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nursing care of obstetric shock-nursing precautions-dietary taboos

nursing care of obstetric shock-nursing precautions-dietary taboos

General nursing care of obstetric shock

Nursing care of obstetric shock

The pathophysiological changes of the decrease of effective circulating blood volume have the following three aspects:

1. Hemodynamic changes

When the effective blood volume decreases, the baroreceptors of carotid sinus and aorta are stimulated, which excite the medulla oblongata heartbeat center, vasomotor center and sympathetic nerve through glossopharyngeal nerve and vagus nerve, and act on the heart, small blood vessels and adrenal gland, etc., so as to accelerate the heartbeat and increase cardiac output; Adrenal medulla and sympathetic postganglionic fibers release a large amount of catecholamines. Catecholamines cause strong contraction of small blood vessels in skin, limbs, intestines, kidneys, etc., including increased contraction resistance of microvessels and anterior sphincter of capillaries, which reduces the blood volume entering true capillaries. The direct passage through microcirculation, or even short circuit of arteries and veins, makes the venous return blood volume can be maintained, so the blood pressure can still be kept from falling. At the same time, cardiac and cerebral vasoconstriction was not obvious. So as to ensure the perfusion of important vital organs, heart and brain. This period is vasoconstriction and shock compensation period of microcirculation compensation.

2. Changes in body fluids

As mentioned earlier, catecholamine secretion during shock not only affects hemodynamics, but also inhibits insulin secretion, promotes glucagon secretion, accelerates glycogen decomposition and gluconeogenesis in muscle and liver, and increases blood sugar. Decreased blood volume, decreased renal blood flow, promote renin secretion, renin promote angiotensin secretion, angiotensin makes adrenaline production of aldosterone increase. The effect of aldosterone is to store sodium and expel potassium, which has the functions of pressurizing and supplementing blood volume. As the blood pressure drops, the left atrial perfusion pressure drops, and the pressurization receptor is stimulated, which promotes the posterior pituitary gland to secrete antidiuretic hormone, which is beneficial to the recovery of plasma volume. Cell ischemia and hypoxia, intracellular glucose anaerobic metabolism, can only produce a small amount of high-energy adenosine triphosphate (ATP), while lactate production increases, liver ischemia, lactic acid can not complete metabolic decomposition in the liver, and lactic acid aggregation acidosis occurs in the body.

3. Secondary multiple organ damage

Long time of shock, long time of ischemia and hypoxia of internal organs and tissues, degeneration, necrosis and hemorrhage of tissues and cells, resulting in organ failure.

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obstetric shock examination, obstetric shock diagnosis



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