opposite situation occurs when the body cannot compensate for the lack of oxygen – it is a decompensatory shock. At this stage, respiration rate, body temperature, and blood pressure are reduced. There is an increase in HP, although the mucous membranes are still pale, the capillaries fill slowly, and the mentation is blurred. The late stage of decompensation is associated with hypotension and bradycardia, and breathing frequency drops even more significantly. The color of the mucous membranes will become turbid grey, and the filling of the capillaries is inhibited. Temperature is lowered to the max, and the mentation is not felt. Given the signals given, the dog is in the last, obstructive stage.
Monitoring Shock
Patient assessment is based on three indicators, such as the increase of lactate, change of urine specific gravity (USG), the PCV status. In shock states, lactate production by multiple hypoxic organs may exceed its metabolism: this is the basis of lactate determination for assessing hypoperfusion. The USG is responsible for the ability of the kidneys to concentrate: values greater than 1.014 indicate insufficient fluid intake into the body. Moreover, monitoring can be done through PCV, which shows the number of red blood cells. In this way, it is possible to determine how well the blood is oxygenated: dehydration increases this figure.
In these cases, plasma volume decreases with normal red blood cell count and the PCV level in the tests increases. As for the physical changes when the patient moves from compensation to decompensated, I would pay close attention to delicate and irregular breathing, reduced body temperature, tachycardia and tachypnea, and quickly falling blood pressure. Drug dosage and metabolism would become the essential objectives when caring for the patient as well as its immune status and response to pain control and nursing care.
Treating Shock
Immediate treatment for the patient should include oxygen therapy, intravenous fluids, and removal of the gas from the stomach. The patient is going to experience less pressure in the stomach and abdomen, which is going to stabilize the patient and improve their lung and heart functioning. Additionally, the patient could get diagnostic testing such as biochemistry screening and complete blood count. An electrocardiogram, a radiograph, and a urine analysis could also be beneficial to the treatment process. Oxygenation of the system should be gauged through the study of blood gases and metabolic shifts. After the patient’s condition has been stabilized, it would be critical to perform a full exploration of the abdomen and see if the stomach had been damaged.
The fluid that has to be selected is the isotonic crystalloids because they resemble the plasma levels of chloride and sodium. Isotonic crystalloids are going to reduce the potential for complications and decrease the mortality risk in the patient. The patient could also benefit from hypertonic saline as it would expand the volume of plasma and increase the cardiac output. Nonetheless, it is recommended to focus on the application of isotonic crystalloids, as the latter is not linked to an extended number of side effects.
Oxygen should be given to the patient via facemask. This method would ensure a lower oxygen flow while delivering a higher percentage of oxygen to the patient. The only problem could be the inability of the patient to tolerate the facemask. The rate of oxygen provided to the patient should be monitored carefully to evade scenarios where either an excessive or insufficient amount of oxygen would negatively affect the patient’s health.