The Inner Workings
The Usual Suspects
Shock it to me
The Body Speaks
Stat Actions
Point of
No Return
No Return
Crucial Calculations
100
When this happens, the sympathetic nervous system is activated, and the compensatory mechanisms begin.
What is when the blood pressure falls?
100
Name this condition that results from circulating blood volume loss.
What is hypovolemic shock?
100
List the three forms of distributive shock.
What are anaphylactic, septic, and neurogenic shock?
100
This vital sign is often the earliest sign of shock as the body tries to compensate for low cardiac output.
What is tachycardia?
100
This is the priority nursing action for any patient showing signs of respiratory distress in shock.
What is administering oxygen?
100
In this initial "compensatory" stage, the body uses this system to maintain blood pressure.
What is the Sympathetic Nervous System (SNS)?
100
A physician orders 500 mg of an antibiotic. The pharmacy sends 250 mg tablets. How many tablets will you give?
What is 2 tablets?
200
Name the two neurotransmitters that also act as hormones that are released from the adrenal medulla during shock.
What are epinephrine and norepinephrine?
200
These two conditions can also cause hypovolemic shock from excessive water loss through sweating.
What are heat exhaustion or heatstroke?
200
This is the most severe form of distributive shock, occurring when the body experiences an extreme hypersensitivity reaction to an antigen.
What is anaphylatic shock?
200
In the early stages of shock, the skin of a patient in septic shock may feel this way, unlike other types of shock.
What is warm and flushed?
200
For a patient in hypovolemic shock, the nurse should position the patient this way to promote venous return.
What is supine with legs elevated?
200
This stage of shock is characterized by organ failure and is usually unresponsive to treatment.
What is the Refractory (Irreversible) stage?
200
Order: Dopamine 400 mg in 250 mL D5W. The patient is to receive 5 mcg/kg/min. The patient weighs 80 kg. What is the dose in mcg/min?
What is 400 mcg/min?
300
During this condition, blood flow to the heart, brain, and liver is preserved by shunting blood from the intestines, kidneys, and skin.
What is shock?
300
Name this condition that occurs when the heart fails as a pump and decreases cardiac output.
What is cardiogenic shock?
300
This form of distributive shock is a life-threatening organ dysfunction caused by dysregulated host response to infection.
What is septic shock?
300
This measurement of "end-organ perfusion" is considered inadequate if it falls below 30 mL per hour.
What is urine output?
300
In cases of suspected septic shock, the nurse must obtain these before administering the first dose of antibiotics.
What are blood cultures?
300
This serious complication of shock involves widespread tiny blood clots followed by severe bleeding.
What is Disseminated Intravascular Coagulation (DIC)?
300
Order: 1,000 mL of Normal Saline over 8 hours. What is the hourly infusion rate?
What is 125 mL/hr?
400
Name the by-product of anaerobic metabolism within the bloodstream.
What is lactic acid?
400
This type of distributive shock is caused by a systemic infection and is the most common cause of death in ICUs.
What is septic shock?
400
This distributive shock is rare and occurs due to the nervous system injury or dysfunction that causes extensive dilation of peripheral blood vessels.
What is neurogenic shock?
400
A hallmark finding in the progressive stage of shock where the systolic blood pressure drops significantly.
What is hypotension?
400
This is the first-line fluid typically ordered for volume resuscitation in hypovolemic shock.
What is 0.9% Normal Saline (or Lactated Ringer’s)?
400
This condition occurs when shock leads to the failure of two or more organ systems.
What is Multiple Organ Dysfunction Syndrome (MODS)?
400
Order: Epinephrine 0.3 mg IM. Available: 1 mg/mL. How many mL will you administer?
What is 0.3 mL?
500
List the compensatory responses that, when together, produce the classic signs and symptoms of the first stage of shock.
What are tachycardia (rapid heart rate), tachypnea (rapid breathing), oliguria (producing small amounts of urine), restlessness, anxiety, pallor, and cool, clammy skin?
500
Name this condition caused by the loss of peripheral vascular resistance due to massive vasodilation.
What is distributive shock?
500
Name this condition that occurs when there is a blockage of blood flow to or from the heart, the rarest form of shock.
What is obstructive shock?
500
This lab value increases when cells switch to anaerobic metabolism due to lack of oxygen.
What is serum lactate?
500
A nurse caring for a patient in cardiogenic shock should question an order for this type of treatment, which could further tax the failing heart.
What are large IV fluid boluses?
500
Shock-related lung injury that results in non-cardiac pulmonary edema and severe hypoxemia.
What is Acute Respiratory Distress Syndrome (ARDS)?
500
Order: Heparin 1,200 units/hr IV. Available: Heparin 25,000 units in 500 mL NS. What is the pump rate in mL/hr?
What is 24 mL/hr?
