During the refractory stage of shock in hypovolemia, which of the following responses accurately describes the physiological changes that occur?
Increased cardiac output and improved tissue perfusion
Restored fluid balance and resolution of hypovolemia
Worsening organ dysfunction and failure
Decreased heart rate and improved blood pressure
The Correct Answer is C
A. In the refractory stage, cardiac output is decreased and tissue perfusion is severely impaired, not improved.
B. Fluid balance is not restored during the refractory stage; instead, hypovolemia worsens.
C. The refractory stage is characterized by irreversible damage with worsening organ dysfunction and failure despite interventions.
D. Heart rate usually increases initially, and blood pressure typically decreases; decreased heart rate and improved blood pressure are not features of this stage.
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Related Questions
Correct Answer is D
Explanation
A. Platelets are administered to treat or prevent bleeding due to thrombocytopenia or platelet dysfunction, not primarily for volume loss.
B. Albumin is a plasma volume expander and may be used in hypovolemia, but it does not replace oxygen-carrying capacity like RBCs do.
C. Cryoprecipitates are rich in clotting factors (e.g., fibrinogen, factor VIII) and are used for coagulopathies, not as a primary treatment for hypovolemic shock.
D. Packed RBCs are the appropriate choice in hypovolemic shock, especially when blood loss has occurred, as they restore oxygen-carrying capacity and circulating blood volume.
Correct Answer is D
Explanation
A. Sepsis is a general systemic infection that can arise from many sources but is not the specific concern addressed by prophylactic antibiotics in valve replacement patients.
B. Otitis media (middle ear infection) is unrelated to dental or surgical procedures and not a concern in valve replacement clients.
C. Deep vein thrombosis (DVT) is prevented with anticoagulants and mobility, not antibiotics.
D. Bacterial endocarditis is a serious infection of the heart's inner lining or valves. Clients with valve replacements are at increased risk, especially during procedures like dental work that may introduce bacteria into the bloodstream. Antibiotic prophylaxis is essential to prevent this potentially life-threatening condition.
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