A nurse is providing postoperative care to a client who lost 800 mL of blood during surgery. The client's blood pressure has been steadily decreasing over the past 2 hr. Which of the following categories of shock should the nurse recognize is occurring?

Hypovolemic shock

Septic shock

Obstructive shock

Neurogenic shock

Answer and Explanation

The Correct Answer is A

A. Hypovolemic shock: Hypovolemic shock occurs due to a significant decrease in circulating blood volume, leading to inadequate tissue perfusion. Blood loss, such as that experienced by the client in the scenario, is a common cause of hypovolemic shock. The decrease in blood pressure observed over time is consistent with the compensatory mechanisms of hypovolemic shock, where the body attempts to maintain perfusion to vital organs despite decreased blood volume.

B. Septic shock: Septic shock results from a systemic inflammatory response to infection, leading to vasodilation, increased capillary permeability, and maldistribution of blood flow. While infection can lead to hypovolemia in some cases, the scenario does not provide evidence of infection or systemic inflammatory response as the cause of shock.

C. Obstructive shock: Obstructive shock occurs when there is obstruction to blood flow within the cardiovascular system, such as in cases of pulmonary embolism, cardiac tamponade, or tension pneumothorax. There is no evidence in the scenario to suggest an obstruction to blood flow as the cause of the client's shock.

D. Neurogenic shock: Neurogenic shock results from loss of sympathetic tone leading to vasodilation and relative hypovolemia. It is often associated with spinal cord injury or severe head injury. While neurogenic shock can lead to hypotension, the scenario does not indicate any neurological injury or insult as the cause of the client's shock.

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Correct Answer is C

Explanation

A. Isolated: This term refers to something that is separate or distinct. Confusion and agitation in a client are not typically isolated but can be part of a broader clinical picture.

B. Permanent: These manifestations are not typically permanent and can often be reversed with appropriate interventions.

C. Reversible: Confusion and agitation in a client are often reversible and can be due to various factors such as medications, infections, metabolic disturbances, or other medical conditions. Identifying and addressing the underlying cause can often restore the client to their baseline mental status.

D. Unique: While every individual's presentation may have unique aspects, confusion and agitation are not considered unique manifestations in the context of acute changes in mental status. They are common symptoms that can occur due to a variety of reasons and are not exclusive to any particular condition.

A. Septal myectomy B. Synchronized electrical cardioversion C. Pericardiocentesis D. Pericardial window

Correct Answer is B

Explanation

A. Septal myectomy: Septal myectomy is a surgical procedure primarily used to treat hypertrophic cardiomyopathy (HCM), not atrial fibrillation. It involves removing a portion of the thickened septal wall in the heart to improve blood flow.

B. Synchronized electrical cardioversion: Synchronized electrical cardioversion is a procedure used to convert abnormal heart rhythms, such as atrial fibrillation, back to normal sinus rhythm. It involves delivering a synchronized electrical shock to the heart at a specific point in the cardiac cycle to restore normal rhythm.

C. Pericardiocentesis: Pericardiocentesis is a procedure used to remove fluid from the pericardial sac surrounding the heart. It is typically performed to relieve cardiac tamponade or to investigate the cause of pericardial effusion.

D. Pericardial window: A pericardial window is a surgical procedure performed to create a permanent opening in the pericardium, the sac surrounding the heart. It is usually done to drain fluid or air from the pericardial space, often in cases of recurrent pericardial effusion or cardiac tamponade.

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A nurse is providing postoperative care to a client who lost 800 mL of blood during surgery. The client's blood pressure has been steadily decreasing over the past 2 hr. Which of the following categories of shock should the nurse recognize is occurring?

Nursing Test Bank

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