NUR 430 Final - LAST EXAM EVER :) Questions With Complete Solutions

What is shock? correct answer: Shock syndrome is generalized systemic response to inadequate tissue perfusion and circulatory failure. Ineffective tissue perfusion Acute circulatory failure What are the stages in shock syndrome? correct answer: Initial Compensatory Progressive Refractory What are the signs of the initial stage in shock syndrome? correct answer: CO is decreased and tissue perfusion is impaired, ability to deliver oxygen to tissues is impaired, aerobic metabolism is beginning to be impaired Sometimes difficult to recognize What is the symptoms of the compensatory stage in shock syndrome? correct answer: SNS comes into play with neural, hormonal, and chemical responses Increased HR and contractility Arterial and venous vasoconstriction Shunting of blood to vital organs Activation of renin response which causes angiotensin II release Stimulation of anterior pituitary and adrenal medulla with: ADH and aldosterone secretion ACTH to stimulate adrenals with increased glucocorticoid release and thus increases serum glucose levels Release of epinephrine and norepinephrine Hyperventilation to neutralize lactic acidosis (chemical) What are the signs of the progressive stage of shock syndrome? correct answer: Energy from anaerobic metabolism is not enough and irreversible damage begins Sodium-potassium pump fails, causing cells to swell Cellular energy production halts, mitochondria swell and rupture Cells cannot utilize oxygen even if the oxygen delivery was adequate Destructive enzymes are released & autodigestion of cells causing cell death All body systems are affected: Cardiac: myocardial hypoperfusion lactic acidosis release of MDF (myocardial depressant factor) which is released