A nurse and a newly licensed nurse are providing care for a client who has distributive shock. How should the nurse explain the pathophysiology of distributive shock to the newly licensed nurse?
"Distributive shock occurs due to increased systemic vascular resistance."
"Distributive shock occurs due to systemic vasodilation."
"Distributive shock occurs due to loss of myocardial contractility."
"Distributive shock occurs due to loss of blood volume."
The Correct Answer is B
A. Increased systemic vascular resistance is typically associated with hypovolemic or cardiogenic shock, not distributive shock.
B. Distributive shock is characterized by systemic vasodilation, which leads to a decrease in systemic vascular resistance and results in inadequate tissue perfusion despite normal or increased cardiac output.
C. Loss of myocardial contractility is related to cardiogenic shock, not distributive shock.
D. Loss of blood volume is a characteristic of hypovolemic shock, whereas distributive shock occurs even when blood volume is normal due to vasodilation.
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Correct Answer is D
Explanation
A. Furosemide is a diuretic and is not indicated in the acute management of anaphylaxis.
B. Methylprednisolone is a corticosteroid that may be used later to reduce inflammation but is not the first-line treatment in anaphylaxis.
C. Dobutamine is a medication used to treat heart failure and shock but does not address the acute allergic reaction.
D. Epinephrine is the first-line treatment for anaphylactic shock, as it acts quickly to reverse severe allergic reactions by causing vasoconstriction, bronchodilation, and inhibiting further release of mediators from mast cells.
Correct Answer is C
Explanation
A. Mottled skin is more indicative of the progressive or refractory stages of shock, where perfusion to the skin is severely compromised.
B. A heart rate of 160/min indicates tachycardia, which is common in shock but is not the most characteristic finding of the compensatory stage.
C. During the compensatory stage of shock, the body attempts to maintain blood pressure and perfusion, and a blood pressure of 115/68 mmHg suggests that compensatory mechanisms are still functioning adequately.
D. Hypokalemia is not a typical finding in the compensatory stage; rather, the body may exhibit signs of hyperkalemia due to tissue breakdown and acidosis.