Recognizing Shock
This term describes inadequate tissue perfusion that prevents organs from receiving sufficient oxygen.
Shock
This type of shock occurs when the circulating blood volume becomes inadequate.
hypovolemic shock
This type of shock is associated with a severe systemic response to infection.
septic shock
This age group is especially vulnerable to sepsis because of immature immune defenses.
Infants, particularly newborns and those under three months.
This assessment measures how quickly color returns to the skin after pressure is released.
Capillary refill time
This vital-sign change is an important early compensatory finding in pediatric shock.
Tachycardia
Severe vomiting and diarrhea place a child at risk for this type of shock.
hypovolemic shock
Infants with sepsis may present with fever or this opposite temperature abnormality.
hypothermia
Missing vaccines against bacteria such as Streptococcus pneumoniae increases the risk for this serious complication.
Bacterial infection and sepsis.
Your professor emphasized that this vital-sign finding is a late indicator of pediatric shock.
hypotension
A child has cool, pale skin, weak peripheral pulses, and a capillary refill time greater than four seconds. What physiological problem do these findings suggest?
Poor tissue perfusion associated with shock
A child has severe dehydration, weak pulses, hypotension, and poor capillary refill. Which type of IV solution is used for initial resuscitation?
an isotonic crystalloid, such as .9% NS or LR
A child with suspected septic shock develops confusion, mottled skin, weak pulses, and decreased urine output. What do these findings indicate?
Inadequate organ perfusion and possible progression of septic shock.
These two chronic conditions mentioned in your lecture increase a child's risk of severe infection and sepsis.
Sickle cell disease and cancer.
Name three findings a nurse should reassess when evaluating tissue perfusion in a child with suspected shock.
Capillary refill, pulse quality, extremity temperature, mental status, or urine output (any three).
A child with suspected shock has tachycardia, lethargy, and delayed capillary refill but a normal blood pressure. Why is shock still a concern?
Children can maintain normal blood pressure during compensated shock; hypotension is a late finding.
A child weighing 12 kg is prescribed a 20 mL/kg normal saline bolus for hypovolemic shock. Calculate the total volume.
240 mL
A child with suspected sepsis has tachycardia, delayed capillary refill, and normal blood pressure. Why should the nurse escalate care immediately?
Normal blood pressure does not rule out shock; signs of poor perfusion require urgent evaluation.
A child receiving chemotherapy develops a fever. Why should the nurse treat this finding as particularly concerning?
Chemotherapy may weaken immune defenses, increasing the risk of serious infection and sepsis.
A parent reports that an infant with fever is unusually sleepy and feeding poorly. The infant's blood pressure is normal, but capillary refill is prolonged. What should the nurse prioritize?
Recognize possible early sepsis or shock, promptly assess perfusion, and escalate care.
A child develops hypotension, anuria, cyanosis, and decreased responsiveness after prolonged tachycardia. What does this progression indicate?
Decompensated shock with severe impairment of tissue perfusion.
Following a prescribed bolus, a child becomes more alert with stronger pulses, improved blood pressure, and capillary refill less than two seconds. What do these findings indicate?
improved circulating volume and tissue perfusion
A child with sepsis develops hypotension, anuria, and signs of liver and coagulation dysfunction. What severe complication does this suggest?
Progressive septic shock with multiorgan dysfunction.
An infant with a central venous catheter develops temperature instability, lethargy, and delayed capillary refill. Identify two risk factors for sepsis present in this scenario.
Young age and an indwelling vascular device.
Two children arrive in the emergency department: one has fever and normal perfusion, while the other has fever, lethargy, weak pulses, capillary refill greater than four seconds, and decreased urine output. Which child requires immediate assessment, and why?
The second child because multiple findings suggest shock and inadequate organ perfusion.