NSG 430 Exam 4
NSG 430 Exam 4 – UPDATED Questions with 100% Verified
Answers
Grand Canyon University
NSG 430
NSG 430 Exam 4
Q1 Low blood flow cardiogenic shock
A -comprimised cardiac output. systolic and diastolic dysfunction CAUSES -MI,
cardiomyopathy, blunt cardiac injury, severe systemic or pulmonary HTN, cardiac
tamponade, myocardial depression from metabolic problems EARLY MANIFESTATIONS
-tachycardia -hypotension -narrowed pulse pressure -increased myocardial o2 consumption
-tachypnea, pulmonary congestion, decreased cap refill time -anxiety, confusion, agitation,
increased pulmonary artery wedge pressure, decreased UO INTERPROFESSIONAL CARE
-goal: decrease heart workload -angioplasty w stenting, vavle replacement -hemodynamic
monitoring -drugs: nitrates, diuretics, vasodilators, b adrenergic blockers
Q2 Low blood flow hypovolemic shock
A -absolute hypovolemia: loss of intravascular fluid volume -when fluid moves out of the
vascular space into the extravascular space -*burns? TYPES? -hemorrhage, vomiting,
diarrhea -fistula drainage, diabetes insipidus -hyperglycemia, diuresis MANIFESTATIONS
-anxiety, tachypnea, increased CO, heart rate -decrease in stroke volume, PAWP, urinary
output -*if loss >30%, blood volume needs replacing INTERPROFESSIONAL CARE -*3:1 rule-
3ml of isotonic crystalloid for every 1ml of EBL
Q3 Distributive shock: neurogenic shock
A -can occur within 30 minutes of a spinal cord injury at the fifth thoracic vertebra or above.
can last up to 6 weeks. -can be induced by spinal anesthesia -DEFINED: massive
vasodilation, leading to pooling of blood in vessels, tissue hypoperfusion, impaired cellular
metabolism MANIFESTATIONS -hypotension, bradycardia -inability to regulate body
temperature (heat loss)-> poikilothermia (taking on temp of environment) -dry skin
INTERPROFESSIONAL CARE -*stability for spinal cord injury -*atropine for hypotension and
bradycardia -monitor for hypothermia
Q4 Distributive shock: anaphylactic shock
Page 1
, NSG 430 Exam 4
A -acute life threatening allergic reaction -massive vasodilation, release of vasoactive
mediators, increased capillary permeability MANIFESTATIONS -anxiety, confusion, dizzy
-sense of impending doom, chest pain -incontinence -swelling of lips and tongue, flushing,
allergic rxn sx -*resp distress and circulatory failure INTERPROFESSIONAL CARE -epi,
diphenhydramine, famotidine -*maintain patent airway (bronchodilators, aerosolized epi, ET
tube may be necessary -*fluid replacement
Q5 Distributive shock: septic shock
A -sepsis: systemic inflammatory response to suspected or documented infection SEPTIC
SHOCK -sepsis w hypotension despite fluid resuscitation -inadequate tissue perfusion
resulting in hypoxia MANIFESTATIONS -increased coagulation and inflammation, decreased
fibrinolysis: formation of microthrombi, obstruction of microvasculature -hyperdynamic
state- increased CO and decreased SVR -tachypnea, hyperventilation -> *respiratory
alkalosis and resp failure -urine output decreased -altered neuro status -GI dysfunction, GI
bleed, paralytic ileus PATHOPHYSIOLOGICAL EFFECTS -vasodilation -maldistribution of blood
flow -myocardial dysfunction (decreased EF and ventricular dilation) INTERPROSFESSIONAL
CARE -antibiotics within 1st hour!!! -keep glucose <180 -give PPIs for stress ulcer
prophylaxis (pantoprazole) -DVT: heparin, enoxaparin -exogenous vasopressin -*IV
corticosteroids: for pts who cannot maintain an adequate BP with vasopressor therapy
despite fluid resuscitation
Q6 Obstructive shock
A CAUSES -SVC syndrome, abdominal compartment syndrome, cardiac tamponade, tension
pneumo, pulmonary embolism MANIFESTATIONS -decreased CO, increased afterload -*need
rapid assessments and immediate tx CARE -*early recognition and tx -mechanical
decompression -thrombolytic therapy -radiation, debulking, removal of mass
-decompressive laparotomy
Q7 Stages of shock
Page 2
NSG 430 Exam 4 – UPDATED Questions with 100% Verified
Answers
Grand Canyon University
NSG 430
NSG 430 Exam 4
Q1 Low blood flow cardiogenic shock
A -comprimised cardiac output. systolic and diastolic dysfunction CAUSES -MI,
cardiomyopathy, blunt cardiac injury, severe systemic or pulmonary HTN, cardiac
tamponade, myocardial depression from metabolic problems EARLY MANIFESTATIONS
-tachycardia -hypotension -narrowed pulse pressure -increased myocardial o2 consumption
-tachypnea, pulmonary congestion, decreased cap refill time -anxiety, confusion, agitation,
increased pulmonary artery wedge pressure, decreased UO INTERPROFESSIONAL CARE
-goal: decrease heart workload -angioplasty w stenting, vavle replacement -hemodynamic
monitoring -drugs: nitrates, diuretics, vasodilators, b adrenergic blockers
Q2 Low blood flow hypovolemic shock
A -absolute hypovolemia: loss of intravascular fluid volume -when fluid moves out of the
vascular space into the extravascular space -*burns? TYPES? -hemorrhage, vomiting,
diarrhea -fistula drainage, diabetes insipidus -hyperglycemia, diuresis MANIFESTATIONS
-anxiety, tachypnea, increased CO, heart rate -decrease in stroke volume, PAWP, urinary
output -*if loss >30%, blood volume needs replacing INTERPROFESSIONAL CARE -*3:1 rule-
3ml of isotonic crystalloid for every 1ml of EBL
Q3 Distributive shock: neurogenic shock
A -can occur within 30 minutes of a spinal cord injury at the fifth thoracic vertebra or above.
can last up to 6 weeks. -can be induced by spinal anesthesia -DEFINED: massive
vasodilation, leading to pooling of blood in vessels, tissue hypoperfusion, impaired cellular
metabolism MANIFESTATIONS -hypotension, bradycardia -inability to regulate body
temperature (heat loss)-> poikilothermia (taking on temp of environment) -dry skin
INTERPROFESSIONAL CARE -*stability for spinal cord injury -*atropine for hypotension and
bradycardia -monitor for hypothermia
Q4 Distributive shock: anaphylactic shock
Page 1
, NSG 430 Exam 4
A -acute life threatening allergic reaction -massive vasodilation, release of vasoactive
mediators, increased capillary permeability MANIFESTATIONS -anxiety, confusion, dizzy
-sense of impending doom, chest pain -incontinence -swelling of lips and tongue, flushing,
allergic rxn sx -*resp distress and circulatory failure INTERPROFESSIONAL CARE -epi,
diphenhydramine, famotidine -*maintain patent airway (bronchodilators, aerosolized epi, ET
tube may be necessary -*fluid replacement
Q5 Distributive shock: septic shock
A -sepsis: systemic inflammatory response to suspected or documented infection SEPTIC
SHOCK -sepsis w hypotension despite fluid resuscitation -inadequate tissue perfusion
resulting in hypoxia MANIFESTATIONS -increased coagulation and inflammation, decreased
fibrinolysis: formation of microthrombi, obstruction of microvasculature -hyperdynamic
state- increased CO and decreased SVR -tachypnea, hyperventilation -> *respiratory
alkalosis and resp failure -urine output decreased -altered neuro status -GI dysfunction, GI
bleed, paralytic ileus PATHOPHYSIOLOGICAL EFFECTS -vasodilation -maldistribution of blood
flow -myocardial dysfunction (decreased EF and ventricular dilation) INTERPROSFESSIONAL
CARE -antibiotics within 1st hour!!! -keep glucose <180 -give PPIs for stress ulcer
prophylaxis (pantoprazole) -DVT: heparin, enoxaparin -exogenous vasopressin -*IV
corticosteroids: for pts who cannot maintain an adequate BP with vasopressor therapy
despite fluid resuscitation
Q6 Obstructive shock
A CAUSES -SVC syndrome, abdominal compartment syndrome, cardiac tamponade, tension
pneumo, pulmonary embolism MANIFESTATIONS -decreased CO, increased afterload -*need
rapid assessments and immediate tx CARE -*early recognition and tx -mechanical
decompression -thrombolytic therapy -radiation, debulking, removal of mass
-decompressive laparotomy
Q7 Stages of shock
Page 2
