NUR 440 - Exam 3 with verified solutions
Causes |of |cardiogenic |shock |- |correct |answer |-MI, |Myocardial |contusion, |cardiomyopathy, |
myocarditis, |severe |HF, |dysrhythmias, |valvular |dysfunction, |ventricular |septal |rupture
Assessment |of |cardiogenic |shock |- |correct |answer |-Increased |HR, |Dysrhythmias, |decreased |BP, |chest
|pain, |tachypnea, |oliguria, |cool |and |pale |skin, |decreased |mentation, |left |ventricular |failure, |right |
ventricular |failure, |decreased |cardiac |output |and |cardiac |index
Causes |of |hypovolemic |shock |- |correct |answer |-External |loss |of |blood, |external |loss |of |fluid, |
internal |sequestration |of |blood/fluid
Assessment |of |hypovolemic |shock |- |correct |answer |-Increased |HR, |decreased |BP, |tachypnea, |
oliguria, |decreased |mentation, |cool |and |pale |skin, |flat |neck |veins, |increased |hct |if |from |
dehydration, |decreased |hct |if |from |blood |loss
What |is |SIRS? |- |correct |answer |-Systemic |Inflammatory |Response |Syndrome
Precipitation |factors |for |SIRS |- |correct |answer |-Infection, |ischemia, |trauma, |hemorrhage, |
pancreatitis
SIRS |demonstrates |at |least |2 |of |these: |- |correct |answer |-Temp: |<36 |or |>38
HR |>90
RR |>20 |or |PaCO2 |<32
WBC |>12,000 |or |<4,000
Shock |causes |- |correct |answer |-Decrease |in |cardiac |function, |blood |volume, |vascular |tone
Stage |1: |Initial |stage |of |shock |- |correct |answer |-No |obvious |signs/symptoms. |
Decrease |in |CO
, Alteration |in |tissue |perfusion
Aerobic |to |anaerobic |metabolism
Stage |2: |Compensatory |stage |of |shock |- |correct |answer |-S+S |are |noticeable. |
HR |and |RR |happen |first. |Mental |status |changes |like |anxiety |and |restlessness. |Neural, |endocrine, |
and |chemical |responses
Stage |2: |Neural |Response |- |correct |answer |-BP |decreases. |Baro/chemoreceptors |sense |change. |
Message |to |medulla. |Release |epi |and |norepi |(catecholamines). |Then, |increase |HR |and |contractility, |
dilate |coronary |arteries, |and |systemic |vasoconstriction
Stage |2: |Endocrine |Response |- |correct |answer |-Release |of |ACTH |and |ADH. |Activation |of |RAA |
response.
Stage |2: |Endocrine |Response |Symptoms |- |correct |answer |-Decreased |urine |output. |Retained |sodium
|and |water. |Increased |urine |specific |gravity. |Decreased |creatinine |clearance. |Hyperglycemia.
Stage |2: |Chemical |Response |- |correct |answer |-Changes |in |CO2 |concentration |due |to |altered |
perfusion |causes |increased |RR |to |compensate. |Respiratory |alkalosis |causes |cerebral |
vasoconstriction.
Stage |2: |Chemical |Response |Symptoms |- |correct |answer |-Increased |RR. |Respiratory |alkalosis |early |
on. |Changes |in |mental |status |like |restlessness |and |confusion.
Stage |3: |Progressive |Stage |- |correct |answer |-Compensatory |mechanisms |start |to |fail. |Continued |
anaerobic |metabolism. |Decrease |in |BP. |Capillary |pooling. |Lack |of |ATP |= |Cellular |edema
Stage |4: |Refractory |Stage |- |correct |answer |-Shock |is |irreversible. |Organs |begin |to |die |(MODS). |
Death |occurs |in |response |to |lack |of |organ |perfusion.
Multiple |Organ |Dysfunction |Syndrome |(MODS) |- |correct |answer |-2 |or |more |organ |systems |fail
Causes |of |cardiogenic |shock |- |correct |answer |-MI, |Myocardial |contusion, |cardiomyopathy, |
myocarditis, |severe |HF, |dysrhythmias, |valvular |dysfunction, |ventricular |septal |rupture
Assessment |of |cardiogenic |shock |- |correct |answer |-Increased |HR, |Dysrhythmias, |decreased |BP, |chest
|pain, |tachypnea, |oliguria, |cool |and |pale |skin, |decreased |mentation, |left |ventricular |failure, |right |
ventricular |failure, |decreased |cardiac |output |and |cardiac |index
Causes |of |hypovolemic |shock |- |correct |answer |-External |loss |of |blood, |external |loss |of |fluid, |
internal |sequestration |of |blood/fluid
Assessment |of |hypovolemic |shock |- |correct |answer |-Increased |HR, |decreased |BP, |tachypnea, |
oliguria, |decreased |mentation, |cool |and |pale |skin, |flat |neck |veins, |increased |hct |if |from |
dehydration, |decreased |hct |if |from |blood |loss
What |is |SIRS? |- |correct |answer |-Systemic |Inflammatory |Response |Syndrome
Precipitation |factors |for |SIRS |- |correct |answer |-Infection, |ischemia, |trauma, |hemorrhage, |
pancreatitis
SIRS |demonstrates |at |least |2 |of |these: |- |correct |answer |-Temp: |<36 |or |>38
HR |>90
RR |>20 |or |PaCO2 |<32
WBC |>12,000 |or |<4,000
Shock |causes |- |correct |answer |-Decrease |in |cardiac |function, |blood |volume, |vascular |tone
Stage |1: |Initial |stage |of |shock |- |correct |answer |-No |obvious |signs/symptoms. |
Decrease |in |CO
, Alteration |in |tissue |perfusion
Aerobic |to |anaerobic |metabolism
Stage |2: |Compensatory |stage |of |shock |- |correct |answer |-S+S |are |noticeable. |
HR |and |RR |happen |first. |Mental |status |changes |like |anxiety |and |restlessness. |Neural, |endocrine, |
and |chemical |responses
Stage |2: |Neural |Response |- |correct |answer |-BP |decreases. |Baro/chemoreceptors |sense |change. |
Message |to |medulla. |Release |epi |and |norepi |(catecholamines). |Then, |increase |HR |and |contractility, |
dilate |coronary |arteries, |and |systemic |vasoconstriction
Stage |2: |Endocrine |Response |- |correct |answer |-Release |of |ACTH |and |ADH. |Activation |of |RAA |
response.
Stage |2: |Endocrine |Response |Symptoms |- |correct |answer |-Decreased |urine |output. |Retained |sodium
|and |water. |Increased |urine |specific |gravity. |Decreased |creatinine |clearance. |Hyperglycemia.
Stage |2: |Chemical |Response |- |correct |answer |-Changes |in |CO2 |concentration |due |to |altered |
perfusion |causes |increased |RR |to |compensate. |Respiratory |alkalosis |causes |cerebral |
vasoconstriction.
Stage |2: |Chemical |Response |Symptoms |- |correct |answer |-Increased |RR. |Respiratory |alkalosis |early |
on. |Changes |in |mental |status |like |restlessness |and |confusion.
Stage |3: |Progressive |Stage |- |correct |answer |-Compensatory |mechanisms |start |to |fail. |Continued |
anaerobic |metabolism. |Decrease |in |BP. |Capillary |pooling. |Lack |of |ATP |= |Cellular |edema
Stage |4: |Refractory |Stage |- |correct |answer |-Shock |is |irreversible. |Organs |begin |to |die |(MODS). |
Death |occurs |in |response |to |lack |of |organ |perfusion.
Multiple |Organ |Dysfunction |Syndrome |(MODS) |- |correct |answer |-2 |or |more |organ |systems |fail
