Shock

Question 1

What does hypovolemic mean?

Answer 1

A loss in fluid

Question 2

Categories of shock?

Answer 2

Hypovolemic, distribution and cardio genie

Question 3

What is distributive shock mean?

Answer 3

Loss of vascular tone

Question 4

Which shock is due to sepsis?

Answer 4

Distributive shock

Question 5

What is cardiogenic shock?

Answer 5

Due to a Heart pump failure

Question 6

If hypovolemic shock is suspected, what is a nursing intervention?

Answer 6

Monitor vitals, ECG, and pulse ox

Question 7

Signs of early compensated shock include?

Answer 7

Tachycardia, poor skin color, cool /dry skin, and delayed capillary refill.

Question 8

Aside from sepsis, what other causes of distributive shock?

Answer 8

Anaphylaxis , toxic chemicals, or spinal cord injury.

Question 9

What does high blood pressure mean?

Answer 9

Is the force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.

Question 10

HTN signs and symptoms? select all that apply

a. Nosebleeds
b. SOB
c. diarrhea
d. HA

Answer 10

a, b, and d.

Headaches, shortness of breath, or nosebleeds, but these signs and symptoms aren’t specific and usually don’t occur until high blood pressure has reached a severe or life-threatening stage.

Question 11

Complications of HTN, and isn’t resolved?

Answer 11

Heart attack or stroke. High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.

Question 12

What is the number reading for hypotension?

a. 90mmHg
b. 80 mmHg
c. 60 mmHg
d. 75 mmHg

Answer 12

a. A blood pressure reading lower than 90 mmHg for the top number (systolic)

C, for 60 mm Hg for the bottom number (diastolic) is generally considered low blood pressure.

Question 13

True or false.

The cause of hypotension can be d/t dehydration, large amounts of blood loss through injury, and a state of shock.

Answer 13

Can be from as low as dehydration to higher (medical conditions)
Ex. Losing blood, sepsis, lack of nutrition, allergic reaction, or heart problems

Question 14

Extreme hypotension leads to shock, what are the signs and symptoms of that you will see as a result of shock? select all that apply.

a. Rapid and shallow breathing
b. pale skin
c. confusion
d. strong and slow pulse
e. cool and clammy skin

Answer 14

answer: A, B, C, E

Extreme hypotension can result in this life-threatening condition. Signs and symptoms include:

Confusion, especially in older people
Cold, clammy, pale skin
Rapid, shallow breathing
Weak and rapid pulse

Question 15

Signs & symptoms of hypotension?
select all that apply

a. fatigue
b. dizziness
c. Nausea
d. LOC
e. Blurry vision

Answer 15

S/Sx:

Dizziness or lightheadedness
Fainting
Blurred or fading vision
Nausea
Fatigue
Lack of concentration

Question 16

How many stages of shock?

a. 4- Initial, compensatory, impressive, and refractory.
b. 5- Initial, refractory, compensatory, progressive, and recovery.
c. 3- Initial, progressive, and recovery
d. 2- initial and compensatory

Answer 16

There are 4 stages of shock. Initial, compensatory, impressive, and refractory.

Question 17

During the initial stage of shock, the body is the demand for oxygen is increasing. What will you start to see change?

a. metabolic changes from aerobic to anaerobic in order to get oxygen to the cells.
b. overcome increasing consequences of anaerobic metabolism to maintain homeostasis
c. impaired GI motility

Answer 17

a. metabolic changes, at the cellular level.  Lactic acid builds up and must be removed by the liver:
• The body makes lactic acid when it is low in the oxygen it needs to convert glucose into energy. Lactic acid buildup can result in muscle pain, cramps, and muscular fatigue

b and c, are in the compensatory stage of shock.

Question 18

The baroreceptors in the caratoid and aortic body will activate the SNS in response to decrease blood pressure occurring d/t what?

a. respiratory depression
b. lactic acid builds up
c. oxygen demand from the ANS
d. volume loss

Answer 18

d. d/t volume loss, the heart, and the brain will make attempts to overcome the infection, then induces vasoconstriction to maintain perfusion.

O2 demand is also happening but in the SNS, NOT ANS, RESULTING in V/Q MISMATCH.

Question 19

Things that are mportant for nurses need to prevent sepsis? select all that apply.

a. increase in Na+ intake
b. start antibiotic therapy
c. fluid resuscitation
d. give vasopressin (if necessary)

Answer 19

o Start antibiotic early
o Fluid resuscitation
o Give vasopressin (if necessary)

Question 20

True or false.

the decrease in blood to the kidneys inactivates the RAAS SYSTEM.

Answer 20

False. the RAAS system activates because it essential for the regulation of blood pressure and fluid balance.

primarily it is regulated by the rate of renal blood flow.

Question 21

True or False.

In stage 3 of progressive shock stage, organs are starting to fail.

Answer 21

True.

The cardiac output begins to decrease= ↓ blood pressure

Question 22

what is the importance of both cardiac output and cardiac index?

a. a decreased in tissue perfusion and impaired cellular metabolism
b. cardiac output is s determined by stroke volume. And the cardiac index is a marker of how well the heart is functioning.
c. cardiac output is the volume of blood the heart pumps out per min. Cardiac Index is an assessment of the cardiac output (relating to the heart’s performance).
d. coagulation and hemodynamic dysfunction

Answer 22

important to let us know if a patient’s heart is pumping enough blood and delivering enough oxygen to cells.

although for “B”, is true about the cardiac index, the cardiac output is not only determined by stroke volume, it is also a combination of stroke volume & heart rate

Question 23

How is stroke volume determined?

a. BP
b. Preload, afterload and contractility
c. Preload and afterload
d. Contractility and BP

Answer 23

It is determined by Preload, contractility and afterload.

Question 24

what is shock characterized as?

Answer 24

it is a decrease in tissue perfusion and impaired cellular metabolism.

Question 25

what is the manifestation of septic shock?

a. clotting in the bloodstream and inflammation.
b. systolic dysfunction
c. impaired card oxygen d/t a pumping and filling problem.
d. diastolic dysfunction

Answer 25

coagulation and inflammation.

B, D and, C are cardiogenic shock

Question 26

What is the main intravascular fluid in the intravascular space?

a. fluid
b. plasma
c. . blood
d. ICP

Answer 26

The main fluid is blood.

plasma is not the correct answer because the liquid portion of blood that remains after red blood cells, white blood cells, platelets, and other cellular components is removed.

Question 27

what is the definition of cardiac output?

a. the amount of blood the heart pumps per systole
b. is the result of the cardiac index
c. is stroke volume x heart rate.
d. the amount of blood the heart pumps per minute.

Answer 27

Answer: D.
it is the amount of blood the heart pumps per minute.

b, can’t be the answer because the cardiac index is an assessment of the cardiac output based on the patient’s size. therefore, in order to find the cardiac index, we must divide the cardiac output by the person’s body surface level.

C. is not the definition of what cardiac output is, it is the formula on finding out what the cardiac output is.

Question 28

what is central venous pressure?

a. determined by the interaction between cardiac function and arterial return.
b. The amount of blood leaving the heart and the ability to monitor its pumping of the blood.
c. is a major determinant of the filling pressure and therefore the preload of the right ventricle

Answer 28

answer: C

• is frequently used as an estimate of right ventricular preload.
• a catheter that is used to assess right ventricular function and systemic fluid status

not A, because It is determined by the interaction between cardiac function and venous return

NOT B because reflects the amount of blood returning to the heart and the ability of the heart to pump the blood back into the arterial system

Question 29

what is the range of the Central venous pressure?

a. 3-6 mmHg
b. 2-6 mmHg
c. >7 mmHg
d. <2 mmHg

Answer 29

Answer: B

an increase in CVP= associated with increase blood pressure

an increase in CVP= associated with a decrease in BP

a decrease in CVP= associated with an increase in BP

Question 30

what is cardioversion? select all that apply.

a. Is used to treat a fast, irregular heart rhythm (AFib)
b. sends an electrical shock to the heart
c. a way to restore a regular rhythm
d. an arrhythmia
e. Is a chemical cardioversion

Answer 30

Answer: A, B, C, and E

cardioversion is a way to restore a regular rhythm. Abnormal heart rhythms are called arrhythmias.

There are 2 types of cardioversions:
- electrical cardioversion (sending an electrical shock to the heart)

• Chemical cardioversion: medicine that brings back your heart

Question 31

what is neurogenic shock? select all that apply.

a. when peripheral hypoperfusion (cyanosis, pallor, and weak pulses occur)
b. is WHEN it lost the ability to stimulate nerve impulses
c. R/t hemodynamic changes

Answer 31

Answer: B and C

Not A, peripheral hypoperfusion is a sign from cardiogenic shock.

Question 32

what is the difference between spinal shock and neurogenic shock?

a. they are the same in showing signs and symptoms
b. Neurogenic effects our reflexes
c. hemodynamic changes in patients vs an autonomic dysfunction
d. the difference is that one has inadequate fluid volume in the intravascular spaces to support adequate perfusion.

Answer 32

answer C

Neurogenic shock is due to a hemodynamic dysfunction whereas, Spinal shocks is an autonomic dysfunction and shows Areflexia is a condition in which your muscles don’t respond to stimuli.

NOT, D because inadequate perfusion is due to hypovolemic shock. it is not part of the disruptive shock.