The surgical ICU nurse is caring for postoperative clients at risk for hypovolemic shock. Which condition represents an early symptom of shock?
Tachypnoea
Heart blocks
Vomiting
Bradycardia
Hypotension
The Correct Answer is A
Tachypnoea, which refers to an increased respiratory rate, is an early symptom of hypovolemic shock. It is the body's compensatory response to inadequate tissue perfusion and decreased oxygen delivery. The increased respiratory rate is an attempt to improve oxygenation and maintain vital organ function.
B. Heart blocks in (option B) are incorrect because Heart blocks refer to disruptions in the electrical conduction system of the heart and are not specific to hypovolemic shock.
C. Vomiting in (option C) is incorrect because: Vomiting may occur in various conditions, including shock, but it is not exclusive to hypovolemic shock and can be present in other forms of shock or illnesses.
D. Bradycardia in (option D) is incorrect because Bradycardia, or a slow heart rate, is not typically an early symptom of hypovolemic shock. Instead, tachycardia (rapid heart rate) is more commonly observed as a compensatory response to maintain cardiac output.
E. Hypotension in (option E) is incorrect because Hypotension, or low blood pressure, can occur in hypovolemic shock but is generally considered a later-stage symptom. In the early stages, compensatory mechanisms may help maintain blood pressure, so hypotension may not be present initially.
F. Bradypnea in (option F) is incorrect because: Bradypnea refers to a slow respiratory rate, which is not typically an early symptom of hypovolemic shock. Tachypnoea, as mentioned earlier, is the more common early respiratory symptom.
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Related Questions
Correct Answer is C
Explanation
Hypovolemic shock is a life-threatening condition resulting from severe blood or fluid loss. The patient in this scenario exhibits signs of hypovolemic shock, such as low blood pressure, tachycardia, cool and clammy skin, and decreased urine output.
When assessing the prescription options, the nurse should consider the appropriateness of each intervention for hypovolemic shock. Plasmanate is a type of plasma protein fraction that is used for volume expansion in certain situations. However, in hypovolemic shock, the primary intervention is to restore intravascular volume promptly. Plasmanate alone may not be sufficient for rapid-volume resuscitation.
In hypovolemic shock, the initial management typically involves the administration of crystalloid solutions, such as Lactated Ringers or Normal Saline, to restore intravascular volume. Therefore, the prescription of Plasmanate as the primary intervention raises concerns and should be questioned by the nurse.
A. Dopamine (Intropin) 12 mcg/min in (option A) is incorrect because: Dopamine is a vasopressor medication used to increase blood pressure and cardiac output. It is a suitable option for hypovolemic shock to support blood pressure and tissue perfusion.
B. Dobutamine (Dobutrex) 5 mcg/kg/min in (option B) is incorrect because: Dobutamine is an inotropic medication that helps improve cardiac contractility and cardiac output. It can be beneficial in cases of hypovolemic shock with signs of poor cardiac function.
D. Bumetanide (Bumex) 1 mg IV in (option D) is incorrect because: Bumetanide is a loop diuretic used to promote diuresis. However, in the context of hypovolemic shock, diuretics are generally not the first-line treatment as they can further reduce intravascular volume and worsen the patient's condition.
It is essential for the nurse to consult with the healthcare provider regarding the prescription order of Plasmanate and consider alternative interventions for rapid volume resuscitation in hypovolemic shock.
Correct Answer is A
Explanation
Disseminated intravascular coagulation (DIC) is a condition characterized by both widespread activation of the coagulation system and excessive clotting, leading to the consumption of clotting factors and platelets. This results in a prothrombotic state, which can lead to organ dysfunction and bleeding manifestations.
Elevated D-dimer levels are a characteristic finding in DIC. D-dimer is a fibrin degradation product that is elevated when there is excessive fibrin formation and breakdown. Elevated D-dimer indicates ongoing fibrinolysis and activation of the clotting system.
B. Decreased prothrombin time in (option B) is incorrect because: DIC is characterized by consumption of clotting factors, which can result in prolongation of the prothrombin time (PT) as well as other coagulation tests.
C. Decreased partial thromboplastin time in (option C) is incorrect because Similar to the prothrombin time, the partial thromboplastin time (PTT) can also be prolonged in DIC due to the consumption of clotting factors.
D. Elevated fibrinogen level in (option D) is incorrect because, In DIC, there is consumption of fibrinogen along with other clotting factors. Therefore, elevated fibrinogen levels are not consistent with the pathophysiology of DIC.
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