Your 15-year-old male patient has a stab wound along the right sternal border at the fourth intercostal space. The patient responds to painful stimuli and shows little evidence of external bleeding. His respirations are 30, his breath sounds are clear and equal, and his radial pulse is weak and disappears on inspiration. The patient has distended jugular veins and is dyspneic. This patient is most likely suffering from ________ shock due to ________.

Question

Quizplus · Accepted Answer

The patient's presentation is consistent with obstructive shock, which can be caused by cardiac tamponade. The location of the stab wound along the right sternal border at the fourth intercostal space, in close proximity to the heart, suggests that the injury has caused blood to accumulate in the pericardial sac, compressing the heart and preventing it from filling properly during diastole. This leads to inadequate cardiac output, which can result in decreased arterial pressure and impaired tissue perfusion. The presence of distended jugular veins and dyspnea further support the diagnosis of cardiac tamponade. Hypovolemic shock, distributive shock, and hypoxic shock are less likely given the patient's symptoms and injury location. Hemothorax and tension pneumothorax are also possible differentials, but the absence of external bleeding and clear breath sounds make these less likely compared to cardiac tamponade.

Your 15-Year-Old Male Patient Has a Stab Wound Along the Right