EMERGENCY DEPARTMENT RN A PROPHECY
EXAM COMPREHENSIVE STUDY GUIDE 2026
◉ Hypovolemic Shock. Answer: Decreased cellular perfusion
secondary to lack of circulating volume or not ENOUGH GAS.
◉ Cardiogenic Shock. Answer: Decreased cellular perfusion
secondary to maldistribution of oxygen to the periphery. Its like
adding a larger engine without increasing the size of the tank.
◉ Obstructive shock. Answer: Decreased cellular perfusion secondry
to obstruction of blood into or out of the ventricles (eg. pulmonary
emboli, tamponade, tension pneumo. Like getting dirt or blockage in
the fuel line.
◉ Prolonged lactic acidosis leads to microvascular thrombosis and
disseminated intravascular coagulation. Answer:
◉ Compensated Shock. Answer: When patient is able to maintain
blood pressure. Body attempting to maintain homeostasis. Increases
perfusion to brain, decreases blood flow to kidneys.
,◉ Uncompensated Shock. Answer: Shock at cellular level.
Intracellular fluid leaks into interstitium causing third spacing and
edema, bp decreases, hr increases, respiratory rate increases,
◉ Hypovolemic Shock. Answer: Blood or fluid loss reduces
circulating blood volume and cardiac output.
◉ Mean Arterial Pressure. Answer: MAP = (Systolic pressure +
2(Diastolic) / 3
Want a MAP above 60
◉ Hypovolemic shock interventions. Answer: Airway control,
control bleeing or fluid loss, restore volume, NS 0.9%, Adult 1-2L
bolus, Pedi 20ml/kg. Never use Dextrose
◉ Cardiogenic Shock. Answer: Inadequate tissue perfusion as a
result of decreased cardiac output despite adequate intravascular
volume. Most common is MI. Pump Failure
◉ Cardiogenic Shock Interventions. Answer: Airway with PEEP will
force pulmonary edema fluid out of the lung interstitium. Decrease
preload by position, nitro, diuretics, morphine. Cardiac cath,
angioplasty.
, ◉ Distributive Shock. Answer: Abnormal distribution of
intravascular volume. Can me anaphylactic, septic, neurogenic
◉ Distributive Shock (Anaphylaxis). Answer: Acute life threatening
allergic reaction to individuals exposed to an antigen to which they
have become hypersensitive.
◉ Anaphylactic Shock Interventions. Answer: IM epi 1:1000 repeat
in 15-20 min as needed. Albuterol, H1 abd H2 blockers,
Corticosteroids.
◉ Septic Shock. Answer: Systemic Inflammatory response syndrome
(SIRS). Sepsis with organ dysfunction, cardio failure leading to
hypotension, Resp failure leading to hypoxia, Renal failure leading to
oliguria and azotemia. MODS, multiple organ dysfumction syndrome.
◉ Septic Shock Interventions. Answer: Positive inotropes,
vasopressors, fluid resuscitation, antibiotics
◉ Neurogenic Shock. Answer: Loss of the sympathetic nervous
system "fight or flight" response is lost and the rest of digest system
is unopposed. Bradycardia, bradypnea, hypotension, priapism.
EXAM COMPREHENSIVE STUDY GUIDE 2026
◉ Hypovolemic Shock. Answer: Decreased cellular perfusion
secondary to lack of circulating volume or not ENOUGH GAS.
◉ Cardiogenic Shock. Answer: Decreased cellular perfusion
secondary to maldistribution of oxygen to the periphery. Its like
adding a larger engine without increasing the size of the tank.
◉ Obstructive shock. Answer: Decreased cellular perfusion secondry
to obstruction of blood into or out of the ventricles (eg. pulmonary
emboli, tamponade, tension pneumo. Like getting dirt or blockage in
the fuel line.
◉ Prolonged lactic acidosis leads to microvascular thrombosis and
disseminated intravascular coagulation. Answer:
◉ Compensated Shock. Answer: When patient is able to maintain
blood pressure. Body attempting to maintain homeostasis. Increases
perfusion to brain, decreases blood flow to kidneys.
,◉ Uncompensated Shock. Answer: Shock at cellular level.
Intracellular fluid leaks into interstitium causing third spacing and
edema, bp decreases, hr increases, respiratory rate increases,
◉ Hypovolemic Shock. Answer: Blood or fluid loss reduces
circulating blood volume and cardiac output.
◉ Mean Arterial Pressure. Answer: MAP = (Systolic pressure +
2(Diastolic) / 3
Want a MAP above 60
◉ Hypovolemic shock interventions. Answer: Airway control,
control bleeing or fluid loss, restore volume, NS 0.9%, Adult 1-2L
bolus, Pedi 20ml/kg. Never use Dextrose
◉ Cardiogenic Shock. Answer: Inadequate tissue perfusion as a
result of decreased cardiac output despite adequate intravascular
volume. Most common is MI. Pump Failure
◉ Cardiogenic Shock Interventions. Answer: Airway with PEEP will
force pulmonary edema fluid out of the lung interstitium. Decrease
preload by position, nitro, diuretics, morphine. Cardiac cath,
angioplasty.
, ◉ Distributive Shock. Answer: Abnormal distribution of
intravascular volume. Can me anaphylactic, septic, neurogenic
◉ Distributive Shock (Anaphylaxis). Answer: Acute life threatening
allergic reaction to individuals exposed to an antigen to which they
have become hypersensitive.
◉ Anaphylactic Shock Interventions. Answer: IM epi 1:1000 repeat
in 15-20 min as needed. Albuterol, H1 abd H2 blockers,
Corticosteroids.
◉ Septic Shock. Answer: Systemic Inflammatory response syndrome
(SIRS). Sepsis with organ dysfunction, cardio failure leading to
hypotension, Resp failure leading to hypoxia, Renal failure leading to
oliguria and azotemia. MODS, multiple organ dysfumction syndrome.
◉ Septic Shock Interventions. Answer: Positive inotropes,
vasopressors, fluid resuscitation, antibiotics
◉ Neurogenic Shock. Answer: Loss of the sympathetic nervous
system "fight or flight" response is lost and the rest of digest system
is unopposed. Bradycardia, bradypnea, hypotension, priapism.
