Your patient had an open colon resection a week ago and developed a subsequent infection of their surgical incision. Now the patient's blood pressure has been dropping for the past 2 hours and is currently 89/65. What type of shock is the patient experiencing?

Distributive

Hypovolemic

Obstructive

Cardiogenic

Answer and Explanation

The Correct Answer is A

A.   This type of shock occurs when there is widespread vasodilation leading to a relative hypovolemia, often seen in conditions like sepsis. Given that the patient has a surgical site infection, this is a plausible consideration. However, distributive shock typically involves more than just hypotension, including symptoms like warm skin and possible fever.
B.   This type of shock results from significant fluid loss, leading to inadequate circulating volume. It can occur after surgery due to bleeding or fluid loss, but the context here suggests that the primary issue is infection rather than direct fluid loss.
C.   Obstructive shock happens when there is a physical obstruction to blood flow, such as in cases of pulmonary embolism or tension pneumothorax. There’s no indication of obstruction in this scenario related to the infection and hypotension.
D.   This shock type occurs when the heart fails to pump effectively, often due to myocardial infarction or severe heart failure. The patient’s history does not suggest heart dysfunction, so this option is less likely.

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Correct Answer is ["A","C","D","E"]

Explanation

A. This term refers to the passage of fresh blood through the anus, usually indicating lower GI bleeding (such as from the colon or rectum). It is a common and significant sign of GI bleeding.
B. Hypertension (high blood pressure) is generally not a sign of GI bleeding. In fact, GI bleeding typically leads to hypotension (low blood pressure) due to volume loss, making this choice incorrect.
C. Tarry stool (melena) indicates the presence of digested blood in the stool, typically resulting from upper GI bleeding. It appears black and sticky and is a common sign of GI bleeding.
D. This refers to vomiting that looks like coffee grounds, which indicates that blood has been present in the stomach and has undergone digestion. This is a classic sign of upper GI bleeding and is a significant symptom.
E. Hematemesis is the vomiting of blood, which can be bright red or resemble coffee grounds, depending on the source and severity of the bleeding. It is a common and serious sign of GI bleeding, particularly from the upper GI tract.

A. The CKD patient is likely to suffer from recurrent bouts of Diabetes Insipidus B. The CKD patient's kidneys don't produce Erythropoietin, so they will receive shots to increase RBC production C. The CKD patient is likely to be chronically hypokalemic D. CKD patients will likely be chronically Hypercalcemic

Correct Answer is B

Explanation

A. Diabetes Insipidus is primarily related to issues with the production of vasopressin (ADH) or the body's response to it, which is not directly caused by CKD. CKD may lead to fluid retention and imbalances, but it does not typically cause recurrent bouts of diabetes insipidus.
B. In CKD, the kidneys lose their ability to produce erythropoietin, a hormone that stimulates red blood cell production in the bone marrow. Patients often require erythropoiesis-stimulating agents (ESAs) like erythropoietin injections to manage anemia associated with CKD.
C. CKD patients are often hyperkalemic (high potassium levels) rather than hypokalemic. As kidney function declines, the kidneys struggle to excrete potassium, leading to elevated levels, which can cause serious complications.
D. CKD patients often experience hypocalcemia (low calcium levels) due to several factors, including decreased activation of vitamin D and imbalances in phosphate levels. While some patients may experience transient hypercalcemia due to treatments or dietary factors, chronic hypercalcemia is not typical in CKD.

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Your patient had an open colon resection a week ago and developed a subsequent infection of their surgical incision. Now the patient's blood pressure has been dropping for the past 2 hours and is currently 89/65. What type of shock is the patient experiencing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following are common signs or symptoms of GI bleeding? (Select all that apply)

Correct Answer is ["A","C","D","E"]

Explanation

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Correct Answer is B

Explanation

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Your patient had an open colon resection a week ago and developed a subsequent infection of their surgical incision. Now the patient's blood pressure has been dropping for the past 2 hours and is currently 89/65. What type of shock is the patient experiencing?

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