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Chapter 13. Hypovolemic Shock

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Which of the following is the key goal of therapy in the first hour of hypovolemic shock?

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A. MAP greater than 90 mm Hg

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B. SBP greater than 90 mm Hg

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C. SBP greater than 60 mm Hg

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D. Hematocrit is at least 30% (0.30) using transfusions

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E. Normalization of urine output and base deficit

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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?

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A. Administer 2 units of Type O PRBCs

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B. Administer 1000 to 2000 mL of 0.9% NaCl or LR

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C. Begin dopamine or norepinephrine infusion

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D. Administer 5% albumin infusion

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E. Begin stress ulcer prophylaxis and antithrombotic therapy

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What is the primary reason that hetastarch products are no longer recommended for initial resuscitation in hypovolemic shock?

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A. Crystalloids clearly result in lower mortality

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B. Hetastarch has a higher risk of infections

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C. Hetastarch is more effective but avoided due to high cost

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D. Hetastarch is associated with acute kidney injury

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E. Crystalloids require a smaller administration volume

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What potential adverse event requires caution if using dextran in hemorrhagic hypovolemic shock?

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A. Hemolytic reaction

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B. Risk of infection from contamination

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C. Drug-induced pancreatitis

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D. Inhibition of the coagulation cascade

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E. Electrolyte abnormalities

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What are some primary indications for whole blood/PRBC administration in the acute resuscitation phase in adults?

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A. All patients should receive 2 units of Type O PRBCs

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B. Blood losses exceeding 750 mL or ongoing bleeding

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C. Blood losses exceeding 1500 mL or ongoing bleeding

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D. Administer in patients with a PA catheter and vasopressors

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E. Administer in all patients requiring mechanical ventilation

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