Homework answers / question archive / Shock Patient 1: M

Shock Patient 1: M

Health Science

Share With

---

Shock

Patient 1: M.J. is a 40-year-old female who had a mastectomy 3 days ago and has started on chemotherapy for stage 4 breast cancer. M.J. has a central line, a urinary catheter, and the surgical incision. She is alert and oriented. Her skin is flushed and hot to touch. Her vitals are: T 104, HR 110, RR 30, B/P 106/66. Hemodynamics are CO 5, CVP 3. EKG is sinus tachycardia per the monitor.

Patient 2: N.H. is a 49-year-old male who was admitted 24 hours ago with chest pain. He has a history of hypertension. He is overweight and exercises little. He was diagnosed with a large Inferior STEMI. N.H. is lethargic and short of breath. His skin is cool and clammy. N.H. has crackles bilaterally in lungs. His vitals are: T 99.2, HR 110 and thready, RR 30, B/P 106/66. EKG shows sinus tachycardia with frequent PVCs. Hemodynamics are CO 3, CVP 6, preload is high.

Patient 3: K.M. is a 25-year-old Korean American male who was not wearing his seatbelt when he was the driver involved in a motor vehicle collision. The windshield was broken and K.M. was found face down, conscious, and moaning, 15 feet from his car. In the ER, a chest tube was placed which drained 500 ml bright red blood immediately. He is on a morphine drip. Left lung without sounds, right lung diminished. His vitals are: T98.5, HR 108, RR 20, B/P 80/60. EKG shows sinus tachycardia. Hemodynamics show: CO 4, CVP 2, preload is decreased.

Patient 4: P.T. is a 76-year-old man who is 16 hours post-op from a left broken hip. He was alert and oriented with 3/10 pain in hip. His lungs are clear bilaterally. His second dose of Ancef began 5 minutes ago. He is now restless and short of breath. He is complaining of itching. His vital signs are T99, HR 130, RR 36, B/P 70/40. No hemodynamics given.

Looking at the above four patients,

• What type of shock is each patient experiencing?
• What are the manifestations for each shock that led you to that answer?
• What are your top three nursing priorities with rationale for each patient?
• What stage of shock is each patient exhibiting? Give rationale for your answer.