obstructive shock

• Pathophysiology

  Physical impairment to adequate circulatory blood flow
• Obstructive shock

  • Mechanical obstruction
  • Preventing heart from filling properly or pumping enough blood through CV System= decreased CO
• Causes of obstructive shock

  • Cardiac tamponade
  • Tension pneumothorax
  • PE
  • Compression of great veins
  • Pericarditis
• Clinical Manifestations

  • Hypotension
  • Dyspnea
  • Chest pain
  • Muffled heart sounds
  • Friction scratchy murmurs
• Clinical Manifestations


  • Jugular venous distension (from FVE)
  • Weak pulses
  • Pale, cool skin
  • Decreased urine output and bowel sounds
• Management

  1. Relieve obstruction

  2. Improve perfusion
• Cardiac tamponade management

  Pericardiocentesis or pericardial window
• Tension pneumothorax management

  Emergency decompression and chest thoracotomy
• PE management

  Fibrinolytics, anticoagulants
• Nursing Implications

  • 100% NRK, Vent
  • Prepare for intubation
  • Assessments
  • Admin meds as ordered
  • Labs (PE labs are coag, Troponin)
• Nursing Implications

  • Prepare for definitive Tx of cause
  • Assist with pericardiocentesis
• Measures


  • Vasoactive meds (pressors, epi, norepi, neo)
  • Antithrombolytics (heparin)