The nurse is caring for a patient with a cervical spine injury. Currently, the patient is demonstrating signs of vasodilation. Which of the following types of shock is imminent with this patient?
1. hypovolemic
2. transport
3. obstructive
4. cardiogenic
1
Rationale: Vasodilation, leading to hypovolemic shock, can occur with neurogenic shock, anaphylactic shock, and septic shock. Neurogenic shock may occur when there is injury to the spinal cord above the midthoracic region. Impulses from the sympathetic nervous system cannot reach the arterioles, prohibiting vasoconstriction of blood vessels. Blood vessels continue to receive parasympathetic innervation, allowing vasodilation and leading to blood pooling in the dilated peripheral venous system. Transport shock states have impaired oxygenation because of a diminished supply of hemoglobin in which to carry oxygen to tissues. Obstructive shock states have impaired oxygenation because of a mechanical barrier to blood flow. Cardiogenic shock states have impaired oxygenation because the heart fails to function as a pump to deliver oxygenated blood.
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