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NRSG 327: Shock: Exam Questions with Answers, Exams of Nursing

Montana State University Nursing

A comprehensive set of exam questions and answers related to shock, a critical medical condition. It covers various types of shock, including hypovolemic, cardiogenic, neurogenic, anaphylactic, and septic shock. The document delves into the causes, symptoms, stages, and management of each type of shock, offering valuable insights for nursing students and professionals. It also explores the systemic inflammatory response syndrome (sirs) and multiple organ dysfunction syndrome (mods) associated with shock.

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2024/2025

Available from 03/18/2025

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NRSG 327: SHOCK: EXAM QUESTIONS WITH THE 100%

CORRECT ANSWERS

1) What is hypovolemic shock? -- Answer ✔✔ Size of vascular compartment remains

unchanged but the volume of plasma decreases

2) What is absolute hypovolemia? -- Answer ✔✔ External loss of whole blood or

other bodily fluids

3) What is relative hypovolemia? -- Answer ✔✔ - Pooling of blood or fluids

- Fluids shifts

- Internal bleeding

- Massive vasodilation

4) What does hypovolemic shock result in? -- Answer ✔✔ - Decreased venous return

to the heart

- Decreased preload

- Decreased stroke volume

- Decreased CO

5) What are some S&S of hypovolemic shock? -- Answer ✔✔ - Decreased preload

- Decreased stroke volume

- Decreased cap refill

- Tachypnea progressing to bradypnea

- Decreased urine output

- Cool and clammy

Partial preview of the text

Download NRSG 327: Shock: Exam Questions with Answers and more Exams Nursing in PDF only on Docsity!

NRSG 327: SHOCK: EXAM QUESTIONS WITH THE 100%

CORRECT ANSWERS

What is hypovolemic shock? -- Answer ✔✔ Size of vascular compartment remains unchanged but the volume of plasma decreases
What is absolute hypovolemia? -- Answer ✔✔ External loss of whole blood or other bodily fluids
What is relative hypovolemia? -- Answer ✔✔ - Pooling of blood or fluids

Fluids shifts
Internal bleeding
Massive vasodilation

What does hypovolemic shock result in? -- Answer ✔✔ - Decreased venous return to the heart

Decreased preload
Decreased stroke volume
Decreased CO

What are some S&S of hypovolemic shock? -- Answer ✔✔ - Decreased preload

Decreased stroke volume
Decreased cap refill
Tachypnea progressing to bradypnea
Decreased urine output
Cool and clammy

Anxiety, confusion, agitation

What are the different types of shock? -- Answer ✔✔ - Hypovolemic shock

Carterm-1diogenic shock
Neurogenic shock
Anaphylactic shock
Septic shock

What are the different categories of shock? -- Answer ✔✔ - Hypovolemic shock = volume problem

Distributive shock = Pipe failure

Who is at risk for shock? -- Answer ✔✔ - Surgery

Comorbidities
Allergies
Elderly
Anything equipment invasive
Someone who already has an infection
Pediatrics and neonates
Trauma patients
Immunocompromised patients

What are the stages of shock? -- Answer ✔✔ - Compensated

Uncompensated (progressive)
Irreversible (refractory)

What is compensated shock? -- Answer ✔✔ - Shows little to no signs or symptoms

Still have good cardiac output

What are some early missed signs and symptoms in shock? -- Answer ✔✔ - Pale skin

Mild tachycardia, strong pulses centrally but weaker pulses peripherally

What are some signs and symptoms of cardiogenic shock? -- Answer ✔✔ - Signs of peripheral hypo perfusion (cyanosis, pallor, cool and clammy)

Decreased renal blood flow results in sodium and water retention and decreased urine output
Tachypnea
Crackles, wheezes
Anxiety, confusion and agitation
May or may not have chest pain

What are the effects of cardiogenic shock on hemodynamics? -- Answer ✔✔ - Increased HR

Decreased pulse pressure
Decreased BP
Decreased CO

What is the management for cardiogenic shock? -- Answer ✔✔ - Treat underlying cause

Improving cardiac output = optimizing 02 supply and demand
Fluids, Vasopressors

What are some BP highering medications and what do they do? -- Answer ✔✔ - Dopamine (increased BP, HR and contractility)

Norepinephrine (Increased BP)
Epinephrine (increases BP, HR and lungs)

What medications decrease preload? -- Answer ✔✔ - Diuretics
What does dobutamine do? -- Answer ✔✔ - Increases HR, myocardial demand and also increases contractility

First line drug in cardiogenic shock

Up to what percentage of blood lost can patients compensate for? -- Answer ✔✔ 15%
At what percentage of blood lost if tissue destruction irreversible? -- Answer ✔✔ 40%
What are the effects of hypovolemic shock on hemodynamics? -- Answer ✔✔ - Increased HR

Decreased pulse pressure
Decreased BP
Decreased CO

What is Neurogenic shock? -- Answer ✔✔ - Hemodynamic consequence of injury, disease or both to the spinal cord at or above T

Vasomotor centre depression

What happens when the vasomotor centre is depressed? -- Answer ✔✔ Massive vasodilation leads to a pooling of blood in the blood vessels, tissue hypo perfusion and impairment of cellular metabolism
What are the clinical manifestations of neurogenic shock? -- Answer ✔✔ - Hypotension

Bradycardia
May be unable to regulate temperature (heat loss)
Initially may be warm d/t dilation but as heart dissipates at risk for hypothermia
Dysfunction related to level of injury
Bladder dysfunction
Decreased skin perfusion
Cool or warm

Diphenhydramine (Benadryl)

What is important to do in anaphylactic shock? -- Answer ✔✔ Maintain potency of airway
What is sepsis? -- Answer ✔✔ Systemic inflammatory response and documented or suspected infection
What is severe sepsis? -- Answer ✔✔ - Sepsis + Organ dysfunction

Lactate greater than 4

What is septic shock? -- Answer ✔✔ - Systemic inflammatory response to a documented or suspected infection

Endotoxing stimulate release of cytokines, and pro inflammatory mediators resulting in damage to epithelium, vasodilation, increased capillary permeability and neutrophils

What are some clinical manifestations of septic shock? -- Answer ✔✔ - Change in temperature

Decreased ejection fraction
Hyperventilation
Respiratory alkalosis progressing to acidosis
Hypoxemia
Respiratory failure
ARDS
Pulmonary hypertension
Crackles
Decreased urine output
Warm and flushed becoming cool and mottled

What are the effects of septic shock on hemodynamics? -- Answer ✔✔ - Increased HR

Decreased pulse pressure
Decreased BP
Decreased, increased or the same CO

What is the plasma enzyme cascade? -- Answer ✔✔ - Compliment system (membrane attacking complex)

Coagulation cascade (wall off the infection and keep it in a certain area)
Kinin system (promotes vasodilation and causes "leaky" capillaries)
Arachidonic acid prostaglandins (Increase vessel diameter)

What are the care measures for septic shock? -- Answer ✔✔ - Requires large amounts of fluid replacement

Overall goal is to restore perfusion
Antibiotics are important
Vasopressors
Contractility interventions (dobutamine)

What vasopressors is the #1 and why? -- Answer ✔✔ Norepinephrine because it increases BP with minimal impact on HR
What is the goal of vasopressor therapy? -- Answer ✔✔ - To achieve and maintain a MAP of at least 65mmHg
What happens to sodium levels during shock? -- Answer ✔✔ - Increases in early shock d/t increased secretion of aldosterone, causing retention

Decreased when excessive hypotonic fluid is administered after fluid loss

What is the criteria for SIRS? -- Answer ✔✔ - Temperature > 38 or < 36

HR > 90

NRSG 327: Shock: Exam Questions with Answers, Exams of Nursing

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Download NRSG 327: Shock: Exam Questions with Answers and more Exams Nursing in PDF only on Docsity!

NRSG 327: SHOCK: EXAM QUESTIONS WITH THE 100%

CORRECT ANSWERS