CCRN Multisystem

Question 1

clinical findings in neurogenic shock are related to which of the following

Answer 1

Loss of SNS innervation

Question 2

when SNS innervation is lost what happens

Answer 2

no alpha or beta receptors function resulting in loss of vascular tone (alpha) and a decrease in heart rate, contractility, and conductivity (beta)

Question 3

colloids do what

Answer 3

increase intravascular colloidal oncotic pressure

Question 4

cardiac index is decreased, SVR is increased, and urine output is decreased in what form of shock

Answer 4

hypovolemic and cardiogenic

Question 5

what differentiates hypovolemic and cardiogenic shock

Answer 5

Decreased PAOP in hypovolemic shock

Question 6

a pulse can be felt at the radial site, the SBP is at least

Answer 6

80

Question 7

Pulse is felt at brachial artery then the carotid; what are the SBPs

Answer 7

70, 60

Question 8

early septic shock looks like this

Answer 8

Increased cardiac output and index, decreased RAP and PAOP, and a decrease in SVR

Question 9

methanol causes what

Answer 9

metabolic acidosis

Question 10

in a toxin situation, what are PNS effects

Answer 10

constricted pupils, brady cardia, hypotension, drooling

Question 11

PNS is to

Answer 11

cholinergic

Question 12

SNS is to

Answer 12

adrenergic

Question 13

this shock shows, increased CO, SVR decreased, and SvO2 is increased

Answer 13

early septic shock

Question 14

at levels greater than 10 mcg/kg/min this drug exerts pure alpha effects, causing peripheral vasoconstriction (ie cool, pale skin, slow capillary refill, and decreased UOP; what drug is it

Answer 14

dopamine

Question 15

The RAAS system is maladaptive in which type of shock

Answer 15

cardiogenic

Question 16

what is the preferred crystallolid in hypovolemic shock

Answer 16

NS

Question 17

what is NOT a common pathophysiologic manifestation seen in patients with septic shock

Answer 17

tissue hypoxia resulting from decreased oxygen delivery

Question 18

This drug may cause QT interval prolongation and may cause torsades

Answer 18

Amitriptyline

Question 19

what is common in all forms of shock

Answer 19

decrease in cellular oxygenation

Question 20

what is an indication to stop treatment of bowel irrigation in toxic ingestions

Answer 20

the rectal effluent is clear

Question 21

to block cholinergic effects, give a what

Answer 21

anticholingergic such as atropine

Question 22

what organ system is most common to fail in severe sepsis

Answer 22

hematologic

Question 23

exaggerated inflammation, excessive coagulation, and impaired fibrinolysis for what

Answer 23

sepsis

Question 24

a patient with a normal serum lactate could also have

Answer 24

renal failure, due to it being an accumulation of nonvolatile acids

Question 25

what is the difference between anaphylactoid and anaphylactic reaction

Answer 25

anaphylactoid reaction does not require previous exposure to the antigen

Question 26

methanol causes what issue with regard to an ABG and why

Answer 26

metabolic acidosis with increased anion gap

Question 27

what is the classic picture of early septic shock

Answer 27

increased CI/CO, decreased RAP and PAOP, and decreased SVR

Question 28

what does the RAAS system do

Answer 28

causes vasoconstriction (increases afterload) and retention of sodium and water (increases preload) all leading to more work for the heart

Question 29

which toxicity causes metabolic acidosis because aspirin is acetylsalicylic acid

Answer 29

salicylate toxicity

Question 30

acid base imbalance in aspirin toxicity

Answer 30

respiratory alkalosis and metaboolic acidosis

Question 31

T/F: renal failure patients have normal serum lactate

Answer 31

true

Question 32

the most specific characteristic of distributive shocks such as septic shock is a decrease in what

Answer 32

SVR ( indicator for afterload)

Question 33

the PAOP is decreased in what type of shock but elevated in which other type

Answer 33

hypovolemic; cardiogenic

Question 34

why is SvO2 increased in septic shock

Answer 34

because the tissue has a difficult time extracting the oxygen from the blood

Question 35

earliest indication of hepatic failure

Answer 35

hypoglycemia (liver performs functions of glycogenolysis and gluconeogenesis)