Chapter 20 Shock
Sepsis has been recently redefined as
a systemic inflammatory response to infection
Administration of a vasodilator to a patient in shock would be expected to
decrease left ventricular afterload
Septic shock is commonly associated with Gram-negative infections and Gram-positive organisms that enter the body through the (Select all that apply.)
genitourinary tract. gastrointestinal tract. respiratory tract. skin
In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with
high cardiac output.
Tumor necrosis factor D and interleukin-1 contribute to shock states because they induce production of
nitric oxide
A patient who was involved in a fall from a tree becomes short of breath. The lung sounds are absent on one side. This patient is experiencing ________ shock.
obstructive
The urinary signs and symptoms of acute renal failure associated with the progressive stage of shock are (Select all that apply.)
oliguria. increased serum creatinine
Hypotension associated with neurogenic and anaphylactic shock is because of
peripheral pooling of blood
Cardiogenic shock is characterized by
reduced cardiac output
A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock.
septic
Improvement in a patient with septic shock is indicated by an increase in
systemic vascular resistance
The progressive stage of hypovolemic shock is characterized by
tachycardia
The effect of nitric oxide on systemic arterioles is
vasodilation
Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body.
T Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.
T Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.
Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?
Anaphylactic
In which stage of shock is a patient who has lost 1200 mL of blood, who has normal blood pressure when supine, but who experiences orthostatic hypotension upon standing?
Class II, Compensated Stage
A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis
F A patient diagnosed with cardiogenic shock who is hyperventilating is at risk for respiratory alkalosis.
A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.
F A type of shock that includes brain trauma that results in depression of the vasomotor center is neurogenic shock.
A patient experiences anaphylactic shock. The nurse expects to observe which signs and symptoms in the patient? (Select all that apply.)
Hypotension Urticaria Angioedema Wheezing
The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with
antibiotics
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?
Septic
Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?
Septic
Administration of which therapy is most appropriate for hypovolemic shock?
Crystalloids
Which causes of shock are considered to be obstructive? (Select all that apply.)
Pulmonary embolus Cardiac tamponade Tension pneumothorax
A patient experiencing shock may exhibit which signs and symptoms? (Select all that apply.)
Pulse of more than 100 beats/minute Fast and deep respirations
Tachycardia is an early sign of low cardiac output that occurs because of
baroreceptor activity
Low cardiac output in association with high preload is characteristic of ________ shock
cardiogenic
Positive inotropic drugs work by increasing (Select all that apply.)
contractility. cardiac output. tissue perfusion. myocardial oxygen demand