Chapter 26: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome

1. Shock syndrome can best be described as a

a. physiologic state resulting in hypotension and tachycardia.

b. generalized systemic response to inadequate tissue perfusion.

c. degenerative condition leading to death.

d. condition occurring with hypovolemia that results in irreversible hypotension.

ANS: B

Shock is a complex pathophysiologic process that often results in multiple organ dysfunction syndrome and

death. All types of shock eventually result in ineffective tissue perfusion and the development of acute

circulatory failure.

2. Hypovolemic shock that results from an internal shifting of fluid from the intravascular space to the

extravascular space is known as

a. absolute hypovolemia.

b. distributive hypovolemia.

c. relative hypovolemia.

d. compensatory hypovolemia.

ANS: C

Hypovolemia results in a loss of circulating fluid volume. A decrease in circulating volume leads to a decrease

in venous return, which results in a decrease in end-diastolic volume or preload.

3. The nursing measure that can best enhance large volumes of fluid replacement in hypovolemic shock is

a. insertion of a large-diameter peripheral intravenous catheter.

b. positioning the patient in the Trendelenburg position.

c. forcing at least 240 mL of fluid each hour.

d. administering intravenous lines under pressure.

ANS: A

Measures to facilitate the administration of volume replacement include insertion of large-bore peripheral

intravenous catheters; rapid administration of prescribed fluids; and positioning the patient with the legs

elevated, trunk flat, and head and shoulders above the chest.

4. The main cause of cardiogenic shock is