American Association of Critical-Care Nurses (AACN) Certification Practice Test

What is the primary treatment for obstructive shock?

1. Volume replacement

2. Inotropic support

3. Relieve the obstruction

4. Administration of glucocorticoids

The correct answer is: Relieve the obstruction

The primary treatment for obstructive shock focuses on alleviating the underlying cause of the obstruction, making the correct choice to relieve the obstruction. Obstructive shock occurs when there is a physical blockage in the circulation that prevents blood from effectively returning to the heart or being pumped forward, such as in conditions like cardiac tamponade, tension pneumothorax, or pulmonary embolism. Relieving the obstruction restores normal circulation and improves hemodynamics, which is crucial for re-establishing perfusion to vital organs. For instance, if the obstruction is due to tension pneumothorax, decompression through needle thoracostomy is necessary to allow air to escape from the pleural space. In the case of cardiac tamponade, pericardiocentesis or surgical intervention might be indicated. Other treatments, such as volume replacement or inotropic support, may be complementary but do not address the primary issue of the obstruction itself. Volume replacement can help support blood pressure but does not remove the causative block, while inotropic support aims to improve myocardial contractility rather than resolving the obstruction. Administration of glucocorticoids is typically not relevant in the context of obstructive shock, as it does not directly address the physical blockage causing the shock