SHOCK STATES
A patient has warm skin, bounding pulses, low BP, and wheezing after eating peanuts. Identify the shock type AND the priority intervention.
What is anaphylactic shock and administer epinephrine.
Before giving diltiazem or verapamil, the nurse must assess what?
What are heart rate and blood pressure!
This congenital defect involves a hole between the atria, allowing mixing of blood, but many children live symptom-free into adulthood.
What is Atrial Septal Defect (ASD).
A patient in early shock has cool skin and delayed cap refill. Which lab BEST helps evaluate tissue hypoxia and adequacy of perfusion?
What is serum lactate (0.5–2.2 mEq/L) elevated levels indicate anaerobic metabolism and poor perfusion.
This EKG wave represents atrial depolarization
What is the P wave
All forms of shock lead to decreased perfusion. Which lab value BEST indicates tissue hypoxia and anaerobic metabolism?
What is elevated serum lactate
A patient taking lisinopril develops a persistent dry cough. What is the priority action and the expected outcome?
What is notifying the provider and expecting a change of order to ARBs
This defect includes four abnormalities and causes cyanosis in infancy.
What is Tetralogy of Fallot (TOF)
A patient comes to the ED with chest pain. The provider orders troponin I and troponin T. The nurse knows an elevated value means what?
What is cardiac muscle injury or infarction (MI). Troponins rise 3–4 hours after injury, peak 10–12 hours, and remain elevated up to 14 days.
A patient presents with irregular rhythm, absent P waves, and reports feeling lightheaded. What complication is this patient MOST at risk for?
What are clots/stroke risk due to atrial fibrillation
A patient with sudden chest pain, severe SOB, JVD, and clear lungs shows a diagnosis of a pulmonary embolism are signs of what kind of shock?
Obstructive shock
A patient asks why they can’t take sildenafil with nitroglycerin. What is the most accurate explanation?
What is both cause vasodilation = severe hypotension
This defect is life-threatening at birth, with the pulmonary artery and aorta switched.
What is Transposition of the Great Arteries.
A patient with unstable angina has a troponin level within normal range but an elevated CK-MB. What does this combination MOST likely indicate?
What is a recent cardiac injury within the last 10–24 hours, or early ischemia that has not yet triggered troponin elevation. CK-MB rises and falls faster and is useful for detecting reinfarction.
You see a wide QRS with a regular but very fast rhythm. The patient is pale, hypotensive, and dizzy.
What is the priority action?
What is assess the patient and prepare for emergency intervention this is a sign of Ventricular Tachycardia.
A patient in shock shows decreased urine output, altered mental status, and weak pulses. Explain WHY urine output decreases.
What is decreased kidney perfusion due to low MAP. Mean Arterial Pressure (MAP) is defined as the average pressure in a person's arteries throughout the cardiac cycle. It is essential for ensuring that organs receive adequate blood flow, which is necessary for delivering oxygen and nutrients.
A patient is prescribed metoprolol. Which assessment finding requires HOLDING the medication
What is HR < 60 or symptomatic hypotension
In Tetralogy of Fallot, toddlers may squat during episodes. Why?
What is to increase systemic vascular resistance and improve oxygenation
A patient with chest pain has the following labs:
LDL = 165 mg/dL
HDL = 38 mg/dL
Triglycerides = 260 mg/dL
Based on these findings, what perfusion-related condition is the patient MOST at risk for, and why?
What is atherosclerosis leading to coronary artery disease, because high LDL, low HDL, and high triglycerides accelerate plaque formation and impaired perfusion
A patient suddenly goes into a rhythm with no identifiable waves, chaotic electrical activity, and no pulse. What rhythm is this, and what is the FIRST action?
What is ventricular fibrillation and call a code/start CPR immediately
A trauma patient has hypotension, tachycardia, cool skin, delayed cap refill, and a history of vomiting and diarrhea. What type of shock do you suspect?
What is hypovolemic shock?
A patient just started taking statins. Which teaching is PRIORITY?!?
What is take at night and report muscle pain!
A child with ASD suddenly becomes fatigued and short of breath. What complication should the nurse assess for?
What is heart failure due to increased blood flow to the right side.
A patient on an ACE inhibitor has a potassium level of 5.8 mEq/L. Which complication is the nurse MOST concerned about?
What is cardiac dysrhythmias due to hyperkalemia. Many perfusion medications (ACE inhibitors, ARBs, potassium-sparing diuretics) can increase potassium, affecting cardiac rhythm and contraction.
A patient with a history of MI shows new ST-segment elevation. What is happening physiologically?
What is active myocardial injury. STEMI An infarction is a blockage of blood flow to the myocardium, the heart muscle.