PN3 EXAM 3 QUESTIONS AND
ANSWERS
Main types of shock
hypovolemic, cardiogenic, septic, neurogenic, and anaphylactic
Hypovolemic shock
decrease in circulating blood volume
Shock is classified as a
CONDITION - not a disease
Who needs to be monitored for shock?
EVERYONE
Hypovolemic shock leads to
inadequate tissue perfusion - hypoxia
What leads to neurogenic shock
acute spinal chord injury, temporary spinal shock or permanent paralysis
Septic shock
infection
What causes hypovolemic shock
bleeding/trauma, dehydration/fluid loss, burns
What causes cardiogenic shock
MI, valve disease, contusion, irregular heartbeat, dysrhythmia, or CHF
Cardiogenic shock
inadequate pumping due to mechanical, or electrical problems or CHF
Anaphylactic Shock
massive histamine response from exposure to antigen causing arterioles and capillaries
to dilate and intravascular fluid to leak out
Symptoms of hypovolemic shock
subtle changes in VS, BP falls, anxiety, restlessness, delayed capillary refill, and
increased respiratory rate, diminished urinary output, cardiac arrhythmias, cardiac
ischemia
Treatment of hypovolemic shock
oxygen, blood products, and IV fluid, electrolyte replacement, watch for changes in VS
and report changes
After giving large volumes of fluid replacement
watch for hypokalemia
Cause of cardiogenic shock
the heart
Symptoms of cardiogenic shock
tachycardia
Treatment for cardiogenic shock
identify the cause
Causes of septic shock
, endotoxins released from bacteria within the body
Early symptoms of sepsis
fever above 104, resp above 20, low OR high WBC,
As sepsis progresses
anxiety, mild HTN, hypoxia, higher fever, more significant mental changes, tachycardia
worsens
When sepsis progresses into septic shock
severe tachycardia, cool and clammy extremities, weak and thready peripheral pulses,
significant hypotension, and hypoxia and respiratory distress, client may be
unresponsive and have minimal urine output
Complications of septic shock
end-organ failure/damage, damage to the brain, heart, lungs, liver, abdominal and
kidneys, death
Symptoms of neurogenic shock
hypotension, bradycardia, low perfusion, and hypoxia, flaccidity and paralysis below
level of injury, loss of bowel and bladder, loss of reflux activity, abnormal increase or
absence of sweating below level of injury
High risk allergy
penicillin
Symptoms of anaphylactic shock
itching, hives, some angioedema, nasal congestion, rhinorrhea, hoarseness, excessive
salivation, headache, nausea, and vomiting or diarrhea, severe hypotension,
tachycardia, bronchoconstriction with wheezing, tachypnea and cyanosis, chest pain
and arrhythmias
Treatment of anaphylactic shock
Establish IV site, ABC's, epinephrine, then oxygen, antihistamines, and corticosteroids,
monitor VS, start cardiac monitoring
What position for shock
trendelenburg
What causes cirrhosis of the liver
alcoholism, hepatitis B and C, fatty liver disease
Cirrhosis of the liver
replacement of liver tissue by scar tissue
S/S of cirrhosis of the liver
fatigue, weight loss, abdominal pain, tachycardia, bleeding easily, jaundice, dry skin,
weakness, confusion, ascities, portal HTN
Treatment of cirrhosis
avoid alcohol, low protein diet, abdominal paracentesis, lactulose
What does lactulose do
promotes ammonia excretion through GI tract
Ascities
abnormal accumulation of protein-rich fluid in the abdominal cavity
Symptom of patient with sever ascites
itching
Esophageal varices
when varicies hemorrhage, it is a medical emergency with high mortality
ANSWERS
Main types of shock
hypovolemic, cardiogenic, septic, neurogenic, and anaphylactic
Hypovolemic shock
decrease in circulating blood volume
Shock is classified as a
CONDITION - not a disease
Who needs to be monitored for shock?
EVERYONE
Hypovolemic shock leads to
inadequate tissue perfusion - hypoxia
What leads to neurogenic shock
acute spinal chord injury, temporary spinal shock or permanent paralysis
Septic shock
infection
What causes hypovolemic shock
bleeding/trauma, dehydration/fluid loss, burns
What causes cardiogenic shock
MI, valve disease, contusion, irregular heartbeat, dysrhythmia, or CHF
Cardiogenic shock
inadequate pumping due to mechanical, or electrical problems or CHF
Anaphylactic Shock
massive histamine response from exposure to antigen causing arterioles and capillaries
to dilate and intravascular fluid to leak out
Symptoms of hypovolemic shock
subtle changes in VS, BP falls, anxiety, restlessness, delayed capillary refill, and
increased respiratory rate, diminished urinary output, cardiac arrhythmias, cardiac
ischemia
Treatment of hypovolemic shock
oxygen, blood products, and IV fluid, electrolyte replacement, watch for changes in VS
and report changes
After giving large volumes of fluid replacement
watch for hypokalemia
Cause of cardiogenic shock
the heart
Symptoms of cardiogenic shock
tachycardia
Treatment for cardiogenic shock
identify the cause
Causes of septic shock
, endotoxins released from bacteria within the body
Early symptoms of sepsis
fever above 104, resp above 20, low OR high WBC,
As sepsis progresses
anxiety, mild HTN, hypoxia, higher fever, more significant mental changes, tachycardia
worsens
When sepsis progresses into septic shock
severe tachycardia, cool and clammy extremities, weak and thready peripheral pulses,
significant hypotension, and hypoxia and respiratory distress, client may be
unresponsive and have minimal urine output
Complications of septic shock
end-organ failure/damage, damage to the brain, heart, lungs, liver, abdominal and
kidneys, death
Symptoms of neurogenic shock
hypotension, bradycardia, low perfusion, and hypoxia, flaccidity and paralysis below
level of injury, loss of bowel and bladder, loss of reflux activity, abnormal increase or
absence of sweating below level of injury
High risk allergy
penicillin
Symptoms of anaphylactic shock
itching, hives, some angioedema, nasal congestion, rhinorrhea, hoarseness, excessive
salivation, headache, nausea, and vomiting or diarrhea, severe hypotension,
tachycardia, bronchoconstriction with wheezing, tachypnea and cyanosis, chest pain
and arrhythmias
Treatment of anaphylactic shock
Establish IV site, ABC's, epinephrine, then oxygen, antihistamines, and corticosteroids,
monitor VS, start cardiac monitoring
What position for shock
trendelenburg
What causes cirrhosis of the liver
alcoholism, hepatitis B and C, fatty liver disease
Cirrhosis of the liver
replacement of liver tissue by scar tissue
S/S of cirrhosis of the liver
fatigue, weight loss, abdominal pain, tachycardia, bleeding easily, jaundice, dry skin,
weakness, confusion, ascities, portal HTN
Treatment of cirrhosis
avoid alcohol, low protein diet, abdominal paracentesis, lactulose
What does lactulose do
promotes ammonia excretion through GI tract
Ascities
abnormal accumulation of protein-rich fluid in the abdominal cavity
Symptom of patient with sever ascites
itching
Esophageal varices
when varicies hemorrhage, it is a medical emergency with high mortality
