NRSG 2500 Unit 5 Shock Practice Exam
Questions With Verified Solutions.
perfusion - Answer Mechanisms that facilitate or impair circulation of blood through tissue.
3 - Answer shock has ____ stages
stages of shock - Answer •Compensatory (stage 1)
•Progressive (stage 2)
•Irreversible or refractory (stage 3)
•Early recognition and treatment are key!!
Compensatory - Answer "Fight or flight"
BP normal, HR increased
Shunting of blood to vital organs
Skin cool and pale (in most categories of shock)
Can lead to metabolic acidosis, to RR can increase
Monitor for progression into next stage
pulse pressure - Answer •Pulse pressure correlates well with stroke volume. It is calculated by
subtracting diastolic from the systolic measurement.
-A narrowing pulse pressure is an earlier sign of deterioration than a drop in systolic pressure < 90.
•Normal pulse pressure is 30-40 mm hg
-Example: BP 120/80
-120 - 80 = 40 mm hg
•Elevation of the diastolic BP releases catecholamines and attempts to increase venous return through
vasoconstriction.
progressive stage - Answer •Mechanisms that regulate BP can no longer compensate
•MAP falls below normal limits (<65)
•Hypotension (Systolic BP <90 or decrease in systolic BP of 40 mmHg from baseline)
•Declining mental status, increased restlessness
•Acute lung injury:
-Respirations rapid and shallow (intubation may be necessary)
-Increased CO2
-Crackles, Pulmonary edema
-If progresses to fibrosis and inflammation, ARDS will result
•Arrhythmias, chest pain
•Impaired kidney, liver, and GI function, hypoxemia
•Assess for declining status and progression
Irreversible stage - Answer B/P remains low
organ dysfunction
acidosis worsens
consider comfort cares
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