Chapter 13 Workbook Flashcards by Tom Bowl

Inadequate cellular perfusion

Shock

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Adequate circulation of blood to the tissues

Perfusion

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Regulate blood flow in capillaries

Sphincters

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Regulates involuntary body functions

Autonomic nervous system

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The pressure of blood within the vessels at a given moment in time

Blood pressure

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Widespread vascular dilation after exposure to an allergen

Anaphylactic shock

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Widespread vascular dilation in response to severe infection

Septic shock

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Fainting or loss of consciousness

Syncope

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Early stage of shock where blood pressure can still be maintained

Compensated shock

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What is the basic definition of shock?
A. A state of inadequate cellular perfusion
B. The loss of blood from the body
C. An inadequate supply of oxygen in the lungs
D. A state of low blood pressure

A. A state of inadequate cellular perfusion

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Blood flow through the capillary beds is regulated by:
A. systolic pressure
B. the capillary sphincters
C. perfusion
D. diastolic pressure

B. the capillary sphincters

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The autonomic nervous system regulates functions such as:
A. running
B. digestion
C. eye movement
D. walking

B. digestion

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Regulation of blood flow is determined by:
A. oxygen intake
B. systolic pressure
C. cellular need
D. diastolic pressure

C. cellular need

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Patients in cardiogenic shock should NOT receive:
A. oxygen
B. positive pressure ventilation
C. ALS care
D. nitroglycerine

D. nitroglycerine

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Which of the following is a cause of obstructive shock?
A. Hemorrhage
B. Infection
C. Myocardial infarction
D. Tension pneumothorax

D. Tension pneumothorax

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Which of the following is NOT a basic cause of shock?
A. Poor pump function
B. Blood or fluid loss
C. Blood vessel dilation
D. Release of norepinephrine

D. Release of norepinephrine

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Which of the following molecules is the primary carrier of oxygen in the bloodstream?
A. Albumin
B. Iron
C. Hemoglobin
D. Thyroglobulin

C. Hemoglobin

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__________ develops when the heart muscle can no longer generate enough pressure to circulate the blood to all organs.
A. Pump failure
B. Cardiogenic shock
C. A myocardial infarction
D. Congestive heart failure

B. Cardiogenic shock

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Neurogenic shock usually results from damage to the spinal cord at the:
A. cervical level
B. thoracic level
C. lumbar level
D. sacral level

A. cervical level

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Which of the following statements about septic shock is FALSE?
A. There is an insufficient volume of fluid in the container.
B. The fluid that has leaked out often collects in the respiratory system.
C. There is a larger-than-normal vascular bed to contain the smaller-than-normal volume of intravascular fluid.
D. There is damage to the spinal cord, resulting in vasodilation.

D. There is damage to the spinal cord, resulting in vasodilation.

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Neurogenic shock causes hypoperfusion due to:
A. widespread dilation of the vascular system
B. massive vasoconstriction
C. low circulating blood volume
D. obstruction of blood flow from the heart

A. widespread dilation of the vascular system

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Hypovolemic shock is a result of:
A. widespread vasodilation
B. low circulating blood volume
C. massive vasoconstriction
D. pump failure

B. low circulating blood volume

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________ is often the last vital sign to change in decompensated shock.
A. Blood pressure
B. Heart rate
C. Respiratory rate
D. Oxygen saturation

A. Blood pressure

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Which of the following statements about anaphylactic shock is TRUE?
A. There is no blood loss in anaphylactic shock.
B. It is caused by a lack of red blood cells.
C. It is associated with bronchodilation.
D. It can result from myocardial pump failure.

A. There is no blood loss in anaphylactic shock.

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In which of the following scenarios would you LEAST suspect shock? A. a mild allergic reaction B. multiple severe fractures C. a severe infection D. abdominal or chest injury

A. a mild allergic reaction

When treating a suspected unstable shock patient, vital signs should be recorded approximately every ________ minutes. A. 2 B. 5 C. 10 D. 15

B. 5

Which of the following is NOT a sign of cardiogenic shock? A. Cyanosis B. strong, bounding pulse C. Nausea D. Anxiety

B. strong, bounding pulse

________ is a sudden reaction of the nervous system that produces temporary vascular dilation and fainting. A. Neurogenic shock B. Psychogenic shock C. Vascular shock D. Cardiogenic shock

B. Psychogenic shock

Life-threatening allergic reactions can occur even when a patient has previously tolerated a substance without having an allergic reaction.

True

Bleeding is a common cause of cardiogenic shock.

False

Shock occurs when oxygen and nutrients cannot get to the body’s cells.

True

A person in shock, left untreated, will survive.

False

Compensated shock will present with falling blood pressure.

False

An injection of epinephrine is the most effective treatment for anaphylactic shock.

True

Septic shock occurs as a result of a severe infection.

True

Metabolism is the cardiovascular system’s circulation of blood and oxygen to all cells in different tissues and organs of the body.

False

Shock occurs only with massive blood loss from the body.

False

Decompensated shock is a late phase of shock and indicates progression of shock is irreversible.

False

________ refers to inadequate cellular perfusion.

Shock

Pressure in the arteries during cardiac ________ is known as systolic pressure.

contraction

The body responds to shock by directing blood flow away from organs that are more ________ of low flow.

tolerant

Pulse pressure represents the force generated with each ________ of the heart.

contraction

Blood contains red blood cells, white blood cells, ________, and a liquid called ________.

platelets, plasma

Inadequate circulation that does not meet the body’s needs is known as ________.

shock

________ are circular muscle walls in capillaries, causing the walls to ________ and ________.

Sphincters, contract, dilate

________ pressure occurs during cardiac relaxation, while ________ pressure occurs during cardiac contractions.

Diastolic, systolic

As a result of the aging process, older patients generally have more serious ________ than younger patients.

complications

The autonomic nervous system controls the ________ actions of the body.

involuntary

You are called to the residence of a 67-year-old man who is complaining of chest pain. He is alert and oriented. During your assessment, the patient tells you he has had two previous heart attacks. He is taking medication for fluid retention. As you listen to his lungs, you notice that he has fluid in his lungs. This is known as pulmonary: A. edema B. overload C. cessation D. failure

A. edema

You are called to a construction site where a 27-year-old worker has fallen from the second floor. He landed on his back and is drifting in and out of consciousness. A quick assessment reveals no bleeding or blood loss. His blood pressure is 90/60 mm Hg with a pulse rate of 110 beats/min. His airway is open, and his breathing is within normal limits. You realize the patient is in shock. Based on this information, the patient’s shock is most likely due to an injury to the: A. thoracic vertebrae B. skull C. spinal cord D. peripheral nerves

C. spinal cord

You respond to the local nursing home for an 85-year-old woman who has altered mental status. During your assessment, you notice that the patient has a fever. She is hypotensive, and her pulse is tachycardic. The nursing staff tells you that she has been sick for several days and that they called because her mental status continued to decline. You suspect the patient is in septic shock. This type of shock is due to: A. pump failure B. massive vasoconstriction C. release of bacterial toxins D. increased volume

C. release of bacterial toxins

You are called to a motor vehicle collision. Your patient is a 19-year-old woman who was not wearing her seat belt. She is conscious but confused. Her airway is open, and respirations are within normal limits. Her pulse is slightly tachycardic. Her blood pressure is within normal limits. She is complaining of being thirsty and appears very anxious. What is the last measurable factor to change that would indicate shock? A. mental status B. blood pressure C. pulse rate D. respirations

B. blood pressure

You respond to a 17-year-old football player who was hit by numerous opponents. While walking off the field, he became unconscious. You take cervical spine control and start your assessment. You know that in the treatment of shock, you must do all of the following EXCEPT: A. secure and maintain an airway B. provide respiratory support C. assist ventilations D. use hot water bottles or heating pads to keep the patient warm

D. use hot water bottles or heating pads to keep the patient warm

Short Answers List the causes, signs and symptoms, and treatment of anaphylactic shock. Here is the text typed out cleanly with no numbering, exactly as it appears on the page: Short Answer

 Causes: Extreme, life threatening allergic reaction  Signs/Symptoms: Can develop within seconds, mild itching/rash, burning skin, vascular dilation, generalized edema, profound coma, rapid death  Treatment: Manage airway, assist ventilations, administer high flow oxygen, determine cause, assist with administration of epinephrine, transport promptly, consider ALS

Short Answers List the causes, signs and symptoms, and treatment of cardiogenic shock.

 Causes: Inadequate heart function, disease of muscle tissue, impaired electrical system, disease or injury  Signs/Symptoms: Chest pain; irregular pulse; weak pulse; low blood pressure; cyanosis (lips, under nails); cool, clammy skin; anxiety; rales; pulmonary edema  Treatment: Position comfortably, administer high flow oxygen, assist ventilations, transport promptly, consider ALS

Short Answers List the causes, signs and symptoms, and treatment of hypovolemic shock.

 Causes: Loss of blood or fluid  Signs/Symptoms: Rapid, weak pulse; low blood pressure; change in mental status; cyanosis (lips, under nails); cool, clammy skin; increased respiratory rate  Treatment: Secure airway, assist ventilations, administer high flow oxygen, control external bleeding, keep warm, transport promptly, consider ALS

Short Answers List the causes, signs and symptoms, and treatment of neurogenic shock.

 Causes: Damaged cervical spine, which causes widespread blood vessel dilation  Signs/Symptoms: Bradycardia (slow pulse), low blood pressure, signs of neck injury  Treatment: Secure airway, spinal stabilization, assist ventilations, administer high flow oxygen, preserve body heat, transport promptly, consider ALS

Short Answers List the causes, signs and symptoms, and treatment of psychogenic shock.

 Causes: Temporary, generalized vascular dilation; anxiety; bad news; sight of injury/blood; prospect of medical treatment; severe pain; illness; tiredness  Signs/Symptoms: Rapid pulse, normal or low blood pressure  Treatment: Determine duration of unconsciousness, position the patient supine, record initial vital signs and mental status, suspect head injury if patient is confused or slow to regain consciousness, transport promptly

Short Answers List the causes, signs and symptoms, and treatment of septic shock.

 Causes: Severe bacterial infection  Signs/Symptoms: Warm skin or fever, tachycardia, low blood pressure  Treatment: Transport promptly, administer oxygen, assist ventilation, keep warm, consider ALS

Short Answers List the three basic physiologic causes of shock.

1. Pump failure 2. Blood or fluid loss from blood vessels 3. Poor vessel function (blood vessels dilate)

Short Answers List the signs and symptoms of decompensated shock.

Falling blood pressure; labored or irregular breathing; ashen, mottled, or cyanotic skin; thready or absent peripheral pulses; dull eyes or dilated pupils; poor urinary output

Ambulance Calls You are dispatched to the victim of a fall at the local community college theater. One of the students involved in rigging the theater backgrounds fell from the platform above the stage. He landed directly on his back and is now complaining of numbness and tingling in his lower body. How would you best manage this patient?

When assessing the victim of a fall, you must take into consideration not only the patient’s complaints and obvious injuries but also the mechanism of injury, including the height of the fall, the surface on which he or she landed, the position in which he or she landed, and any medical and/or previous traumatic injuries that could exacerbate the injuries. This patient landed on a hard surface, most likely a wooden floor, and now presents with numbness and tingling of his lower body. These are all indicators of spinal cord injury. Assume spinal fractures are present; ensure that you assess pulse, motor, and sensation of all extremities prior to placing him in full spinal precautions; and reassess again after he is stabilized. Be alert for signs of neurogenic shock. Document your findings and continue this assessment en route to the hospital.

Ambulance Calls You are dispatched to a local long‑term care facility for an older man with a fever. You arrive to find an 80‑year‑old man who is responsive to painful stimuli and has the following vital signs: blood pressure of 80/40 mm Hg, weak radial pulse of 140 beats/min and irregular, respirations of 60 breaths/min and shallow, and pulse oximetry of 80% on 4 L/min nasal cannula. His temperature is 101.8°F (38.8°C). How would you best manage this patient?

This patient is in shock, and it seems to be related to an infectious organism (septic shock). In this case, although he has not lost blood volume through hemorrhage, his vessels, or “container,” have become too large, making his available blood volume inadequate. Immediate transport is required. The patient should be given high flow oxygen. Consider ALS.

Ambulance Calls You are dispatched to a residence where a 16‑year‑old girl was stung by a bee. Her mother tells you she is severely allergic to bees. She is voice responsive, covered in hives, and wheezing audibly. She has a very weak radial pulse and is blue around the lips. How would you best manage this patient?

Treat this patient for anaphylactic shock. Apply high flow oxygen while inquiring if the patient has an EpiPen. Based on local protocols, obtain orders and administer the EpiPen, if available. Monitor the patient’s vital signs. Rapid transport is required. Consider ALS.

In the scene size up for a patient(s) who you think may be susceptible to shock, your initial step is to: A. ensure scene safety B. splint all potential fractures first C. ask the patient if he or she has an EpiPen D. immediately obtain a patient history

A. ensure scene safety

During the primary assessment of a patient in shock, you should: A. treat any immediate life threats B. obtain a SAMPLE history C. get a complete set of vital signs D. inform medical control of the situation

A. treat any immediate life threats

You have completed your primary assessment of an embarrassed patient who fainted after seeing a coworker injure himself. Your next step should be: A. a rapid secondary assessment B. to obtain a medical history C. a detailed physical examination D. a reassessment

B. to obtain a medical history

Interventions for the treatment of shock should include: A. giving the patient something to drink B. maintaining normal body temperature C. withholding high flow oxygen D. delaying transport to splint fractures

B. maintaining normal body temperature

You are transporting an unstable patient who you feel is going into shock. How often do you recheck his vital signs? A. Every 3 minutes B. Every 10 minutes C. Every 5 minutes D. Every 15 minutes

C. Every 5 minutes

Chapter 13 Workbook Flashcards

(69 cards)