UPDATE 2026
is the condition of acute and progressive circulatory dysfunction that results in inadequate delivery of
oxygen and nutrients to the tissues and is present in poor systemic perfusion, regaurdless of blood
pressure - Answers shock
___ shock is systolic blood pressure is adequate for age, but signs of inadequate tissue perfusion is
evident - Answers compensated
___ shock is systolic hypotension is associated with inadequate tissue perfusion - Answers
hypotensive shock
___ simutaneous failure of at least tow organs resulting from a single cuase - Answers MODS
___ MODS is directly attributable to the insult, occuring 33-7 days after insult - Answers primary
MODS
___ MODS typically occurs later, may be associated wtih more sequential development of organ
dysfunciton - Answers secondary MODS
Risk factor for MODS - Answers prolonged shock, sepsis or trauma
chemotherapy, organ transplant, surgical correction of CHD
children with chronic disease
NPODS develops with what - Answers severe sepsis
clinical manifestations of shock in children - Answers inadequate cardiac output demonstrates signs of
inadequate blood flow to tissue beds and organ system dysfunction
extremely irritable
lethargy
decrease response to painful stimuli indicating cardiorespiratory or neurological compromise
tachypnea, hyperpnea (high respiration depth)
retractions or grunting
apnea or inadequate respiratory rate requirign vent, airway, oxygen
MOTTLING marbelized or blotchy skin
pallor
flushed, BRIGH RED SKIN from sepsis
prolonged cap refill more than 2 seconds
vital signs- not always best indicator
tachycardia 200-220 in infant; 160-180 in child or bradycardia due to hypoxia
Central venous pressure and pulmonary artery wedge pressure high
urine output volume lab values for all ages - Answers less than 2/kg/hr in infants
less than 1/kg/hr in children
less than 0.5/kg/hr in adults
shock lab values - Answers high liver enzymes
lactate above 4
glucose level high in infants, hypoglycemia less than 60 hyperglycemia more than 150, ciritcal glucose
above 180
which parameter will the nurse monitor best to determine the systemic perfusion in a child - Answers
serum lactate
most common shock in children - Answers hypovolemic
dehydration, hypovolemia, and low cardiac output stimulate adrengic and renal compensation
mechanisms in what shock - Answers hypovolemic shock
what are compensatory mechanisms to hypovolemic shock in children - Answers tachycardia to
redistribute blood from skin, gut, and kidney to the brain and heart
stimulation of RAS for sodium and water retention
secretion of anti-diuretic hormone for water retention by kidneys
neonatal and young infants are incapable of excreting what to check on fluid volume measurement -
Answers concetrated urine
clinical manifestations of hypovolemic shock - Answers tachycardia, peripheral vasocontriction,
altered LOC, cool extremities, oliguria
treatment for hypovolemic shock - Answers IVF
oxygen delivery humidified
glucose and electrolyte monitoring; temperature too