Shock Stages Nursing NCLEX: Initial, Compensatory, Progressive, Refractory

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Shock stages include initial, compensatory, progressive, and refractory stages.

Shock results from a cause of some type that leads to decrease tissue perfusion to organ/tissue's cells. When the cells are deprived of perfusion they lack oxygen to function and can suffer hypoxic injury. If this is not corrected, multiple organ dysfunction syndrome can occurs along with death.

Types of shock include the following:

-Hypovolemic shock
-Cardiogenic shock
-Neurogenic shock
-Septic shock
-Obstructive shock
-Anaphylactic shock

During the initial stage of shock, the cells start to switch from aerobic metabolism to anaerboic. This results in the accumulation of lactic acid in the body. The signs and symptoms during this stage are not yet noticeable.

During the compensatory stage of shock, the body utilizes it neural, biochemical, and hormonal faculties in attempt to increase cardiac output and perfusion to the cells. For a while this works but will eventually fail in the cause of shock is not treated. This stage is reversible and the patient can recovery is the shock is successfully treated. If the patient is not treated correctly, they will progress to the progressive stage of shock.

During the progressive stage of stock, the body has failed to compensate and it is progressing to MODS. This stage is highlighted by the malfunction of all the organs. The patient's neuro status will be impaired due to a severe decrease of cerebral perfusion. The mean arterial pressure (MAP) will be less than 60 mmHg. Renal failure will ensure along with GI bleeding, acute respiratory distress syndrome (ARDS), DIC (disseminated intravascular coagulation) and so forth.

The last stage of shock is the refractory stage. The word refractory means "unmanageable". This stage is irreversible and MODS will occurs along with death.

#shock
#shockstages
#shocknursing

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Hey Everyone! I'm so EXCITED to start this shock series! Don't forget:

RegisteredNurseRN
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Thank you so much for this video. It isn’t for nursing school but because my brother just died of Sepsis on the 23 of October. He was 40. I flew to Colorado (from Mo.) to be with him and had to be his proxy and make the decision to shut off his pressers 9 days later and let him go. He died in 29 minutes while I held him. He was my only sibling. I didn’t understand everything that was happening at the time. The Dr told my mom he would only live 48 hours. I had them keep him alive 9 days not knowing he had already crossed all the these stages and was in MODS when he arrived at the ER. He was found on the bathroom floor and was left there for 16 hours before anyone called 911. When paramedics arrived he had a blood sugar of 21, body temp of 87. His liver, kidneys and pancreas had shut down. Had I known all of this I wouldn’t have fought to keep him alive so long. I thought they could do something to save him. They kept giving me tiny glimpses of hope. I think that’s only because they couldn’t come right out and tell me he was not going to live. I saw every part of the last category at the hospital. Especially with his labs. The DIC, All of it. He never had a chance. In a strange way I’m so thankful for this video because I still wondered if there was anything that could have been done and if I had made the right decision. I know now I did. For him. So, thank you so much. ❤️

charlierose
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If you aren't a professor yet, Idk what you are waiting for. You are AWESOME!!!! Your videos are long, but they replace lectures and help people prepare for NCLEX so well. It's time you do this full time. You are saving lives through the people you educate. Thank you.

mckenziefamily
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I used to think you should be a professor, but now I have changed my mind.. You are way too valuable for that! You should be a director or owner of a nursing school, so you can teach professors how to teach this well.. A consult of numerous nursing schools, your ability to teach exceed anybody's I've seen this far!

When you think about that, you are not just blessing the people who watch your videos, you are blessing the people that we will be taking care of.. It's getting me choked up, because your light will extend so far Miss Sarah! Thank you so much and God bless your beautiful family

staceyarey
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Just learned I passed my NCLEX! 75 questions, first attempt! Thanks for all your videos as they were God sent during my studies ❤️

Ketovore-RN
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Hello Registered Nurse Sara I am very happy and excited to tell you that today I had passed my nclex RN in 76. It’s because of your awesome lectures. It was impossible too pass without your amazing videos.I gave my test on Saturday on 16 March 2019, my computer shut down at 76th question . It was unbelievable in 2 hrs and found PASS today on 18 March 2019 @9:00am . I am very grateful and thankful to you for your lovely help 🥰🤗🙏.I ❤️ love you much.

simmigill
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I have been a nurse over a year and a half and I STILL re-watch your videos and take notes today! You make the information so easy to understand and it has made me a better nurse! YOU ALSO GOT ME THROUGH NURSING SCHOOL! THANK YOU FROM THE BOTTOM OF MY HEART!

stephaniehorency
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WOW- CAN'T BELIEVE THAT SHE ACKNOWLEDGES EVERYONE'S MESSAGE. SHE IS TRULY A GEM! XOXO

nosotress
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OMFG my final is tomorrow and you JUST uploaded this 2 days ago, florence nightinggale has blessed me

marypoppinamolly
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Wouldn't you know, the only test I didn't do well on all year was the shock one! I used your excellent videos to study all through nursing school! I'm so glad this came out just in time for my final tomorrow! 10 days til Thank you Nurse Sarah!

bethpritchard
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Sarah! you have helped me tremendously during nursing school! 4 years later and I still go back to watch your videos! Thank you! May God bless you and keep you. May His Face shine upon you and give you peace!

malakmagdy
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Ive been studying for the NCLEX for months (scheduled for the end of the month) but I never understood the "entire picture" until I started watching your videos!!! I LOVE how you explain the patho and how you really explain the meaning behind the different signs and symptoms. My husband is also preparing for his Physical Therapy board exam and I'm able to teach him some of our topics with confidence!!! Thats how I know I actually understand now. thank you Sarah!!!

anavictoriabustalino
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Nurse Sara I want to thank you for sharing your gift with all of us. You are truly a blessing. With the help of your videos, I was able to have an easier transition into my nursing career. Yesterday was my pinning ceremony and you were one of my best assets. Thank you, and keep blessing us with your knowledge.

stiventorres
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I wanted to thank you and show my appreciation to you the day I passed my RN exam from first try . Your videos are very thorough and easy to understand. I think you are a great professor and obviously a great nurse . Thank you for what you do to your fellow nurses and student nurses . You are the best youtube nurse professor ❤️

sitorapulatova
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Nurse Sarah is the reason I am about to graduate...thank you for pulling me through Nursing School!!!

haleyburke
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You are amazing. I watched your videos throughout my nursing school & also while preparing for my NCLEX. I passed my NCLEX in 75 questions. A big thanks to you. May God bless you with all that you desire.

manpreetk
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Sara U R the bestest of the best just took my RN NCLEX on the 02/28/2019 I passed At 80 Thanks to Ur videos I appreciate your videos keep up the good work bless you

hugomejia
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You are amazing, I love that you write everything in different colors, this makes it so easy to follow and understand. I can't imagine how long it takes to prepare one lesson, and all this for free! you are my hero. Thank you.

sharonschallenges
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Sarah! THANK YOU, THANK YOU!!! Your videos got me through nursing school and NCLEX RN. I had 75 questions with 75% select all. 😳. I passed! Thank you Sarah!😎

ninagrantham
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Sarah, you are a life saver!!! After almost a week of reading shock in my textbook i finally understand by watching this one video.n Patiently waiting on the others in the series for my finals on monday. I need to mail you a thank you card when i take Nclex!!! I LOVE YOU BESTFRIEND LOL

trigzyboograham