ExamI4:INSGI430/INSG430I(LatestI2024/I
2025IUpdate)IAdultIHealthINursingIIII
CompleteIGuideIwithIQsI&IAsI|I100%I
Correct|IGradeIAI(VerifiedIAnswers)-IGCU
QUESTION
ColloidI:IHumanIserumIalbuminI(5%IorI25%)
Answer:
IMOA:ICanIincreaseIplasmaIcolloidIosmoticIpressure.
RapidIvolumeIexpansion.
Use:IAllItypesIexceptIcardiogenicIandIneurogenicIshock.
QUESTION
vasopressorIdrugs
Answer:
IperipheralIvasoconstrictionI=IcorrectIlowItissueIperfusionIex:Inorepinephrine,Idopamine,Iphen
ylephrine
FLUIDSIFIRSTIbeforeIvasopressors
UseIofIvasopressorIdrugsIisIlimitedItoIpatientsIwhoIdoInotIrespondItoIfluidIresusci-Itation
goal:ImaintainIaIMAPIofIgreaterIthanI65ImmIHg
QUESTION
vasodilators
Answer:
IusedIforIcariogenicIshockI=IreducesImyocardialIworkloadIandIO2Irequirements
decreaseIafterIload,ImaintainIMAPI>65Iex:Initroglycerin,Initroprusside
QUESTION
,earlyIsignsIofIshock
Answer:
IincreasedINa+I(RAAS)
decreasedIK+I(opposesINa+)
I
increaseIBGI(glycogenIreleaseIfromIliverIdueItoISNSIresponse)
respiratoryIalkalosisI(hyperventilation)
QUESTION
nursingIinterventionsIforIshock:Inutrition
Answer:
IEnteralInutritionI(EN)IshouldIbeIstartedIwithinItheIfirstI24IhoursI(enhancesIperfusionIofIGIItr
act)
-IstartIslowI(10mL/hr)
-IevenIBGIcheckIthroughoutIshiftI(fromIcontinuousIfeed)
-IdailyIweightsIhelpImeasureIfluidIstatus
QUESTION
angiotensinIIII(Giapreza)
Answer:
IMOA:I‘IBP,I‘IMAP
‘SVR
Use:ISepticIandIotherIdistributiveIshock
Nursing:IGiveIviaIcentralIline.
MonitorIforIthromboembolicIevents.IVTEIprophylaxisIisIrecommended.
QUESTION
dobutamine
Answer:
IMOA:
‘IMyocardialIcontractility
“IVentricularIfillingIpressures
,“ISVR,IPAWP
‘ICO,ISV,ICVP
‘/“IHR
Use:IcariogenicIshock,IsepticIshockI(increaseIO2Idelivery)INursing:
-GiveIviaIcentralIlineI(infiltrationIleadsItoItissueIsloughing).
-IDoInotIgiveIinIsameIlineIwithINaHCO3.
-IMonitorIHR,IBPI(hypotensionImayIworsen,IrequiringIadditionIofIaIvasopressor).
-IStopIinfusionIifItachydysrhythmiasIdevelop.
QUESTION
Dopamine
Answer:
IMOA:IPositiveIinotropicIeffects:
‘IMyocardialIcontractility
‘IAutomaticity
‘IAtrioventricularIconduction
‘IHR,ICO
‘IBP,I‘IMAP
‘IMVO2
CanIcauseIprogressiveIvasoconstrictionIatIhighIdoses
Use:ICardiogenicIShock
Nursing:
-IGiveIviaIcentralIlineI(infiltrationIleadsItoItissueIsloughing).
-IDoInotIgiveIinIsameIlineIwithINaHCO3.
-IMonitorIforItachydysrhythmias.
I
-IMonitorIforIperipheralIvasoconstrictionI(e.g.,Iparesthesias,IcoldnessIinIextremities)
atImoderateItoIhighIdoses.
QUESTION
epinephrineI(Adrenalin)
Answer:
IMOA:I²AdrenergicIagonistI(cardiacIstimulation,Ibron-Ichodilation,IperipheralIvasodilation)
‘IHR,Icontractility,ICOI“ISVR
Use:ICardiogenicIshock,IAnaphylacticIshock,ISepticIshock,IifI2ndIagentIneededIafterInorepine
phrin
, QUESTION
hydrocortisone
Answer:
IMOA:I“IInflammation,IreversesI‘IcapillaryIpermeability
‘IBP,IHR
Use:ISepticIshockIrequiringIvasopressorItherapyI(despiteIfluidIresuscitation)ItoImaintainIadequ
ateIBP
AnaphylacticIshockIifIhypotensionIpersistsIafterIinitialItherapy
Nursing:
-IMonitorIforIhypokalemia,Ihyperglycemia.
-IConsiderIuseIasIcontinuousIinfusion.
QUESTION
nitroglycerin
Answer:
IusedIforIcardiogenicIshock
Nurisng:
monitorIBP,IuseIglassIbottle
QUESTION
norepinephrineI(Levophed)
Answer:
IMOA:I‘IBP,IMAP,ICVP,IPAWP,ISVR,I‘/“ICOIUSe:ISepticIshock—
firstIdrugIofIchoiceIforIBPIunresponsiveItoIadequateIfluidIresuscitation
CardiogenicIshockIafterIMI
QUESTION
phenylephrine
Answer:
