Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AGACNP Exam 1 > Name that Shock > Flashcards

Name that Shock Flashcards

1
Q

At this stage, changes occur at the cellular level and compensatory mechanisms are able to maintain tissue perfusion

A

What is Stage 1 (Pre-shock)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe nervous system compensatory mechanisms which occur after baroreceptors are stimulated and send impulses to the vasomotor center of the medulla

A 
SNS Activation
Norepinephrine release
decrease CO and BP
increased sweat gland activity
dilation of pupils
increase HR = contractility
vasodilation of cardiac arteries to increase oxygen to the heart
vasoconstriction of vasculature in skin, GI tract, kidneys, venous return, and shunting of blood to vital organs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name the three sub-types of distributive shock

A

Septic
Neurogenic
Anaphylactic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Stroke volume is …

A

the amount of blood ejected by the heart in one contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which symptom is one of the earliest signs of cardiogenic shock?

  • 4th heart sound
  • cyanosis
  • altered mental status
  • decreased urine output
A

Altered mental status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When compensatory mechanisms for hypovolemic shock are activated, which two patient findings do you expect to normalize?

  • CO & BP
  • metabolic alkalosis and O2 sat
  • intensity of peripheral pulses and body temperature
  • peripheral pulses and HR
A

CO and BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

This type of shock is characterized by massive vasodilation due to a release of histamines in response to an allergic reaction

A

Anaphylactic Shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

You are treating a patient in hypovolemic shock. Which assessment finding indicated you should stop fluid boluses?

  • peripheral cyanosis
  • tachycardia and hypotension
  • crackles throughout the lung fields
  • increased O2 saturations
A

Crackles throughout lung fields

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A patient with undifferentiated shock has the following vital signs: BP 92/54, HR 64, elevated PCWP
You are reviewing the chart: which order would you question?
- start nipride infusion unless SBP , 90 mmHg
- keep HOB at 30 degrees
- give NS at 250 ml/hr
- begin dobutamine to keep SBP > 90 mmHg

A

Give NS at 250 ml/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which finding is the BEST indicator fluid resuscitation for a patient with hypovolemic shock has been successful?

  • PAWP is normal
  • MAP is 65 mmHg
  • Hemoglobin is within normal limits
  • Urine output is 60 mL over the last hour
A

Urine output is 60 mL over the last hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A patient with cardiogenic shock is cool, clammy, and hemodynamic monitoring reveals a high SVR. Which intervention is appropriate?

  • decrease the rate of a prescribed D5W infusion
  • increase the rate of a prescribed Nipride infusion
  • decrease the rate for the prescribed Nitroglycerine infusion
  • initiate a dopamine infusion
A

Increase the rate of the current Nipride infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The agents cause which type of shock?

IV contrast, drugs, insect bites/stings, anesthetic agents, vaccines, foods, materials

A

Anaphylactic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name 3 key treatments for anaphylactic shock

A

A-B-C!
Ensure patient airway
Give oxygen
Medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of shock are those medications most likely used in?
Histamine H2 blocker, epinephrine, benadryl, volume expanders, solumedrol, bronchodilatiors

A

Anaphylactic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the drug of choice in anaphylactic shock?

A

Epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of shock are these meds most likely used?

Levophed, Neo-synephrine, dobutamine, vasopressin

A

Hypovolemic shock after fluid resuscitation is exhausted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

This type of shock is characterized by loss of intravascular volume, decreased SV, decreased CO

A

Hypovolemic shock

18
Q

In this stage of shock, multisystem organ failure is evident, and death is highly probable

A

Stage 3 : Irreversible Shock

19
Q

Name the shock most associated with these causes:
3rd spacing, diuresis, hemorrhage, burns, GI losses (vomiting, diarrhea, NGT output), diabetes insipidus, diabetic ketoacidosis, addison’s disease

A

Hypovolemic shock

20
Q

Name the #1 cause of hypovolemic shock

A

Hemorrhage

21
Q

List key treatments in hypovolemic shock

A 
Medications
Rapid volume replacement
Control bleeding
Oxygen
Hemodynamic monitoring
22
Q

Name 3 causes of cardiogenic shock

A

Myocardial infarction
Lethal ventricular arrhythmias
end-stage heart failure

23
Q

Inability of the heart to effectively pump blood out to the system resulting in decreased CO

A

Cardiogenic Shock

24
Q

Which type of shock do these treatments best indicate?

  • medication
  • IABP
  • correction of arrhythmias
  • oxygen supplementation
  • intubation/mechanical ventilation
A

Cardiogenic Shock

25
Q

These medications are used to treat which type of shock?

dobutamine, dopamine, epinephrine, primacor, nitroglycerin, nipride, cardene, morphine

A

Cardiogenic shock

26
Q

Massive vasodilation caused by inflammatory response of the body due to an overwhelming infection

A

Septic Shock

27
Q

What is the hallmark S/S of septic shock?

A

Hypotension

28
Q

List key treatments in septic shock

A
  • antimicrobial therapy
  • volume replacement
  • cultures (blood, urine, sputum)
  • vasopressors
  • hemodynamic monitoring
29
Q

What do these have in common?

  • massive vasodilation
  • suppression of the SNS
  • injury or disease to the spinal cord at the T6 level
  • spinal anesthesia
A

Neurogenic shock

30
Q

List 3 key treatments/interventions for neurogenic shock

A

Treat the cause
Airway and Ventilation Support
Vasopressors

31
Q

These are 3 major effects of which type of shock?

  • vasodilation
  • maldistribution of blood flow
  • myocardial depression
A

Septic Shock

32
Q

What is the root cause of this phenomena?

Even with adequate fluid volume resuscitation there is hypotension and hypovolemia

A

Vasodilation

33
Q

Name that shock:

  • Pooling of blood
  • Decreased venous return
  • Decreased CO
  • Hypotension
  • Byradycardia
A

Neurogenic Shock

34
Q

This key characteristic of septic shock causes decreased microcirculation and poor oxygen delivery to the tissues = tissue hypoxia

A

Maldistribution of blood flow

35
Q

Name that shock:

Decreased EF
Hyperventilation
Confusion
Decreased UOP
increased WBC
Hypoactive or no bowel sounds
Flush/cool extremities
A

Late-stage septic shock

36
Q

Tension pneumothorax
cardiac tamponade
pulmonary embolism
aortic dissection

A

Obstructive Shock

37
Q

Which stage of shock is characterized by failing compensatory mechanisms and organ dysfunction

A

Stage 2 (Shock)

38
Q

What is key to recognition and differentiating the presence of shock?

A

a good history and physical exam

39
Q

Name that Shock:

CVP is low
PCWP is low
CO is elevated
SVR is low

A

Distributive shock

40
Q

Name that shock:

CVP is elevated
PCWP is elevated
CO is decreased
SVR is increased

A

Cardiogenic Shock

41
Q

Name that shock:

CVP is elevated
PCWP is low or high
CO is decreased
SVR is increased

A

Obstructive Shock

42
Q

Name that shock:

CVP is decreased
PCWP is low
CO is decreased
SVR is increased

A

Hypovolemic Shock

AGACNP Exam 1 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions