RN Nursing · High-Risk Pregnancy — Ectopic Pregnancy and Spontaneous Abortion · Practice question
A client in the emergency department has a suspected ruptured ectopic pregnancy. Which type of shock should the nurse monitor for?
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Cardiogenic shock
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Anaphylactic shock
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✓
Hypovolemic shock
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Septic shock
Answer & explanation
Correct: Hypovolemic shock
A ruptured ectopic pregnancy causes sudden, massive internal hemorrhage into the peritoneal cavity as the fallopian tube or other implantation site ruptures. This acute blood loss leads to a dramatic reduction in intravascular volume, meeting the definition of hypovolemic shock. Clinical signs include hypotension, tachycardia, dizziness, pallor, and referred shoulder pain from diaphragmatic irritation by blood. Immediate surgical intervention and aggressive fluid resuscitation are required. Cardiogenic shock arises from pump failure of the heart, such as in acute myocardial infarction or severe valvular disease, and is not related to hemorrhage. Anaphylactic shock is a distributive shock caused by a severe allergic or hypersensitivity reaction involving massive histamine release, vasodilation, and bronchospasm; there is no allergen exposure in this scenario. Septic shock is also a distributive shock caused by systemic infection and inflammatory mediator release; while ruptured ectopic pregnancy carries infection risk, the acute presentation is hemorrhagic. Students sometimes confuse the types of shock; the key differentiating feature here is rapid blood loss, which points definitively to hypovolemic shock as the primary concern in the emergency setting.
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