20 Heart Failure/Circulatory Shock
Assessment of an elderly female patient reveals the presence of bilateral pitting edema of the patient's feet and ankles and pedal pulses that are difficult to palpate. Auscultation of the patient's lungs reveals clear air entry to bases, and the patient's oxygen saturation level is 93%, and vital signs are within reference ranges. What is this patient's most likely health problem? A) Right-sided heart failure B) Pericarditis C) Cardiogenicshock D) Cor pulmonale
A) right-sided heart failure
In an ICU setting, one assessment that would lead the nurse to suspect shock has resulted in decrease blood flow to vital organs is: A) Warm legs with peripheral vasodilation B) Urine output less than 20 mL/hour C) Blood pressure staying in the 98/72 range for the past hour D) Sleepiness and difficulty to arouse without using painful stimuli
B) Urine output less than 20 mL/hour
A patient who developed a deep vein thrombosis during a prolonged period of bed rest has deteriorated as the clot has dislodged and resulted in a pulmonary embolism. Which of the following types of shock is this patient at risk of experiencing? A) Cardiogenic shock B) Hypovolemic shock C) Obstructive shock D) Distributive shock
C) Obstructive shock
A patient has been experiencing increasing fatigue in recent months, a trend that has prompted an echocardiogram. Results of this diagnostic test suggest that the patient's end-diastolic volume is insufficient. Which of the following parameters of cardiac performance will directly decrease as a result of this? A) Inotropy B) Cardiac contractility C) Preload D) Afterload
C) preload
A patient has just returned from his surgical procedure. During initial vital sign measurements, the nurse notes that the patient's heart rate is 111 beats/minute and the BP is 100/78 (borderline low). In this early postoperative period, the nurse should be diligently monitoring the patient for the development of: A) Pulmonary embolism due to development of deep vein thrombosis B) Side effects from versed administration causing excessive vasoconstriction C) Renal failure due to an overdose of medication D) Hypovolemic shock due to acute intravascular volume loss
D) Hypovolemic shock due to acute intravascular volume loss