Shock and Hemodynamic Monitoring Flashcards

A flight nurse is transporting a patient with a mean arterial pressure (MAP) of 55 mmHg, heart rate of 128 bpm, and cold clammy skin. Which type of shock is most consistent with these findings?

Answer: Hypovolemic shock

Hypovolemic shock presents with tachycardia, hypotension, and cold/clammy skin due to compensatory vasoconstriction from volume loss.

Which hemodynamic profile is most characteristic of cardiogenic shock?

Answer: High SVR, low CO, high PCWP

Cardiogenic shock features a failing pump (low CO), compensatory vasoconstriction (high SVR), and fluid backup causing elevated PCWP.

A patient's blood pressure is 90/60 mmHg. What is the calculated mean arterial pressure (MAP)?

Answer: 70 mmHg

MAP = DBP + 1/3(PP) = 60 + 1/3(30) = 60 + 10 = 70 mmHg.

A shock index greater than 1.0 in an adult trauma patient indicates:

Answer: Significant hemodynamic compromise requiring aggressive intervention

A shock index (HR/SBP) > 1.0 signals significant compromise and predicts the need for massive transfusion or surgical intervention.

During transport of a septic patient, the flight nurse notes a central venous pressure (CVP) of 2 mmHg. This finding is most consistent with:

Answer: Hypovolemia requiring fluid resuscitation

A CVP below 5 mmHg indicates low right-sided filling pressure, suggesting hypovolemia and the need for fluid resuscitation.

According to the American College of Surgeons, Class III hemorrhagic shock is characterized by blood loss of approximately:

Answer: 1500–2000 mL (30–40% blood volume)

Class III hemorrhage (30–40% blood volume loss) manifests with marked tachycardia, tachypnea, altered mental status, and hypotension.

Which vasopressor is considered first-line therapy for septic shock according to current Surviving Sepsis Campaign guidelines?

Answer: Norepinephrine

Norepinephrine is the first-line vasopressor for septic shock due to its potent alpha-adrenergic effect restoring vascular tone with minimal tachycardia.