NR 328 EXAM
(CHAMBERLAIN UNI)
QNS & ANS
2023/2024
, 1. Differentiate between hypovolemic, anaphylactic, septic and neurogenic shock
Hypovolemic, anaphylactic, septic and neurogenic shock are four types of circulatory shock that have
different causes and manifestations. Hypovolemic shock occurs when there is a significant loss of blood
or fluid from the body, leading to low blood pressure and reduced tissue perfusion. Anaphylactic shock
is a severe allergic reaction that causes widespread vasodilation and increased capillary permeability,
resulting in hypotension and edema. Septic shock is a life-threatening complication of infection that
causes systemic inflammation, vasodilation, coagulation and organ dysfunction. Neurogenic shock is a
rare condition that results from spinal cord injury or damage to the autonomic nervous system, causing
loss of sympathetic tone and vasodilation.
2. Explain how to assess for edema
Edema is the swelling of tissues due to excess fluid accumulation. To assess for edema, you can use the
following steps:
- Inspect the affected area for signs of puffiness, tightness, or shiny skin.
- Gently press the swollen area with your finger for a few seconds and then release. If a dent remains, it
indicates pitting edema.
- Measure the circumference of the affected limb or body part with a tape measure and compare it to the
other side. A difference of more than 1 cm may indicate edema.
- Check for other symptoms such as pain, redness, warmth, or fever that may indicate an infection or
inflammation.
3. List the clinical manifestations of hypocalcemia
Hypocalcemia is a condition in which the blood calcium level is below the normal range. It can cause
various clinical manifestations, such as:
- Muscle spasms, cramps, and tetany (involuntary contraction of muscles)
- Paresthesia (tingling or numbness) of the fingers, toes, and lips
- Chvostek's sign (twitching of the facial muscles when tapping the cheek)
- Trousseau's sign (carpopedal spasm when inflating a blood pressure cuff on the arm)
- Cardiac arrhythmias, hypotension, and heart failure
- Seizures, confusion, and depression
4. Discuss the purpose of Dopamine in a pediatric patient with shock
Dopamine is a vasoactive drug that can be used to treat pediatric patients with septic shock who are fluid-
refractory and normotensive. It has both inotropic and vasopressor effects, depending on the dose. However,
some studies have shown that dopamine is not superior to epinephrine in terms of shock reversal, mortality,
(CHAMBERLAIN UNI)
QNS & ANS
2023/2024
, 1. Differentiate between hypovolemic, anaphylactic, septic and neurogenic shock
Hypovolemic, anaphylactic, septic and neurogenic shock are four types of circulatory shock that have
different causes and manifestations. Hypovolemic shock occurs when there is a significant loss of blood
or fluid from the body, leading to low blood pressure and reduced tissue perfusion. Anaphylactic shock
is a severe allergic reaction that causes widespread vasodilation and increased capillary permeability,
resulting in hypotension and edema. Septic shock is a life-threatening complication of infection that
causes systemic inflammation, vasodilation, coagulation and organ dysfunction. Neurogenic shock is a
rare condition that results from spinal cord injury or damage to the autonomic nervous system, causing
loss of sympathetic tone and vasodilation.
2. Explain how to assess for edema
Edema is the swelling of tissues due to excess fluid accumulation. To assess for edema, you can use the
following steps:
- Inspect the affected area for signs of puffiness, tightness, or shiny skin.
- Gently press the swollen area with your finger for a few seconds and then release. If a dent remains, it
indicates pitting edema.
- Measure the circumference of the affected limb or body part with a tape measure and compare it to the
other side. A difference of more than 1 cm may indicate edema.
- Check for other symptoms such as pain, redness, warmth, or fever that may indicate an infection or
inflammation.
3. List the clinical manifestations of hypocalcemia
Hypocalcemia is a condition in which the blood calcium level is below the normal range. It can cause
various clinical manifestations, such as:
- Muscle spasms, cramps, and tetany (involuntary contraction of muscles)
- Paresthesia (tingling or numbness) of the fingers, toes, and lips
- Chvostek's sign (twitching of the facial muscles when tapping the cheek)
- Trousseau's sign (carpopedal spasm when inflating a blood pressure cuff on the arm)
- Cardiac arrhythmias, hypotension, and heart failure
- Seizures, confusion, and depression
4. Discuss the purpose of Dopamine in a pediatric patient with shock
Dopamine is a vasoactive drug that can be used to treat pediatric patients with septic shock who are fluid-
refractory and normotensive. It has both inotropic and vasopressor effects, depending on the dose. However,
some studies have shown that dopamine is not superior to epinephrine in terms of shock reversal, mortality,
