When cells in shock do not get enough oxygen, they switch to anaerobic metabolism, which produces lactic acid.
Missing Word
anaerobic
Anaerobic metabolism makes energy without oxygen and yields lactic acid as a by-product, which is why acidosis develops as perfusion fails.
Category: Cellular Effects
Question 2
In the refractory stage of shock, pooled deoxygenated blood gives the skin a lacy, bluish-red pattern called mottling.
Missing Word
mottling
Mottling is a patchy, net-like discoloration from sluggish, poorly oxygenated blood in the skin, a sign of severe and late hypoperfusion.
Category: Stages of Shock
Question 3
Stored blood contains the anticoagulant citrate, which binds calcium, so rapid transfusion of many units can cause tingling, tetany and dysrhythmias.
Missing Word
citrate
Citrate keeps stored blood from clotting by binding calcium; when many units are given quickly, the extra citrate lowers calcium and magnesium levels, a problem called citrate toxicity that the nurse watches for.
Category: Hypovolemic Shock
Question 4
After massive transfusion, oozing from IV sites and wounds can signal a coagulopathy, an impaired ability of the blood to clot, because the replacement fluids and stored cells supply too few clotting factors.
Missing Word
coagulopathy
A coagulopathy is a disorder of clotting; replacing large blood losses with fluids and packed cells dilutes the clotting factors, so the nurse monitors for bleeding and platelets or plasma may be ordered.
Category: Hypovolemic Shock
Question 5
In the compensatory stage of shock, epinephrine and norepinephrine narrow the blood vessels, a response called vasoconstriction, to raise blood pressure.
Missing Word
vasoconstriction
Vasoconstriction increases vascular resistance and supports blood pressure, but it also reduces flow to the skin, gut and kidneys.
Category: Stages of Shock
Question 6
When poor blood flow to the gut in shock stops peristalsis without any physical blockage, the abdomen distends, bowel sounds disappear, and the patient has developed an ileus.
Missing Word
ileus
An ileus is a loss of intestinal movement with no mechanical obstruction; gut hypoperfusion in shock can cause it, so the nurse assesses bowel sounds and abdominal distention.
Category: Organ Dysfunction
Question 7
After prolonged, severe vomiting and diarrhea, a patient in hypovolemic shock has a high hematocrit that reflects hemoconcentration, a rise in the proportion of red cells because plasma water has been lost while the cells remain.
Missing Word
hemoconcentration
Hemoconcentration occurs when fluid is lost from the blood but red cells are not, so the hematocrit and hemoglobin read high even though the patient is volume depleted. Once fluids are replaced, the values can fall as the blood is diluted, so the nurse interprets them alongside the clinical picture.
Category: Hypovolemic Shock
Question 8
For a patient with sepsis who cannot eat, feeding delivered through a tube into the stomach or small intestine, called enteral nutrition, is linked with better outcomes.
Missing Word
enteral
Enteral nutrition uses the gastrointestinal tract; in sepsis it helps meet raised metabolic needs and may improve outcomes compared with no feeding.
Category: Septic Shock
Question 9
Late septic shock, often called cold shock, is a hypodynamic state with low cardiac output, high vascular resistance and cool, pale limbs.
Missing Word
hypodynamic
Hypodynamic describes falling cardiac output; it follows the earlier warm, high-output phase and signals worsening shock.
Category: Septic Shock
Question 10
Before the first dose of broad-spectrum antibiotics for suspected sepsis, the nurse makes sure blood is sent for cultures, tests that grow the organism in the laboratory and show which drugs will kill it.
Missing Word
cultures
Cultures identify the organism causing sepsis and its drug sensitivities. They are drawn before antibiotics because a dose given first can keep the organism from growing; antibiotics are then started promptly and adjusted once results return.
Category: Septic Shock
Question 11
Early in sepsis, sympathetic stimulation produces a tachycardia that raises the heart muscle's oxygen demand and shortens the time the ventricles have to fill.
Missing Word
tachycardia
Tachycardia is a fast heart rate; in sepsis it compensates for low blood pressure at first, but it increases myocardial oxygen use and reduces filling time, which can lower cardiac output.
Category: Septic Shock
Question 12
High blood glucose pulls water into the urine and causes an osmotic diuresis that drains fluid from the circulation.
Missing Word
diuresis
Diuresis is increased urine production; glucose spilling into the urine drags water with it, causing absolute hypovolemia as fluid leaves the body.
Category: Hypovolemic Shock
Question 13
A spinal cord injury that weakens the abdominal muscles leaves the patient with a weak cough, so airway secretions are hard to clear and pneumonia becomes more likely.
Missing Word
cough
An effective cough depends on the abdominal muscles; when injury weakens them, secretions pool, so the nurse assesses breathing closely and supports airway clearance.
Category: Neurogenic Shock
Question 14
Below a high spinal cord injury the patient cannot sweat, shiver or constrict skin vessels, so body temperature drifts toward that of the surrounding room.
Missing Word
temperature
Loss of sympathetic control removes the body's ways of holding its temperature steady, so the patient can become hypothermic or hyperthermic and temperature is monitored closely.
Category: Neurogenic Shock
Question 15
When a patient in neurogenic shock has significant bradycardia, some providers place a temporary pacemaker to keep the heart rate adequate.
Missing Word
pacemaker
A pacemaker delivers electrical impulses that set the heart rate, supporting cardiac output when unopposed vagal tone slows the heart in neurogenic shock.
Category: Neurogenic Shock