In an ICU setting, one assessment that would lead the nurse to suspect shock has resulted in decrease blood flow to vital organs is:
A) Warm legs with peripheral vasodilation
B) Urine output less than 20 mL/hour
C) Blood pressure staying in the 98/72 range for the past hour
D) Sleepiness and difficulty to arouse without using painful stimuli
Ans: B
Feedback:
Continuous measurement of urine output is essential for assessing the circulatory status of a person in shock. Oliguria of 20 mL/hour or less indicates inadequate renal perfusion. Continuous measurement of urine output is essential for assessing the circulatory and volume status of the person in shock and monitoring the response to fluid replacement. As the shock progresses and blood flow to the brain decreases, restlessness is replaced by apathy and stupor. Sympathetic stimulation also leads to intense vasoconstriction of the skin vessels and activation of the sweat glands. As a result, the skin is cool and moist. There is an increase in heart rate, cool and clammy skin, a decrease in arterial blood pressure, and a decrease in urine output.
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