Approved for 4 clock hours by Commission on Case Manager Certification from 1/1/07 to 12/31/08.

The purpose of this course is to provide nurses with important information about shock and shock states, including cardiogenic, hypovolemic, anaphylactic, neurogenic, and septic shock. The pathophysiology, clinical signs and symptoms, and current trends in treatment are reviewed. Case studies highlight important components of patient assessment, diagnosis, and treatment.

After studying the information presented here, you will be able to:

• Identify the alterations in tissue perfusion and cellular metabolism that occur in shock states.
• List two risk factors for the development of cardiogenic shock.
• Distinguish the stages of hypovolemic shock.
• Identify the clinical presentation of anaphylactic shock.
• List three risk factors for the development of septic shock.
• Describe how septic shock can lead to multiple organ dysfunction syndrome.
• Identify treatment goals for shock.
• Discuss the pathophysiology of sepsis including the role of pro-inflammatory and antiinflammatory mediators in the systemic inflammatory response syndrome (SIRS).
• Describe new evidence-based guidelines for the management of sepsis.
• Discuss the role of the nurse in identifying and managing patients with shock states.