RN Nursing · Health Assessment · Practice question
A nurse is providing care for a client experiencing obstructive shock. Which of the following diagnoses should the nurse expect?
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✓
Cardiac tamponade.
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Cardiomyopathy.
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Third spacing.
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Ruptured aneurysm.
Answer & explanation
Correct: Cardiac tamponade.
Obstructive shock occurs when blood flow is physically blocked outside the heart, preventing adequate cardiac output despite normal cardiac function and adequate circulating volume. Cardiac tamponade is the classic cause of obstructive shock: fluid accumulates in the pericardial sac, compressing the heart and preventing ventricular filling, which dramatically reduces stroke volume and cardiac output. Other causes of obstructive shock include tension pneumothorax, pulmonary embolism, and constrictive pericarditis. Cardiomyopathy is a cause of cardiogenic shock, not obstructive shock, because the problem lies within the myocardium itself rather than in an external obstruction. Third spacing refers to fluid shifting into a third compartment and is associated with distributive or hypovolemic shock mechanisms, not obstructive shock. A ruptured aneurysm causes hypovolemic shock due to massive blood loss, not an obstruction to blood flow. Understanding the mechanism behind each shock type is essential: in obstructive shock, the pump is structurally intact but mechanically prevented from filling or ejecting blood. Recognizing cardiac tamponade as the correct answer requires students to distinguish the four shock categories — distributive, cardiogenic, hypovolemic, and obstructive — and match each to its underlying etiology.
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