Shock and Fluid Resuscitation Flashcards
6 cards from real TNCC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Shock and Fluid Resuscitation flashcards as text
Which type of shock is characterized by decreased cardiac output due to impaired myocardial contractility following blunt chest trauma?
Answer: Cardiogenic shock
Cardiogenic shock from blunt cardiac injury (myocardial contusion) results in decreased contractility and reduced cardiac output despite adequate intravascular volume.
During massive transfusion protocol, which electrolyte abnormality is most likely to cause cardiac arrest?
Answer: Hyperkalemia
Hyperkalemia from stored blood products (potassium leaks from aged RBCs) can cause fatal cardiac dysrhythmias including ventricular fibrillation and asystole during massive transfusion.
A trauma patient receiving crystalloid resuscitation develops worsening metabolic acidosis. Which crystalloid is LEAST likely to cause hyperchloremic acidosis?
Answer: Lactated Ringer's solution
Lactated Ringer's solution has a chloride concentration (109 mEq/L) closer to plasma (98-106 mEq/L) and contains lactate buffer, making it less likely to cause hyperchloremic metabolic acidosis compared to normal saline (154 mEq/L chloride).
Tranexamic acid (TXA) administration in trauma hemorrhage is most effective when given within what time frame from injury?
Answer: 3 hours
The CRASH-2 trial demonstrated that TXA reduces mortality from hemorrhage when administered within 3 hours of injury. Administration after 3 hours may increase mortality.
Which assessment finding differentiates obstructive shock from hypovolemic shock?
Answer: Distended neck veins are present in obstructive shock but flat in hypovolemic shock
Obstructive shock (cardiac tamponade, tension pneumothorax) presents with distended neck veins from impaired venous return to the heart, while hypovolemic shock presents with flat neck veins from volume depletion.
A trauma patient in hemorrhagic shock has received 4 units of PRBCs and remains hypotensive with a heart rate of 140. The next priority in the massive transfusion protocol is:
Answer: Continue balanced transfusion with plasma and platelets in a 1:1:1 ratio with PRBCs
Current evidence supports a balanced 1:1:1 ratio of PRBCs to plasma to platelets during massive transfusion to address both oxygen-carrying capacity and coagulopathy simultaneously.