COMPREHENSIVE STUDY AND ANSWER GUIDE
◉ Hematological system w/ shock. Answer: Sluggish blood flow
allows for formation of microemboli & DVT/PE
Hypoperfusion to the liver causes dec clotting factors which puts pt
at risk for DIC
Early on, pt will have leukopenia
◉ Appearances w/ shock. Answer: Early: Peripheral
vasoconstriction makes pt look pale, cool, clammy & moist
Neurogenic shock & early septic shock cause vasodilation so pt look
warm, dry, & flushed
Anaphylactic shock causes pt to look flushed w/ urticaria,
angiodema, & pruritus
LAte shock: Pt looks cool, cyanotic, mottled
,◉ Hypovolemic shock. Answer: Loss of intravascular blood volume
Results from
• Internal bleeding
• Long bone fracture
• Ruptured spleen
• Surgical procedure
• 3rd spacing (ex: Ascites)
• Trauma
• GI losses (Vomiting, diarrhea)
• Addison's disease
• DI
• Excessive diuresis (HHNK, DKA)
◉ Hemodynamic changes w/ hypovolemic shock. Answer: Dec SV
Dec CO
Dec CI
Dec PAP
Dec O2 consumption
Inc SVR
, ◉ What should a nurse expect to see in a pt w/ hypovolemic shock?.
Answer: Pale/cool skin
Dec peripheral pulses
Hypotension
Inc RR & HR
Resp alkalosis
Flat jugular vein (dec CVP & PAP)
Dec UO
◉ What should be given to help treat hypovolemic shock?. Answer:
Crystalloids
---> 0.9% NaCl or LR
---> Give 3x the volume needed
---> Causes hemodilution w/ dec Hgb & O2 delivery
Colloids
---> Dec risk for pulmonary edema & maintains oncotic pressure
---> Works better than crystalloids for volume expander BUT it is
expensive & alters coagulation
Blood products
---> Pt's own blood (autologous)