Chapter 13. Hypovolemic Shock
Which of the following is the key goal of therapy in the first hour of hypovolemic shock?
A. MAP greater than 90 mm Hg
B. SBP greater than 90 mm Hg
C. SBP greater than 60 mm Hg
D. Hematocrit is at least 30% (0.30) using transfusions
E. Normalization of urine output and base deficit
What should be the first pharmacologic/fluid intervention in an adult patient with an SBP less than 90 mm Hg or MAP less than 60 mm Hg?
A. Administer 2 units of Type O PRBCs
B. Administer 1000 to 2000 mL of 0.9% NaCl or LR
C. Begin dopamine or norepinephrine infusion
D. Administer 5% albumin infusion
E. Begin stress ulcer prophylaxis and antithrombotic therapy
What is the primary reason that hetastarch products are no longer recommended for initial resuscitation in hypovolemic shock?
A. Crystalloids clearly result in lower mortality
B. Hetastarch has a higher risk of infections
C. Hetastarch is more effective but avoided due to high cost
D. Hetastarch is associated with acute kidney injury
E. Crystalloids require a smaller administration volume
What potential adverse event requires caution if using dextran in hemorrhagic hypovolemic shock?
B. Risk of infection from contamination
C. Drug-induced pancreatitis
D. Inhibition of the coagulation cascade
E. Electrolyte abnormalities
What are some primary indications for whole blood/PRBC administration in the acute resuscitation phase in adults?
A. All patients should receive 2 units of Type O PRBCs
B. Blood losses exceeding 750 mL or ongoing bleeding
C. Blood losses exceeding 1500 mL or ongoing bleeding
D. Administer in patients with a PA catheter and vasopressors
E. Administer in all patients requiring mechanical ventilation