Your patient had an open colon resection a week ago and developed a subsequent infection of their surgical incision. Now the patient's blood pressure has been dropping for the past 2 hours and is currently 89/65. What type of shock is the patient experiencing?

Distributive

Hypovolemic

Obstructive

Cardiogenic

Answer and Explanation

The Correct Answer is A

A.   This type of shock occurs when there is widespread vasodilation leading to a relative hypovolemia, often seen in conditions like sepsis. Given that the patient has a surgical site infection, this is a plausible consideration. However, distributive shock typically involves more than just hypotension, including symptoms like warm skin and possible fever.
B.   This type of shock results from significant fluid loss, leading to inadequate circulating volume. It can occur after surgery due to bleeding or fluid loss, but the context here suggests that the primary issue is infection rather than direct fluid loss.
C.   Obstructive shock happens when there is a physical obstruction to blood flow, such as in cases of pulmonary embolism or tension pneumothorax. There’s no indication of obstruction in this scenario related to the infection and hypotension.
D.   This shock type occurs when the heart fails to pump effectively, often due to myocardial infarction or severe heart failure. The patient’s history does not suggest heart dysfunction, so this option is less likely.

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Correct Answer is B

Explanation

A. This statement is not typically related to rheumatoid arthritis. RA does not cause low blood sugar directly. While medications or other conditions might affect blood sugar levels, this is not a common symptom or concern specific to RA.
B. Morning stiffness is a hallmark symptom of rheumatoid arthritis. Patients often report increased stiffness and discomfort in their joints upon waking, which can improve with activity throughout the day.
C. While some individuals might gain weight due to reduced physical activity or medication side effects (like corticosteroids), weight loss is also common due to pain and decreased mobility. Thus, this statement is not universally applicable.
D. Abdominal pain is not a primary symptom of RA. However, certain medications used to treat RA, like nonsteroidal anti-inflammatory drugs (NSAIDs), can cause gastrointestinal discomfort, but this is not a direct result of the disease itself.

A. Anemia B. Pancytopenia C. Neutropenia D. Leukopenia

Correct Answer is B

Explanation

A. While anemia is a common finding in aplastic anemia, it is not the most comprehensive answer. Aplastic anemia results in a deficiency of all blood cell types due to bone marrow failure, so while anemia is present, it does not fully capture the extent of the disorder.
B. This is the most accurate choice. Pancytopenia refers to the simultaneous reduction of red blood cells, white blood cells, and platelets. In aplastic anemia, the bone marrow fails to produce adequate blood cells, leading to this triad of cytopenias, making it the hallmark of the disease.
C. Neutropenia, which is a low level of neutrophils (a type of white blood cell), can occur in aplastic anemia. However, it is only one component of the broader condition and does not represent the complete picture of the disease.
D. Leukopenia refers to a low white blood cell count. Like neutropenia, it can be a finding in aplastic anemia, but it does not encompass the anemia and thrombocytopenia that also occur.

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Your patient had an open colon resection a week ago and developed a subsequent infection of their surgical incision. Now the patient's blood pressure has been dropping for the past 2 hours and is currently 89/65. What type of shock is the patient experiencing?

Nursing Test Bank

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