A client admitted with septic shock develops tachycardia and an increase of 20 mm Hg in systolic blood pressure. What pathophysiologic factors of hyperdynamic shock are influential in the development of these manifestations?
A. Inflammatory reaction of circulating endotoxins
B. Vasoconstriction resulting in tissue hypoxia
C. Reductions in hematocrit and hemoglobin
D. Platelet aggregation
A
Circulating endotoxins interact with white blood cells and blood vessel walls to trigger inflam-matory reactions. Some endotoxins exert a direct effect on the heart, causing an initial increase in cardiac output and resulting in tachycardia, with normal to elevated systolic blood pressure. In hyperdynamic shock, vasodilation is present. Reductions in hematocrit and hemoglobin levels are seen late in septic shock accompanying hemorrhage. Platelet aggregation can cause micro-thrombus formation, leading to disseminated intravascular coagulation (DIC).
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