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