Early Vs Late Shock
A patient with rising HR and cool skin, but a normal BP, is in what stage of shock?
Early/compensated shock.
You suspect shock, what is always your first assessment priority?
Airway!
ABCs
In which type of shock is giving a fluid bolus potentially dangerous?
Cardiogenic
Which type of IV fluid do we give FIRST for most shock types?
Isotonic
Your post-op patient has a sudden drop in BP and a rapidly swelling abdomen. What is the FIRST suspicion?
Internal hemorrhage, hypovolemic shock
Which finding shows the body is no longer compensating?
Falling blood pressure
After stabilizing airway, what intervention should the nurse always take for any type of shock?
High-flow oxygen
A patient has bradycardia and warm, dry skin after a trauma. What shock is this likely?
Neurogenic
Which medication is first in anaphylactic shock?
IM epi
A patient recovering from an MI becomes extremely short of breath with frothy sputum. What action is PRIORITY?
Apply O2 and prepare to give diuretics
A patient in shock becomes restless, then becomes confused. What does this change indicate?
Worsening cerebral perfusion
A patient's BP is 78/40 after surgery. What is the best position to improve perfusion?
Supine with legs elevated.
Anaphylactic
Which medication class improves contractility in cariogenic shock?
Inotropes like dobutamine
A patient with septic shock has urine output less than 20mL/hr. What should the nurse anticipate next?
Kidney damage/failure, renal perfusion is decreased
You give fluids but the patient remains hypotensive. What does this suggest about the stage of shock?
It is progressive
You suspect septic shock. Before starting antibiotics, the nurse MUST do this?
Collect cultures.
Your patient has a fever and hypotension. What shock type is most likely?
Septic
What medication may be required if a patient in neurogenic shock has persistent bradycardia?
Atropine
A patient develops tingling lips, tightness in the throat, and wheezing after IV antibiotics. What do you do FIRST?
STOP infusion
The main indicator a patient is entering irreversible shock is this failure?
Multi-organ failure. Patient's may also go into DIC (disseminated intravascular coagulation).
Vasopressors
Non-hemorrhagic hypovolemic
Which medication class is needed when septic shock does NOT respond to fluids?
Vasopressors like norepinephrine
A patient with a spinal injury has low BP and HR is 48. Fluids made no improvement. What is your next action?
Prepare for vasopressors (BP) and give atropine (HR)