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Shock and Mods
HGTC NUR 221 Test 3 Shock/Mods
| Question | Answer |
|---|---|
| Physiologic responses to all types of shock include the following | activation of the inflammatory response, hypermetabolism, hypoperfusion of tissues |
| A patient's blood pressure is 110/70 mm Hg. What is his MAP? | 83 |
| How is MAP calculated? | systolic BP + (2 x diastolic pressure) divided by 3 |
| Baroreceptors are a primary mechanism of blood pressure regulation which results from the initial stimulation of what types of receptors? | pressure |
| Which type of shock is caused by a hypersensitivity reaction? | Anaphylictic |
| The initial stage of shock characterized by a normal blood pressure is the | compensatory stage |
| The nurse knows to report an early indicator of compensatory shock such as a pulse pressure of: | 25 mm Hg |
| In progressive stage shock, clinical hypotension is present if the sytematic blood pressure is: | 85 mm Hg |
| The nurse assesses a patient in compensatory shock whose lungs have decompensated. To assess for this condition, the nurse should look for | respirations fewer than 15 breaths/min. |
| Oliguria occurs in the progressive stage of shock because the kidneys compensate. To asses for this condition, the nurse should look for which of the following signs or symptoms? | systolic BP greater than 120 mm Hg |
| Hematologic system changes in progressive shock would NOT be characterized by | hypertension |
| The nurse would expect acute renal failure to develop when the mean arterial pressure reaches | 65 mm Hg |
| Depleted ATP stores and multiple organ failure are characteristics of which stage of shock? | irreversible stage |
| Patients receiving fluid replacement should frequently be monitored for: | adequate urinary output, changes in mental status, vital signs stability |
| The most commonly used colloidal solution to treat hypovolemic shock is: | 5% albumin |
| Vasoactive agents are effective in treating shock because of there ability to | increase cardiac output |
| A common vasoactive agent used to improve cardiac contractility is | dopamine |
| Hypovolemic shock occurs when intravascular volume decreases by | 15-25% |
| Coronary cardiogenic shock is seen primarily in patients with | myocardial infarction |
| In cardiogenic shock, decreased cardiac contractility leads to all the following compensatory responses EXCEPT: | increased stroke volume |
| In cardiogenic shock, decreased cardiac contractility leads to the following compensatory responses: | decreased stroke volume, decreased tissue perfusion, pulmonary congestion |
| The primary goal of treating cardiogenic shock is to | treat the oxygenization needs of the heart muscle |
| The drug of choice for cardiac pain relief is: | morphine |
| Sympathomimetic drugs increase cardiac output by the following measures: | increasing myocardial contractility, tachycardia, vasoconstriction |
| The nurse assesses for the negative effect of intravenous nitroglycerine (tridil) for shock management, which is | increased blood pressure |
| The sequence of organ failure in multiple organ dysfunction syndrome (MODS) usually begins in the | lungs |
| A clinical sign of septic shock would not be | bradypnea |
| The primary cause of distributive shock is | arterial and venous dilatation |
| Which of the following vasoactive agents is used for its vasoconstrictive properties? | Norepinephren (Levophed) is a vasoconstrictor used in the treatment of shock |
| A patient has a blood pressure of 150/90. What is the pulse pressure? | 60 |
| How do you determine pulse pressure? | Systolic BP - Diastolic BP example: 150-90= 60 |
| Proper positing for a patient showing signs of shock is: | Modified Trendelenburg. (The lower extremities are elevated to an angle of about 20 degrees; the knees are straight, the trunk is horizontal, and the head is slightly elevated. |
| A colloid that rapidly expands plasma volume: | albumin |
| A central line used to monitor central venous pressure: | CVP |
| A popular vasoactive agent that improves cardiac contractility | dopamine |
| The most common side effect of fluid replacement in shock: | pulmonary edema |
| These solutions are used to expand intravascular volume in shock: | colloids |
| A vasodilator used to reduce the hearts demand for oxygen in conditions of shock: | Tridil |
| The nurse knows that the progressive pattern of changes in vital signs is more important than the exact readings. A __________ in pulse rate, followed by a _____ in BP, is indicative of shock. | rise, decline |
| A urine output of less than__________ is indicative of decreased glomular filtration. | 30 mL/hr |
| Fluids used to treat shock include: | colloids, ringers lactate, normal saline |
| Septic shock is most commonly caused by gram-negative organisms. A common gram-negative bacteria is: | escheria coli |
| The 4 modalities of treatment essential to manage septic shock are: | aggressive fluid replacement, antibiotics, crystalloids, and colloids |
| The 2 most common and serious side effects of fluid replacement are: | cardiovascular overload and pulmonary edema |
| A CVP helps monitor fluid replacement. A normal CP value is: | 4-12 cm H20 |
| The nurse suspects the dr. will request body fluid specimens for her septic patient. The nurse prepares to collect specimens of:___________, __________,___________, and_______ | urine, blood, sputum, and wound drainage |
Created by:
Laurie2000
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