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STUVIA 2024/2025Ch 14 Shock and MODS
140-180 mg/dL
Tight glycemic control (serum glucose of 80 to 100 mg/dL) is no longer recommended, as
hypoglycemic events associated with regulating tight control in critically ill patients have been found to
result in adverse patient outcomes (Griesdale, DeSouza, VanDam, et al., 2009). Current evidence
suggests that maintaining serum glucose between 140 and 180 mg/ dL with aggressive insulin
therapy and close monitoring is indicated in the management of the critically ill patient (Kavanagh &
McCowen, 2010). - ✔✔The nurse is performing glucose checks for sliding scale four times per day
for a patient in the progressive stage of shock. What glucose range would the nurse expect to see for
the best outcomes in this patient?
a) 160-190 mg/dL
b) 140-180 mg/dL
c) 120-140 mg/dL
d) 100-120 mg/dL
A myocardial infarction.
%
Cardiogenic shock is seen most frequently as a result of a myocardial infarction. - ✔✔A nurse
practitioner visits a patient in a cardiac care unit. She assesses the patient for shock, knowing that the
primary cause of cardiogenic shock is:
a) Cardiomyopathies.
b) Arrhythmias.
c) Valvular damage.
d) A myocardial infarction.
Adrenergic drugs
Adrenergic drugs are the main medications used to treat shock. - ✔✔You are caring for a client in
shock who is deteriorating. You are infusing IV fluids and giving medications as ordered. What type of
medications are you most likely giving to this client?
a) Hormone antagonist drugs
b) Antimetabolite drugs
c) Adrenergic drugs
d) Anticholinergic drugs
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Brain
The body displays a "fight-or-flight" response, with the release of catecholamines. Blood will be
shunted to the brain, heart, and lungs to ensure adequate blood supply. The organ that will always be
protected over the others is the brain. - ✔✔During preshock, the compensatory stage of shock, the
body, through sympathetic nervous system stimulation, will release catecholamines to shunt blood
from one organ to another. Which of the following organs will always be protected?
a) Lungs
b) Liver
c) Kidneys
d) Brain
Compensatory
In compensatory shock, the patient's BP is normal, respirations are above 20, and heart rate is above
100, but below 150. In progressive shock, the patient's skin appears mottled and mentation
demonstrates lethargy. In refractory or irreversible shock, the patient requires complete mechanical
and pharmacologic support. - ✔✔The nurse is caring for a patient with a systolic BP less than 80 mm
%
Hg, respirations are rapid and shallow, heart rate is over 150 beats per minute, and the patient's urine
output is 20 mL/hr. The nurse recognizes that the patient is demonstrating which stage of shock?
a) Compensatory
b) Irreversible
c) Progressive
d) Refractory
Decreased blood pressure.
A potentially serious side effect of IV Tridil is hypotension. Blood pressure needs to be monitored
frequently according to the manufacturer's recommendation and institutional policy. - ✔✔The nurse
assesses the patient for the negative effect of IV nitroglycerin (Tridil) for shock management which is:
a) Increased cardiac output.
b) Reduced preload.
c) Reduced afterload.
d) Decreased blood pressure.
Epinephrine
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