1. Chapter 4 Shock
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2. Instructions
The following unit contains individual case studies which are based on the information learned in the pathophysiology review.
Evaluate each case, review the signs and symptoms and determine the diagnosis of the disease from the provided options.
Once you have determined the diagnosis, proceed to the next slide to receive the answer with the rationale.
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3. Question 1 of 5
24 year old white /female had been stabbed in the abdomen during an assault. She extremely lethargic and difficult to awaken. Her skin is pale, cool and clammy. Pupils are equal and reactive to light.
Lung sounds are clear in all lung fields. The abdomen is rigid and she has pain on palpation. She has equal range of motion and strength in all extremities. The patient has a history of Diabetes.
Her Blood pressure was 81/57, pulse 126 and is weak and thready, respirations 24. Her blood sugar is 107 mg/dl. Oxygen saturation by pulse oximeter is 97%.
a. Anaphylactic shock d. Neurogenic shock
b. Cardiogenic shock e. Septic shock c. Hypovolemic shock
Answer

4. Question 1 of 5
24 year old white /female had been stabbed in the abdomen during an assault. She extremely lethargic and difficult to awaken. Her skin is pale, cool and clammy. Pupils are equal and reactive to light.
Lung sounds are clear in all lung fields. The abdomen is rigid and she has pain on palpation. She has equal range of motion and strength in all extremities. The patient has a history of Diabetes.
Her Blood pressure was 81/57, pulse 126 and is weak and thready, respirations 24. Her blood sugar is 107 mg/dl. Oxygen saturation by pulse oximeter is 97%.
Stabbed in the abdomen
Lethargic and difficult to awaken
Skin is pale, cool and clammy
Abdomen is rigid and she has pain on palpation.
Blood pressure was 81/57
Pulse 126 and is weak and thready, respirations 24
Key Indicators
a. Anaphylactic shock d. Neurogenic shock
b. Cardiogenic shock e. Septic shock c. Hypovolemic shock
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5. Question 2 of 5
78 year old black/female has been sick with a productive cough, fever, chills and diarrhea for several days. She is presently lethargic and confused to person, place and time. Her skin is dry, hot and flushed.
Pupils are equal and reactive to light. Lung sounds demonstrate the presence of mucous (rhonchi) in all lung fields. The abdomen is soft and non-tender. She has equal range of motion and strength in all extremities. The patient has a history of Diabetes.
Her Blood pressure was 81/49, pulse 132 and is weak, respirations 32. Her blood sugar is 167 mg/dl. Her temperature is degrees Fahrenheit. Oxygen saturation by pulse oximeter is 94%.
a. Anaphylactic shock d. Neurogenic shock
b. Cardiogenic shock e. Septic shock c. Hypovolemic shock
Answer

6. Question 2 of 5
78 year old black/female has been sick with a productive cough, fever, chills and diarrhea for several days. She is presently lethargic and confused to person, place and time. Her skin is dry, hot and flushed.
Pupils are equal and reactive to light. Lung sounds demonstrate the presence of mucous (rhonchi) in all lung fields. The abdomen is soft and non-tender. She has equal range of motion and strength in all extremities. The patient has a history of Diabetes.
Her Blood pressure was 81/49, pulse 132 and is weak, respirations 32. Her blood sugar is 167 mg/dl. Her temperature is degrees Fahrenheit. Oxygen saturation by pulse oximeter is 94%.
Sick with a productive cough, fever, chills and diarrhea for several days.
Lethargic and confused to person, place and time
Skin is dry, hot and flushed
Lung sounds - mucous (rhonchi) in all lung fields
Blood pressure was 81/49
Pulse 132 and is weak, respirations 32.
Fever - Temperature is degrees
Key Indicators
a. Anaphylactic shock d. Neurogenic shock
b. Cardiogenic shock e. Septic shock c. Hypovolemic shock
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7. Question 3 of 5
16 year old black/female had jumped in head first into a lake striking her head on the shallow bottom. She presently complains of no feeling below her neck and a laceration on her head.
She is alert and oriented to person, place and time. Her skin is dry, warm and flushed. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and non-tender.
She has no sensation, range of motion or strength in all extremities. The patient has no medical history. Her Blood pressure was 77/47, pulse 126 and is weak and thready, respirations 24. Her blood sugar is 117 mg/dl. Oxygen saturation by pulse oximeter is 98%.
a. Anaphylactic shock d. Neurogenic shock
b. Cardiogenic shock e. Septic shock c. Hypovolemic shock
Answer

8. Question 3 of 5
16 year old black/female had jumped in head first into a lake striking her head on the shallow bottom. She presently complains of no feeling below her neck and a laceration on her head.
She is alert and oriented to person, place and time. Her skin is dry, warm and flushed. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and non-tender.
She has no sensation, range of motion or strength in all extremities. The patient has no medical history. Her Blood pressure was 77/47, pulse 126 and is weak and thready, respirations 24. Her blood sugar is 117 mg/dl. Oxygen saturation by pulse oximeter is 98%.
Jumped in head first into a lake striking her head
No feeling below her neck
Skin is dry, warm and flushed
No sensation, range of motion or strength in all extremities
Blood pressure was 77/47
Pulse 126 and is weak and thready, respirations 24
Key Indicators
a. Anaphylactic shock d. Neurogenic shock
b. Cardiogenic shock e. Septic shock c. Hypovolemic shock
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9. Question 4 of 5
65 year old white /male had been suffering from severe dull, mid-sternal chest pain all morning with extreme difficulty breathing. He presently no longer has pain but is extremely lethargic and difficult to awaken. His skin is pale, cool and clammy.
Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. He has equal range of motion and strength in all extremities.
The patient has a history of Angina, Hypertension and Diabetes. His Blood pressure was 77/42, pulse 56 and weak, respirations 24. His blood sugar is 107 mg/dl. Oxygen saturation by pulse oximeter is 95%.
a. Anaphylactic shock d. Neurogenic shock
b. Cardiogenic shock e. Septic shock c. Hypovolemic shock
Answer

10. Question 4 of 5
65 year old white /male had been suffering from severe dull, mid-sternal chest pain all morning with extreme difficulty breathing. He presently no longer has pain but is extremely lethargic and difficult to awaken. His skin is pale, cool and clammy.
Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. He has equal range of motion and strength in all extremities.
The patient has a history of Angina, Hypertension and Diabetes. His Blood pressure was 77/42, pulse 56 and weak, respirations 24. His blood sugar is 107 mg/dl. Oxygen saturation by pulse oximeter is 95%.
Severe dull, mid-sternal chest pain all morning with extreme difficulty breathing
Extremely lethargic and difficult to awaken
Skin is pale, cool and clammy
History of Angina, Hypertension and Diabetes
Blood pressure was 77/42
Pulse 56 and weak, respirations 24
Key Indicators
a. Anaphylactic shock d. Neurogenic shock
b. Cardiogenic shock e. Septic shock c. Hypovolemic shock
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11. Question 5 of 5
12 year old black/male was stung by a bee 10 minutes ago. He is presently complaining of difficulty breathing, hives, and swelling of the lips, tongue, face. He is very lethargic; is alert to person, place and time. His skin is dry and flushed. Pupils are equal and reactive to light.
Lung sounds are diminished with expiratory wheezing in all lung fields. The abdomen is soft, and non-tender. He has equal range of motion and strength in all extremities. The patient has no medical history.
His Blood pressure was 84/46, pulse 124 and regular, respirations 36 and labored. His blood sugar is 101 mg/dl. Oxygen saturation by pulse oximeter is 92%.
a. Anaphylactic shock d. Neurogenic shock
b. Cardiogenic shock e. Septic shock c. Hypovolemic shock
Answer

12. Question 5 of 5
12 year old black/male was stung by a bee 10 minutes ago. He is presently complaining of difficulty breathing, hives, and swelling of the lips, tongue, face. He is very lethargic; is alert to person, place and time. His skin is dry and flushed. Pupils are equal and reactive to light.
Lung sounds are diminished with expiratory wheezing in all lung fields. The abdomen is soft, and non-tender. He has equal range of motion and strength in all extremities. The patient has no medical history.
His Blood pressure was 84/46, pulse 124 and regular, respirations 36 and labored. His blood sugar is 101 mg/dl. Oxygen saturation by pulse oximeter is 92%.
Stung by a bee
Difficulty breathing
Hives
Swelling of the lips, tongue, face
Skin is dry and flushed
Expiratory wheezing in all lung fields
Blood pressure was 84/46
Pulse 124 and regular, respirations 36 and labored
Key Indicators
a. Anaphylactic shock d. Neurogenic shock
b. Cardiogenic shock e. Septic shock c. Hypovolemic shock
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13. Proceed to the next unit
COMPLETE UNIT 4
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