Chapter 12 Shock

Neurogenic shock occurs when:

failure of the nervous system causes widespread vasodilation.

A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival?

Rapid transport to a trauma center

Which of the following statements regarding anaphylactic shock is correct?

Subsequent exposure after sensitization often produces a more severe reaction.

Clinical signs of compensated shock include all of the following, EXCEPT:

absent peripheral pulses.

A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should:

apply a tourniquet proximal to the wrist.

You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:

apply direct pressure to the wound.

When assessing a patient with signs and symptoms of shock, it is important to remember that:

blood pressure may be the last measurable factor to change in shock.

A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:

cardiogenic hypo perfusion.

Pulmonary edema and impaired ventilation occur during:

cardiogenic shock.

When treating an 80-year-old patient who is in shock, it is important to remember that:

changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.

Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate action should be to:

check her airway for obstructions.

Your patient is in shock, but the body's defense mechanisms are currently able to maintain adequate circulation. This is called ___________.

compensated shock

You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to:

determine if she was injured when she fainted.

You are transporting a 33-year-old male who was involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should:

reassess his condition in 5 minutes.

A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should:

repeat the epinephrine injection after consulting with medical control.

Shock due to severe infection is called ________.

septic shock

Distributive shock occurs when:

widespread dilation of the blood vessels causes blood to pool in the vascular beds.

Your patient has a decreased cardiac output and poor myocardial contractility. This will likely lead to ___________.

cardiogenic shock

Which of the following MOST accurately describes septic shock?

Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation

Which of the following injuries would MOST likely cause obstructive shock?

Cardiac tamponade