Chapter 25 Bleeding and Shock

Question 1

Key Terms

bleeding from an artery, which is characterized by bright red blood that is rapid, profuse, and difficult to control

Answer 1

Arterial Bleeding

Question 2

Key Terms

bleeding from capillaries, which is characterized by a slow, oozing flow of blood

Answer 2

Capillary Bleeding

Question 3

Key Terms

shock, or lack of perfusion, brought on not by blood loss but by the heart’s inadequate pumping action. It is often the result of a heart attack or congestive heart failure

Answer 3

Cardiogenic Shock

Question 4

Key Terms

when the patient is developing shock but the body is still able to maintain perfusion

Answer 4

Compensated Shock

Question 5

Key Terms

when the body can no longer compensate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident

Answer 5

Decompensated Shock

Question 6

Key Terms

bleeding, especially severe bleeding

Answer 6

Hemorrhage

Question 7

Key Terms

shock resulting from blood loss

Answer 7

Hemorrhagic Shock

Question 8

Key Terms

substances applied as powders, dressings, gauze, or bandages to open wounds to stop bleeding

Answer 8

Hemostatic Agents

Question 9

Key Terms

the body’s inability to adequately circulate blood to the body’s cells to supply them with oxygen and nutrients

Answer 9

Hypoperfusion

Question 10

Key Terms

shock resulting from blood or fluid loss

Answer 10

Hypovolemic Shock

Question 11

Key Terms

hypoperfusion due to nerve paralysis (sometimes caused by spinal cord injuries) resulting in the dilation of blood vessels that increases the volume of the circulatory system beyond the point where it can be filled

Answer 11

Neurogenic Shock

Question 12

Key Terms

the supply of oxygen to and removal of wastes from the body’s cells and tissues as a result of the flow of blood through the capillaries

Answer 12

Perfusion

Question 13

Key Terms

a bulky dressing held in position with a tightly wrapped bandage, which applies pressure to help control bleeding

Answer 13

Pressure Dressing

Question 14

Key Terms

the body’s inability to adequately circulate blood to the body’s cells to supply them with oxygen and nutrients, which is a life-threatening condition. Also known as “hypoperfusion”

Answer 14

Shock

Question 15

Key Terms

a device used for bleeding control that constricts all blood flow to and from an extremity

Answer 15

Tourniquet

Question 16

Key Terms

bleeding from a vein, which is characterized by dark red or maroon blood and a steady, easy-to-control flow

Answer 16

Venous Bleeding

Question 17

Short Answer

Name the three main types of blood vessels, and describe the type of bleeding you would expect to see from each one.

Answer 17

The three main blood vessels and the bleeding that might present from each one are:

• Arteries: arterial bleeding is often rapid, spurting with each heartbeat, profuse, and bright red.
• Veins: venous blood is usually a steady flow, can be quite heavy, and is usually dark red or maroon in color.
• Capillaries: capillary bleeding is usually slow, oozing, and red (though not as bright as arterial blood).

Question 18

Short Answer

List the patient care steps for external bleeding control.

Answer 18

The patient care steps for external bleeding include performing a scene size-up, taking Standard Precautions, applying direct pressure to the wound, and administering oxygen. If hemostatic dressings are available, they can be applied, you can use a gloved hand to provide pressure. If bleeding fails to stop, you may need to consider a tourniquet. The patient should be assessed and treated for shock.

Question 19

Short Answer

Define “perfusion” and “hypoperfusion”.

Answer 19

Perfusion is defined as the supply of oxygen to, and removal of wastes from, the body’s cells and tissues as a result of the flow of blood through the capillaries. Hypoperfusion is the body’s inability to adequately circulate blood to the body’s cells to supply them with oxygen and nutrients, similar to what occurs in shock.

Question 20

Short Answer

List the steps and symptoms of shock. Which would you expect to see early? Which are late signs? Explain what causes each of them.

Answer 20

Signs and symptoms of shock include altered mental status; pale, cool, and clammy skin; nausea and vomiting; and vital sign changes (increased pulse, increased respirations, decreasing blood pressure, and narrow pulse pressure). Late signs of shock include thirst, dilated pupils, and cyanosis around the lips and nail beds.

Question 21

Short Answer

List the three major types of shock and what causes each one.

Answer 21

The three major types of shock and their causes are:

• Hypovolemic (hemorrhagic) shock, caused by uncontrolled bleeding.
• Cardiogenic shock, caused by inadequate pumping of blood by the heart.
• Neurogenic shock, caused by uncontrolled dilation of blood vessels due to nerve paralysis from spinal cord injury.

Question 22

Short Answer

List the emergency care steps for treating a patient in shock.

Answer 22

Managing shock includes maintaining an open airway, administering oxygen, and taking spinal precautions as needed. The patient should be kept warm and transported.