LM 7 thermo/shock Pre/Post Learnings

When an acute event occurs and the circulatory system can no longer provide the body with adequate perfusion of its tissues and organs, cellular hypoxia occurs and the body goes into shock. What are the causes of shock in the human body? Select all that apply.

-Maldistribution of blood flow -Hypovolemia -Obstruction of blood flow

Diagnosing the primary cause is one of several methods used to treat fever. What are some other methods? Select all that apply.

-Modification of external environment to increase heat transfer from the internal to the external environment -Support of hypermetabolic state that accompanies fever -Protection of vulnerable body organs and systems

Which client will the nurse be assessing in relation to problems with thermoregulation?

66 yr old client with damage to hypothalamus secondary to CVA

The nurse is assessing the blood pressure of a client who is experiencing cardiogenic shock. Which blood pressure reading is most likely?

90/75 A blood pressure reading of 90/75 in a client experiencing cardiogenic shock is related to a decreased pulse pressure. The other readings do not indicate a narrowed pulse pressure. **systolic 90 or below indicative of shock

A client has been diagnosed with a fever of unknown cause. The nurse recognizes this as:

A prolonged fever that does not have an identified source.

A client with a rising temperature is pale and has begun to shiver. The nurse reports that the client is in which phase of fever development?

Chill

A client has developed cardiogenic shock. The most frequent cause of this type of shock is:

Myocardial Infarction

A client has developed cardiogenic shock. The most frequent cause of this type of shock is:

Myocardial infarction

Anaphylactic shock causes severe hypoxia very quickly because of which reason?

Histamine release causes massive vasodilation

A 22-year-old man is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. Which immediate treatments are likely to most benefit the man?

Infusion of normal saline or Ringer's lactate to maintain vascular space Maintenance of vascular volume is the primary goal in the treatment of hypovolemic shock and can be achieved in the short term through intravenous administration of saline solution or Ringer's lactate. Resolution of pulmonary edema and heart dysrhythmias and infusion of vasodilators are associated with treatment of cardiogenic shock, while oxygen and epinephrine would address anaphylactic shock.

A 30-year-old client arrives with these vital signs: Blood pressure 50/30 mm Hg, pulse 100 beats/min, respiratory rate 12 breaths/min, temperature 101°F (38.3°C). The nurse interprets these results as the client being in shock based on which reading?

Low blood pressure

Antipyretic drugs, such as aspirin, ibuprofen, and acetaminophen, are often used to alleviate the discomforts of fever and protect vulnerable organs, such as the brain, from extreme elevations in body temperature. The use of aspirin is limited in children, however, because it can sometimes cause which disease?

Reye syndrome

Emergency medical technicians respond to a call to find an 80-year-old man who is showing signs and symptoms of severe shock. Which phenomenon is most likely taking place?

The man's alpha- and beta-adrenergic receptors have been activated, resulting in vasoconstriction and increased heart rate. Alpha- and beta-adrenergic receptor activation is a central response to all types of shock. Hemolysis is not a noted accompaniment to shock. Bronchodilation, not bronchoconstriction, often results from adrenergic stimulation. Sodium-potassium pump failure results in increased extracellular potassium and intracellular sodium.

A client who has been exercising says to the nurse, "My skin is so hot!" What is the nurse's best response?

Your body is trying to lower your temperature

A client is rushed to the emergency department with assessment findings of urticaria, wheezing, chest tightness, and difficulty breathing. The client is most likely experiencing which type of shock?

anaphylactic

The nurse suspects neurogenic shock (spinal shock) in a client. Which set of assessment findings will the nurse use as evidence to support neurogenic shock rather than hypovolemic shock?

decreased heart rate and dry warm skin The most profound features of neurogenic shock are bradycardia with hypotension from the decreased sympathetic activity. The skin is frequently warm, dry, and flushed. In hypovolemic shock there is also a drop in blood pressure but an increase in heart rate. There is often cool clammy skin with prolonged capillary refill time due to decreased peripheral blood flow.

A 30-year-old woman presents at a hospital after fainting at a memorial service and she is diagnosed as being in neurogenic shock. Which signs/symptoms is she most likely to display?

dry and warm skin

A nurse is planning care for a client coming into the emergency department via ambulance on a hot summer day with the following symptoms: temperature of 105°F (40.5°C), absence of sweating, and loss of consciousness. The nurse presents this evidence to the health care provider as supporting which condition?

heatstroke

When an acute event occurs and the circulatory system can no longer provide the body with adequate perfusion of its tissues and organs, cellular hypoxia occurs and the body goes into shock. What are the causes of shock in the human body? Select all that apply.

• Maldistribution of blood flow • Hypovolemia • Obstruction of blood flow