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 A

Explanation

A. Atrial fibrillation: Atrial fibrillation is characterized by an irregularly irregular rhythm, absence of identifiable P waves, and irregular ventricular response. The heart rate in atrial fibrillation can be variable, and the absence of identifiable P waves indicates disorganized atrial electrical activity.

B. Sinus bradycardia: Sinus bradycardia is characterized by a regular rhythm with a heart rate less than 60 beats per minute (bpm) and normal P waves preceding each QRS complex. In sinus bradycardia, the PR interval and QRS duration are typically within normal limits.

C. Supraventricular tachycardia: Supraventricular tachycardia (SVT) is characterized by a regular rhythm with a heart rate greater than 100 bpm. SVT typically presents with narrow QRS complexes and may or may not have discernible P waves.

D. First-degree heart block: First-degree heart block is characterized by a prolonged PR interval (>0.20 seconds) but maintains a regular rhythm with normal QRS duration. In first-degree heart block, P waves are typically identifiable, and the rhythm is not irregular.

A. "I'm glad that I can work remotely from my computer." B. "l can't wait to be able to take a bath." C. "l get bored only being able to watch television." D. "l will be relieved once I can drive myself to the store." E. None F. None

Correct Answer is C

Explanation

Answer: C

Rationale:

A) "I'm glad that I can work remotely from my computer. Prolonged use of a computer can strain the eyes, potentially interfering with the healing process after a retinal reattachment procedure. Clients are generally advised to limit screen time during recovery.

B) "I can't wait to be able to take a bath. Submerging the face in water, as during a bath, is discouraged postoperatively due to the risk of introducing bacteria into the eye and delaying healing. Clients are advised to stick to showers and avoid getting the affected eye wet.

C) "I get bored only being able to watch television. Watching television is usually permissible following retinal surgery, as it does not strain the eye excessively. This statement aligns with typical postoperative instructions.

D) "I will be relieved once I can drive myself to the store." Driving is contraindicated during the recovery phase due to potential visual disturbances and the need for the eye to heal properly. Clients are typically instructed to avoid driving until cleared by their ophthalmologist.

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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

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is evaluating the plan of care during a postoperative visit for a client who had a retinal reattachment procedure. Which of the following statements indicates the client is following the instructions in the plan of care?

Correct Answer is C

Explanation

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