RNSG 2432, Exam 4: Module 15 Shock & Module 17 Critical Care/Disaster|Advanced Emergency and Critical Care Nursing Examination: Shock Pathophysiology, Hypovolemic Cardiogenic and Septic Shock Progression, Systemic Inflammatory Response Syndrome Criteria,

RNSG 2432, Exam 4: Module 15 Shock & Module 17 Critical Care/Disaster|Advanced Emergency and Critical Care Nursing Examination: Shock Pathophysiology, Hypovolemic Cardiogenic and Septic Shock Progression, Systemic Inflammatory Response Syndrome Criteria, Sepsis Early Recognition, Septic Shock Vasopressor Management, Tissue Perfusion Failure and Lactic Acidosis, Mean Arterial Pressure Monitoring, Central Venous Pressure Hemodynamic Assessment, Rapid Fluid Resuscitation and Lactated Ringers Therapy, Broad Spectrum Antibiotic Initiation, Trauma Triage Emergency Severity Index Protocols, ABCDE Primary Trauma Survey Assessment, Secondary Head to Toe Trauma Evaluation, Rapid Sequence Intubation Airway Stabilization, Mechanical Ventilation Critical Support, Multiple Organ Dysfunction Syndrome Progression, Compensatory Progressive and Refractory Shock Stages, Heat Stroke Hyperthermia Emergency Management, Hypothermia Rewarming Treatment Protocols, Submersion Injury and Drowning Resuscitation, Snakebite Envenomation Antivenom Therapy Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 Shock Defined: •Shock = decreased tissue perfusion and impaired cellular metabolism. •The demand for O2 and nutrients exceeds the supply •What builds up in the body in the absence of oxygen? lactic acid •Shock of any cause is life-threatening as it leads to ischemia and cellular death Shock: Emergency Management -Assess & monitor airway, breathing and circulation -Stabilize cervical spine -Assess for life threatening injuries – such as? pneumothorax, internal bleeding, cardiac tampanade -Control any external bleeding -Give high flow 02 – such as? 100% non-rebreather -Assess need for intubation & mechanical ventilation -Establish IV access – what type? 2 large bore -Begin fluid resuscitation as ordered -Draw blood for ordered labs -Consider vasopressor therapy when? pt not responding to fluid therapy, still hypotensive -Insert indwelling urinary catheter -Obtain 12 lead ECG normal CVP 2-8 mmHg goal CVP for hypovolemic shock 15 goal CVP for septic shock 8-12 Sepsis:What will we see? General variables: = early signs -Altered mental status -Fever (100.9 F) -Heart rate 90 -RR than 22 -Altered mental status -Hyperglycemia in absence of diabetes (glucose 140) -SBP 100 or narrowed pulse pressure *Review Table 42.4 Diagnostic Criteria for Sepsis Sepsis 1.What findings would indicate inflammation? 2.What findings would indicate organ dysfunction? 3.What findings would indicate decreased tissue perfusion? 1. CRP, ESR, WBC 2. inc. creatinine, inc. INR, inc. liver func., inc. CO2, inc. amonia, dec. platelets 3. inc. lactate, cool/clammy, modeling of skin, cap refill, pulses SIRS criteria precursor to sepsis 2 or more is positive ( + underlying infection = sepsis) temp 100.4 F or 96.8 F HR 90 RR 22 PaCO2 32mmHg WBC 12K or 4K or 10% bands Sepsis: Treatment Sepsis is a medical emergency! It needs to be treated as such. In other words, sepsis should be treated as quickly and efficiently as possible as soon as it has been identified. Goals: •Rapid assessment of infectious vs. noninfectious causes of acute illness! •Administer antimicrobials immediately, ideally within 1 hour of recognition! Sepsis:Common IV Antibiotic Therapy -piperacillin-tazobactam (zosyn) -vancomycin