JSCC NUR 114/115 Shock Questions With
Complete Solutions
Absolute Hypovolemia Correct Answers
Hemorrhage, diarrhea, Diabetes Insipidus,
Hyperglycemia r/t DKA, diuresis (too much Lasix)
Anaphylactic Shock Correct Answers When you
have a severe rx with capillary leak and
permeability. Vasodilation, blood flow to organs
decreases, neurological compromise, respiratory
distress r/t edema, bronchospasms, decreased CO,
and circulatory failure. Can lead to cardiac arrest.
Anasarca Correct Answers Profound edema
throughout entire body.
Assess--Allergies Correct Answers Because
anaphylaxis is a type of shock, so if exposed to
allergens it is important to know.
Assess--Hx Correct Answers Onset and duration of
signs and symptoms.
Any prior treatments before ED?
Assess--Tissue Perfusion Correct Answers Cap
refill, pulses, UP, VS, may need CVP monitoring if
severe enough or even arterial line (Live BP), LOC
r/t cerebral tissue perfusion. Skin (cool and mottled
means poor perfusion).
,Cardiogenic Shock Correct Answers 50-80%
Mortality --> Pump shock. The ability of the heart
to contract and pump blood around the body is
impaired. This decreases O2 and blood to tissues.
Inadequate perfusion.
Cardiogenic Shock(CS) Med-Dobutamine Correct
Answers Inotropic to improve CO. Increases SV.
Causes of Cardiogenic Shock? Correct Answers MI
is most common cause. If large enough MI then at
risk for pump shock, cardiomyopathy, severe
hypotension, pericardial tamponade r/t increased
pressure on the heart, ventricular hypertrophy,
dysrythmias, and valvular dx.
Changes during Compensatory Stage of Shock
Correct Answers Lactic acid buildup can cause
palpitations, HA, alt. mental status, muscle
weakness. There is decreased motility,
decreased/slow bowel sounds, paralytic ileus r/t to
decreased blood flow. Cool/clammy skin unless
septic then they are warm/flushed. RR increases in
response to metabolic acidosis, so you breathe
faster to blow off extra CO2 to get blood pH back to
normal. SNS tries to maintain BP w/RAA system,
but this can increase the nutrients and O2 your
heart needs, so it is hard on your heart.
, Clinical S+S during Compensatory Stage of Shock
Correct Answers This is clinically apparent now.
There is a drop in bp from decreased CO. This
activates the bar. receptors which activates SNS
which causes renin-angiotensinogen-aldosterone
system to increase CO + BP. Causes
vasoconstriction and holds onto Na and water to
increase volume, BP and Co. Why when you're
dehydrated you pee less.
Compensatory Stage of Shock Correct Answers
Attempt to overcome consequences of anaerobic
metabolism and maintain homeostasis. The lactic
acid builds up.
Continued Nursing Management of Septic Shock?
Correct Answers Strict I&O. Daily weights. Albumin
lab to assess nutr. status to see protein content.
Albumin IV helps keep volume in the intravascular
spaces.
CS Med--Antiarrhythmics Correct Answers
Especially if dysrhythmias is a cause of shock.
Lopressor, amiodarone, Cardizem (Diltiazem).
CS Med--Dopamine Correct Answers Improves
contractility of heart and may increase HR slightly.
High doses can cause vasoconstriction, which can
increase systemic vascular resistance which makes
Complete Solutions
Absolute Hypovolemia Correct Answers
Hemorrhage, diarrhea, Diabetes Insipidus,
Hyperglycemia r/t DKA, diuresis (too much Lasix)
Anaphylactic Shock Correct Answers When you
have a severe rx with capillary leak and
permeability. Vasodilation, blood flow to organs
decreases, neurological compromise, respiratory
distress r/t edema, bronchospasms, decreased CO,
and circulatory failure. Can lead to cardiac arrest.
Anasarca Correct Answers Profound edema
throughout entire body.
Assess--Allergies Correct Answers Because
anaphylaxis is a type of shock, so if exposed to
allergens it is important to know.
Assess--Hx Correct Answers Onset and duration of
signs and symptoms.
Any prior treatments before ED?
Assess--Tissue Perfusion Correct Answers Cap
refill, pulses, UP, VS, may need CVP monitoring if
severe enough or even arterial line (Live BP), LOC
r/t cerebral tissue perfusion. Skin (cool and mottled
means poor perfusion).
,Cardiogenic Shock Correct Answers 50-80%
Mortality --> Pump shock. The ability of the heart
to contract and pump blood around the body is
impaired. This decreases O2 and blood to tissues.
Inadequate perfusion.
Cardiogenic Shock(CS) Med-Dobutamine Correct
Answers Inotropic to improve CO. Increases SV.
Causes of Cardiogenic Shock? Correct Answers MI
is most common cause. If large enough MI then at
risk for pump shock, cardiomyopathy, severe
hypotension, pericardial tamponade r/t increased
pressure on the heart, ventricular hypertrophy,
dysrythmias, and valvular dx.
Changes during Compensatory Stage of Shock
Correct Answers Lactic acid buildup can cause
palpitations, HA, alt. mental status, muscle
weakness. There is decreased motility,
decreased/slow bowel sounds, paralytic ileus r/t to
decreased blood flow. Cool/clammy skin unless
septic then they are warm/flushed. RR increases in
response to metabolic acidosis, so you breathe
faster to blow off extra CO2 to get blood pH back to
normal. SNS tries to maintain BP w/RAA system,
but this can increase the nutrients and O2 your
heart needs, so it is hard on your heart.
, Clinical S+S during Compensatory Stage of Shock
Correct Answers This is clinically apparent now.
There is a drop in bp from decreased CO. This
activates the bar. receptors which activates SNS
which causes renin-angiotensinogen-aldosterone
system to increase CO + BP. Causes
vasoconstriction and holds onto Na and water to
increase volume, BP and Co. Why when you're
dehydrated you pee less.
Compensatory Stage of Shock Correct Answers
Attempt to overcome consequences of anaerobic
metabolism and maintain homeostasis. The lactic
acid builds up.
Continued Nursing Management of Septic Shock?
Correct Answers Strict I&O. Daily weights. Albumin
lab to assess nutr. status to see protein content.
Albumin IV helps keep volume in the intravascular
spaces.
CS Med--Antiarrhythmics Correct Answers
Especially if dysrhythmias is a cause of shock.
Lopressor, amiodarone, Cardizem (Diltiazem).
CS Med--Dopamine Correct Answers Improves
contractility of heart and may increase HR slightly.
High doses can cause vasoconstriction, which can
increase systemic vascular resistance which makes
