Shock

Question 0

What guidelines apply to the prehospital administration of IV fluids in a patient with hemorrhagic shock?

Answer 0

administer isotonic crystalloid fluids only as necessary to maintain perfusion

Question 1

In a previously healthy individual, what type of shock may NOT result in typical signs of cool, pale, moist skin, tachycardia, and narrowed pulse pressure?

Answer 1

neurogenic

Question 2

Pt 23 y/o male with GSW to abdomen and exit wound in the right flank. Responds to verbal stimuli, has cool, pale, diaphoretic skin, HR 128, RR 24, BP 82/60. These findings indicated which stage of shock?

Answer 2

decompensated

Question 3

What results from anaerobic metabolism in shock?

Answer 3

metabolic acidosis

Question 4

What is located in the aortic arch, monitors BP and sends feedback to the medulla oblongata to maintain homeostasis?

Answer 4

baroreceptors

Question 5

managing a laceration with arterial bleeding most often requires:

Answer 5

direct pressure

Question 6

In which patient with hemorrhagic shock can you employ aggressive fluid resuscitation?

Answer 6

A 26 year-old male with a GSW involving the popliteal artery

Question 7

anaphylactic shock is a form of ___________ shock

Answer 7

distributive

Question 8

What results from relaxation of the postcapillary sphincters in shock?

Answer 8

“washout” of microemboli and lactic acid

Question 9

What is expressed as the HR multiplied by the amount of blood ejected by the left ventricle during systole?

Answer 9

cardiac output

Question 10

A fracture of the femur may result in a hematoma that contains enough blood to make it a Stage ___ hemorrhage.

Answer 10

2

Question 11

Pt 45 y/o male with several stab wounds to the chest and abdomen. Although bleeding was significant at first, rate of bleeding has slowed. He is agitated and confused, pale, diaphoretic, cool to the touch. He lacks a radial pulse, his carotid pulse is weak and rapid. Respirations 28 and shallow. What is certain with this patient?

Answer 11

He is in decompensated shock

Question 12

Your patient has a possible pelvic fracture from a frontal motor vehicle collision. BP 78 by palpation, HR 130, responds only to painful stimuli. BLS have immobilized her to a long backboard. What should you do next?

Answer 12

Initiate rapid transport

Question 13

Which layer of the arteries controls the diameter of the vessels?

Answer 13

tunica media

Question 14

What substance has the most rapid effect when compensating for hemorrhage?

Answer 14

catecholamines

Question 15

Which is the preferred fluid for resuscitation in hemorrhagic shock?

Answer 15

whole blood

Question 16

What best describes the importance of oxygen in cellular metabolism?

Answer 16

It prevents pyruvic acid from being converted to lactic acid

Question 17

When cells become hypoxic and the amount of carbon dioxide in them increases, reducing tissue pH, what occurs to restore homeostasis?

Answer 17

Mast cells release histamine, resulting in dilation of capillary sphincters and an increase in tissue perfusion

Question 18

The phase of blood clotting in which the smooth muscle of an injured blood vessel contracts is known as the _______ phase.

Answer 18

vascular

Question 19

What findings indicate a progression from compensated shock to decompensated shock?

Answer 19

altered mental status

Question 20

When assessing the chest during rapid trauma survey, what is most likely to indicate major internal hemorrhage?

Answer 20

dullness to percussion

Question 21

What types of wound facilitate the effectiveness of normal blood-clotting mechanisms?

Answer 21

transverse laceration of the vessel