NURS 4121 MIDTERM – SHOCK Prep
Exam Questions And All Correct
Answers.
What is shock? - Answer A life-threatening medical condition where the body suffers from an
imbalance b/w demand and delivery of oxygen
Inadequate tissue perfusion resulting in cellular dysfunction and eventual organ failure
Body compensates to maintain vital organs
Hemostatic regulation requires... (4) - Answer 1. Cardiac output --> bodily requirements
2. Uncompromised vascular system
3. Adequate blood volume
4. Tissues can extract and use oxygen delivered
Types of Shock - Answer PUMP, PIPES, and FLUID
1. Cardiogenic --> due to the heart's impaired ability to pump blood (pump)
2. Distributive or vasogenic --> due to excessive vasodilation. There is no change in vascular tone - no
change in blood volume (pipes)
3. Hypovolemic --> Due to decreased intravascular volume (fluid)
Medical care for the patient with shock focuses on... (3) - Answer 1. Treating underlying cause
, 2. Increasing arterial oxygenation
3. Improving tissue perfusion
hypovolemic shock is caused by - Answer - Decreased circulating blood volume (most commonly from
hemorrhage)
- Develops from internal fluid shifts or external fluid losses
- Absolute and relative hypovolemia
Internal fluid shifts happen when... - Answer When fluid moves out of the blood vessels into another
fluid compartment (e.g., third spacing, internal hemorrhage, ascites, burns and tissue damage)
External fluid shifts - Answer E.g., GI bleed, traumatic amputation, diuretics, diarrhea, vomiting
Mild to Severe Hypovolemic shock - Answer Mild = <20% of blood volume is lost (750ml to 1000ml).
Vasoconstriction begins, blood is shunted to critical organs
Moderate = 20-40% of blood volume is lost (1500-2000ml). Decreased perfusion to organs such as the
kidneys, spleen, and pancreas
Severe = >40% of blood volume is lost (>2000ml). Decreased perfusion of the heart and brain.
Autoregulation in microcirculation is lost --> DIC.
What amount of blood volume loss can the body compensate for? - Answer <15% (750ml). This
depends on other co-morbidities, age, etc.
What happens with further blood volume loss (15-30%)? - Answer SNS responds. Increases HR, CO, RR
and depth, stroke volume decreased b/c decreased blood volume (vasoconstriction, shunting to critical
organs, decreased cap. refill, cool extremities, pulses decreased). Bowel sounds decrease, agitation,
anxiety, confusion, decreased urine output as kidneys compensate - increased Na+ and H2O retention -
RAA system.
Exam Questions And All Correct
Answers.
What is shock? - Answer A life-threatening medical condition where the body suffers from an
imbalance b/w demand and delivery of oxygen
Inadequate tissue perfusion resulting in cellular dysfunction and eventual organ failure
Body compensates to maintain vital organs
Hemostatic regulation requires... (4) - Answer 1. Cardiac output --> bodily requirements
2. Uncompromised vascular system
3. Adequate blood volume
4. Tissues can extract and use oxygen delivered
Types of Shock - Answer PUMP, PIPES, and FLUID
1. Cardiogenic --> due to the heart's impaired ability to pump blood (pump)
2. Distributive or vasogenic --> due to excessive vasodilation. There is no change in vascular tone - no
change in blood volume (pipes)
3. Hypovolemic --> Due to decreased intravascular volume (fluid)
Medical care for the patient with shock focuses on... (3) - Answer 1. Treating underlying cause
, 2. Increasing arterial oxygenation
3. Improving tissue perfusion
hypovolemic shock is caused by - Answer - Decreased circulating blood volume (most commonly from
hemorrhage)
- Develops from internal fluid shifts or external fluid losses
- Absolute and relative hypovolemia
Internal fluid shifts happen when... - Answer When fluid moves out of the blood vessels into another
fluid compartment (e.g., third spacing, internal hemorrhage, ascites, burns and tissue damage)
External fluid shifts - Answer E.g., GI bleed, traumatic amputation, diuretics, diarrhea, vomiting
Mild to Severe Hypovolemic shock - Answer Mild = <20% of blood volume is lost (750ml to 1000ml).
Vasoconstriction begins, blood is shunted to critical organs
Moderate = 20-40% of blood volume is lost (1500-2000ml). Decreased perfusion to organs such as the
kidneys, spleen, and pancreas
Severe = >40% of blood volume is lost (>2000ml). Decreased perfusion of the heart and brain.
Autoregulation in microcirculation is lost --> DIC.
What amount of blood volume loss can the body compensate for? - Answer <15% (750ml). This
depends on other co-morbidities, age, etc.
What happens with further blood volume loss (15-30%)? - Answer SNS responds. Increases HR, CO, RR
and depth, stroke volume decreased b/c decreased blood volume (vasoconstriction, shunting to critical
organs, decreased cap. refill, cool extremities, pulses decreased). Bowel sounds decrease, agitation,
anxiety, confusion, decreased urine output as kidneys compensate - increased Na+ and H2O retention -
RAA system.
