Which of the following are types of shock and their respective causes? (Select All that Apply.)
Neurogenic shock - caused by a disruption in the autonomic nervous system.
Hypovolemic shock - caused by severe blood loss or fluid loss.
Metabolic shock - caused by severe metabolic acidosis.
Anaphylactic shock - caused by an allergic reaction.
Septic shock - caused by a severe infection.
Cardiogenic shock - caused by a failure of the heart to pump effectively.
Correct Answer : A,B,D,E,F
Choice A Reason:
Neurogenic shock occurs due to a disruption in the autonomic nervous system, often resulting from spinal cord injuries. This disruption leads to a loss of sympathetic tone, causing widespread vasodilation and a subsequent drop in blood pressure. The hallmark of neurogenic shock is hypotension with bradycardia, which differentiates it from other types of shock that typically present with tachycardia. The loss of vascular tone results in pooling of blood in the extremities, reducing venous return to the heart and decreasing cardiac output.
Choice B Reason:
Hypovolemic shock is caused by a significant loss of blood or fluids, leading to inadequate circulating volume. This can result from trauma, surgery, gastrointestinal bleeding, or severe dehydration. The primary mechanism is a reduction in preload, which decreases stroke volume and cardiac output. Clinical signs include tachycardia, hypotension, and cool, clammy skin. Rapid fluid resuscitation is critical to restore circulating volume and improve tissue perfusion.
Choice C Reason:
Metabolic shock is not a recognized type of shock in medical literature. The term might be confused with metabolic acidosis, which can occur secondary to shock but is not a primary cause. Metabolic acidosis results from the accumulation of lactic acid due to anaerobic metabolism when tissues are inadequately perfused. Therefore, metabolic shock is not considered a valid type of shock.
Choice D Reason:
Anaphylactic shock is a severe, life-threatening allergic reaction that leads to widespread vasodilation, increased capillary permeability, and bronchoconstriction. Common triggers include foods, insect stings, medications, and latex. Symptoms include hypotension, swelling, difficulty breathing, and hives. Immediate administration of epinephrine is crucial to counteract the severe allergic response and stabilize the patient.
Choice E Reason:
Septic shock results from a severe infection that leads to systemic inflammation and widespread vasodilation. The infection triggers an overwhelming immune response, causing damage to blood vessels and organs. Clinical features include fever, hypotension, tachycardia, and altered mental status. Early recognition and aggressive treatment with antibiotics and fluid resuscitation are essential to improve outcomes.
Choice F Reason:
Cardiogenic shock occurs when the heart fails to pump effectively, leading to inadequate tissue perfusion. Common causes include myocardial infarction, severe heart failure, and arrhythmias. Symptoms include hypotension, tachycardia, and signs of poor perfusion such as cool extremities and altered mental status. Treatment focuses on improving cardiac output through medications, mechanical support, or revascularization procedures.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Establishing IV access and starting fluid replacement is important for maintaining hemodynamic stability, especially if there is significant blood loss. However, it is not the immediate priority in this scenario. Ensuring the neck is stabilized takes precedence to prevent potential spinal cord injury.
Choice B Reason:
Inserting a nasogastric tube is not a priority in the acute management of a trauma patient with a head injury. This procedure can be deferred until the patient's airway and cervical spine are secured and other life-threatening conditions are addressed.
Choice C Reason:
Keeping the neck stabilized is the priority action. In a trauma patient with a head injury, there is a high risk of cervical spine injury. Stabilizing the neck prevents further damage to the spinal cord, which could result in paralysis or other severe complications.
Choice D Reason:
Monitoring pulse and blood pressure frequently is essential for assessing the patient's hemodynamic status. However, it is not the immediate priority over stabilizing the cervical spine. Once the neck is stabilized, continuous monitoring of vital signs should follow.
Correct Answer is B
Explanation
Choice A Reason:
Fluid imbalance is a significant concern in burn patients due to the loss of fluids through damaged skin. This can lead to hypovolemic shock if not managed properly. However, while fluid resuscitation is crucial, it is not the immediate priority over airway management in the case of burns to the head and neck. Ensuring the airway is clear and unobstructed takes precedence because airway compromise can lead to rapid deterioration and death.
Choice B Reason:
Airway obstruction is the most critical risk in patients with extensive burns to the head and neck. Burns in these areas can cause swelling, leading to airway compromise. Inhalation injuries from smoke or hot gases can also cause airway edema and respiratory distress. Immediate assessment and intervention to secure the airway are paramount to prevent hypoxia and ensure the patient can breathe adequately. This is why airway management is the top priority in such cases.
Choice C Reason:
Infection is a major risk for burn patients due to the loss of the skin barrier, which normally protects against pathogens. Burn wounds are highly susceptible to bacterial colonization and infection, which can lead to sepsis if not properly managed. While infection control is vital, it is not the immediate priority over securing the airway in the acute phase of burn management. Once the airway is secured, infection prevention and control measures can be implemented.
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