SHOCK IDENTIFICATION
A 58-year-old male patient with a history of MI presents with Hypotension, weak pulses, and a low cardiac output, despite normal intravascular volume. Which type of shock is most likely?
What is cardiogenic shock?
Name two vital signs would be elevated during the compensatory stage of shock while blood pressure remains normal.
What is tachycardia and tachypnea
A 62-year-old patient presents with signs of shock, including hypotension and reduced cardiac output. This combination of medications is administered to enhance myocardial contractility and decrease afterload, improving cardiac function and reducing the strain on the heart.
What are dobutamine and nitroglycerin?
A patient who has been receiving long-term vasopressor therapy develops black discoloration of the fingers and toes. What is the most likely cause of this condition?
What is ischemia/ Necrosis due to prolonged vasoconstriction
In septic shock, this diagnostic test must be completed before administering antibiotics.
Blood cultures from two different sites?
A 65-year-old patient presents with hypotension, bradycardia, and warm, dry skin. Given these symptoms, which type of shock is most likely?
What is neurogenic shock?
A 68-year-old patient in septic shock has a capillary refill time greater than 3 seconds. What does this indicate about the patient's circulatory status?
What is poor peripheral perfusion and inadequate blood flow.
This life-saving medication should be administered first in anaphylactic shock.
What is epinephrine?
In septic shock, this syndrome occurs when multiple body systems begin to fail despite treatment.
What is MOD?
This initial fluid bolus volume is recommended for resuscitation in shock states.
What is 30 mL/kg of 0.9% normal saline?
A 72-year-old patient with a history UTI presents with initially warm, flushed skin and mild hypotension. However, as the condition worsens, the patient begins to develop cool extremities and further hypotension. Based on this progression, which type of shock is most likely?
What is septic shock?
This lab value above 4 mmol/L strongly suggests inadequate tissue perfusion in a patient with suspected septic shock.
What is lactate (or lactic acid)?
When administering vasopressors,they must be given through this type of vascular access.
What is a central line?
Describe the significance of a urine output of less than 30 mL per hour over a 3-hour period in an adult and what it may indicate in the context of shock.
inadequate perfusion?
For a client in septic shock with a high glucose level and decreased level of consciousness, this intervention, involving the administration of 500 to 1,000 mL of isotonic crystalloid solution, should be prioritized first before considering vasopressor therapy."
"What is fluid resuscitation?"
A 60-year-old patient assessed using a passive leg raise maneuver. After the maneuver, the patient’s blood pressure increases. What does this indicate about the patient’s condition, and what underlying pathophysiological mechanism might explain this response?
What is fluid responsiveness?
In the compensatory phase of shock, blood is shunted away from these two body systems.
What are the gastrointestinal tract and kidneys?
This value is the target mean arterial pressure (MAP) when titrating vasopressors for a patient in shock.
What is greater than or equal to 65 mmHg?
A patient in shock presents with an elevated bilirubin level and jaundice. Which organ failure is most likely responsible for these findings?
What is the Liver
The nurse assesses the physiological mechanism that explains why patients in neurogenic shock present with bradycardia and warm, dry skin, as opposed to the tachycardia and cool, clammy skin seen in other types of shock. What is the underlying mechanism?
What is loss of sympathetic tone? (or What is disruption of sympathetic nervous system due to spinal cord injury?)
A 70-year-old patient with a history of congestive heart failure presents with hypotension, jugular vein distention, and pulmonary crackles upon auscultation. Given these findings, which type of shock is most likely, and what pathophysiological processes are contributing to these clinical manifestations?
What is cardiogenic shock?
A pregnant woman in her third trimester presenting with severe abdominal pain and vaginal bleeding should be prioritized due to risk of this type of shock.
What is hemorrhagic shock?
A 72-year-old patient with septic shock is receiving vasopressin to support blood pressure. The nurse notes the patient's blood pressure has risen to 190/100mmHg. The patient also exhibits signs of confusion and chest discomfort. What is the nurse's first priority action?"
What is titrate down (decrease) the vasopressin
This life-threatening complication of shock occurs when the body’s inability to maintain adequate tissue perfusion leads to widespread cellular dysfunction, multi-organ failure, and an increased risk of death despite intervention.
What is refractory shock?
In a postpartum patient presenting with multiple large clots and a boggy uterus, the presence of tachycardia, hypotension, oliguria, and altered mental status are indicative of which type of shock?
What is hemorrhagic shock, which is a type of hypovolemic shock caused by significant blood loss.