A trauma patient is being assessed with the Champion Revised ...

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A trauma patient is being assessed with the Champion Revised Scoring System. What assessment data should the nurse use with this scoring system?
 
  Select all that apply.
  1. diastolic blood pressure
  2. heart rate
  3. Glasgow coma scale
  4. systolic blood pressure
  5. respiratory rate

Question 2

The nurse is reviewing data for a patient experiencing shock. Based on these data, the nurse recognizes that the patient is in which stage of shock?
 
  1. compensatory
  2. early, reversible
  3. progressive
  4. refractory

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Answer to Question 1

Correct Answer: 3, 4, 5

The Champion Revised Scoring System analyzes three elements: the Glasgow Coma Scale, systolic blood pressure, and respiratory rate. The patient receives a total score; the highest score is 12. Although the diastolic blood pressure and heart rate are part of the patient's assessment, they are not included in the Champion Revised Scoring System.

Answer to Question 2

Correct Answer: 3
In compensatory shock, the blood loss is 750 mL, with up to 15 blood volume loss. Other indicators are normal or increased; the patient is only slightly anxious. In early reversible shock there is a blood loss of 7501500 mL, 1530 blood volume loss, heart rate >100, blood pressure normal, pulse pressure decreased, capillary refill and respiratory rate slightly increased, urine output 2030 mL/h. The patient is mildly anxious to agitated. The manifestations in progressive shock are: blood loss of 15002000 mL, 3040 blood volume loss, heart rate >120, blood pressure and pulse pressure decreased, capillary refill increased over normal, moderate tachypnea, urinary output below normal, and mental status altered. In refractory shock, the patient's condition has deteriorated markedly, with over 2,000 mL blood loss and >40 loss of blood volume.