A 19-year-old patient with massive trauma and possible spinal ...

[pepyto]

A 19-year-old patient with massive trauma and possible spinal cord injury is admitted to the emergency department (ED). Which assessment finding by the nurse will help confirm a diagnosis of neurogenic shock?
 
  a. Inspiratory crackles.
  b. Cool, clammy extremities.
  c. Apical heart rate 45 beats/min.
  d. Temperature 101.2 F (38.4 C).

Question 2

An older patient with cardiogenic shock is cool and clammy and hemodynamic monitoring indicates a high systemic vascular resistance (SVR). Which intervention should the nurse anticipate doing next?
 
  a. Increase the rate for the dopamine (Intropin) infusion.
  b. Decrease the rate for the nitroglycerin (Tridil) infusion.
  c. Increase the rate for the sodium nitroprusside (Nipride) infusion.
  d. Decrease the rate for the 5 dextrose in normal saline (D5/.9 NS) infusion.

[wshriver]

Answer to Question 1

ANS: C
Neurogenic shock is characterized by hypotension and bradycardia. The other findings would be more consistent with other types of shock.

Answer to Question 2

ANS: C
Nitroprusside is an arterial vasodilator and will decrease the SVR and afterload, which will improve cardiac output. Changes in the D5/.9 NS and nitroglycerin infusions will not directly decrease SVR. Increasing the dopamine will tend to increase SVR.