Case Study Question 1 A 72-year-old female patient is recovering on the telemetry unit after a cardiac catheterization. She was ambulating to the bathroom when she reported feeling lightheaded and weak. Upon assessment, the nurse notes the following: Vital signs: Blood pressure: 90/60 mmHg (down from 120/80 mmHg 1 hour ago) Heart rate: 115 bpm Respiratory rate: 24 breaths per minute SpO₂: 94% on room air The nurse observes a rapidly expanding hematoma and active bleeding at the groin site where the femoral artery was accessed. The telemetry monitor shows the following: Based on the patient’s condition, the nurse recognizes the patient is likely experiencing hypovolemic shock due to bleeding. Which of the following interventions should the nurse prioritize, and why?  

You are the RN managing care for a patient with multiple gunshot wounds to the abdomen, and the massive transfusion protocol has been activated. Which three interrelated conditions, collectively known as the “Triad of Death,” must be closely monitored and prevented during this critical situation?

Sepsis and anaphylactic shock both fall under the umbrella of distributive shock. Please address the two following components.  1.) What is the hallmark of distributive shock? 2.) How does their pathophysiology differ?

Case Study Question 3 Despite immediate interventions to control bleeding and aggressive volume resuscitation, the patient’s condition continues to deteriorate. The nurse notes the following changes: BP: 70/40 (33) HR: 160 bpm RR: 36 breaths per minute SPO2: 88% on a non-rebreather mask Skin: Cold, mottled, and clammy Urine output: 5 mL in the past hour The patient’s ABG now shows: pH: 7.20  PaCO₂: 48 HCO₃⁻: 14  Lactate: 9.2  The patient is transitioning from the progressive stage of shock to the refractory stage. Which physiological changes best characterize this transition, and what is the nurse’s next priority?

A 55-year-old male is brought to the emergency department after a motor vehicle collision. He reports severe chest pain and difficulty breathing. His vital signs and clinical findings are as follows: Vital signs: BP – 90/50 mmHg HR – 122 RR – 30  SPO2: 90% on room air Physical exam: Tachypnea and diaphoresis Decreased breath sounds at the base of the lungs Jugular venous distention (JVD) is noted Muffled heart sounds upon auscultation The physician suspects pericardial tamponade as a result of blunt chest trauma. What is the priority intervention for this patient?

  Order: Neurontin 0.1 g p.o. t.i.d. Give: __[A]__ form of drug __[B]__

  Order: Motrin 600 mg p.o. b.i.d Supply: Motrin 200 mg tablet Give: ____ tablet(s)

Order: Diabinese 0.1 g p.o. daily Supply: Diabinese 100 mg tablets Give: -___tablet(s)

  Order: Tranxene 7.5 mg p.o. q.i.d. Supply: Tranxene 3.75 mg capsules Give: ____capsule(s)

  Order: carbamazepine 0.2 g p.o. t.i.d. Give: __[A]__ Form of the drug __[B]__