Neurogenic shock NCLEX Qs

Neurogenic shock NCLEX Qs Leave the first rating Students also studied Terms in this set (10) Science MedicineEmergency Medicine Save Spinal Cord Injury NCLEX Questions...Teacher 53 terms julia11213Preview Nclex Questions for Shock - Critical ...32 terms karmageniePreview Shock and Sepsis NCLEX questions 28 terms T_Adams7Preview Shock N 201 term feli P You're working on a neuro unit. Which of your patients below are at risk for developing neurogenic shock?

Select all that apply:

• A 36-year-old with a spinal cord injury at L4.
• A 42-year-old who has spinal anesthesia.
• A 25-year-old with a spinal cord injury above T6.
• A 55-year-old patient who is reporting seeing green

halos while taking Digoxin.

B C

True or False: The parasympathetic nervous system loses

the ability to stimulate nerve impulses in patients who are experiencing neurogenic shock. This leads to hemodynamic changes.FALSE - sympathetic NS

A 42-year-old male patient is admitted with a spinal cord injury. The patient is experiencing severe hypotension and bradycardia. The patient is diagnosed with neurogenic shock. Why is hypotension occurring in this patient with neurogenic shock?

• The patient has an increased systemic vascular

resistance. This increases preload and decreases afterload, which will cause severe hypotension.

• The patient's autonomic nervous system has lost the

ability to regulate the diameter of the blood vessels and vasodilation is occurring.

• The patient's parasympathetic nervous system is being

unopposed by the sympathetic nervous system, which leads to severe hypotension.

• The increase in capillary permeability has depleted the

fluid volume in the intravascular system, which has led to severe hypotension.B You receive a patient in the ER who has sustained a cervical spinal cord injury. You know this patient is at risk for neurogenic shock. What hallmark signs and symptoms, if experienced by this patient, would indicate the patient is experiencing neurogenic shock? Select all

that apply:

• Blood pressure 69/38
• Heart rate 170 bpm
• Blood pressure 250/120
• Heart rate 29
• Warm and dry extremities
• Cool and clammy extremities
• Temperature 104.9 'F
• Temperature 95 'F

A D E H

In neurogenic shock, a patient will experience a decrease in tissue perfusion. This deprives the cells of oxygen that make up the tissues and organs. Select all the mechanisms, in regards to pathophysiology, of why this is

occurring:

• Loss of vasomotor tone
• Increase systemic vascular resistance
• Decrease in cardiac preload
• Increase in cardiac afterload
• Decrease in venous blood return to the heart
• Venous blood pooling in the extremities

A C E F

You're providing care to a patient experiencing neurogenic shock due to an injury at T4. As the nurse, you know which of the following is a patient safety priority?

• Keeping the head of the bed greater than 45 degrees

at all times.

• Repositioning the patient every thirty minutes.
• Keeping the patient's spine immobilized.
• Avoiding log-rolling the patient during transport.

C

A patient in neurogenic shock is ordered intravenous fluids due to severe hypotension. During administration of the fluids the nurse will monitor the patient closely and immediately report?

• Increase in blood pressure
• High central venous pressure (CVP) and pulmonary

artery wedge pressure (PAWP)

• Urinary output of 300 mL in the past 5 hours
• Mean arterial pressure (MAP) 85 mmHg

B A patient with neurogenic shock is experiencing a heart rate of 30 bpm. What medication does the nurse anticipate will be ordered by the physician STAT?

• Adenosine
• Warfarin
• Atropine
• Norepinephrine

C Your patient in neurogenic shock is not responding to IV fluids. The patient is started on vasopressors. What option below, if found in your patient, would indicate the medication is working?

• Decreased CVP (central venous pressure)
• Mean arterial pressure (MAP) 90 mmHg
• Serum lactate 6 mmol/L
• Blood pH 7.20

B You're developing a nursing plan of care for a patient with neurogenic shock. As the nurse, you know that due to venous blood pooling from vasodilation a deep vein thrombosis can occur in this type of shock. A patient goal is that the patient will be free from the development of a deep vein thrombosis. Select all the nursing interventions

below that can help the patient meet this goal:

• Perform range of motion exercises daily.
• Place a pillow underneath the patient knees as

needed.

• Administer anticoagulants as scheduled per physician's

order.

• Apply compression stockings daily.

A C D