Obstructive, not cardiogenic: this NU656 Unit 2 paper classifies a composite post-operative shock from bedside hemodynamics and an echo, and reaches treatment only on its last page. Searches like "nu 656 unit 2 assignment example", "nu656 unit 2 sample" and "nu656 unit 2 example" land here.
What a finished NU656 Unit 2 shock classification paper looks like
The paper runs four pages. Its case opens in one paragraph: sudden breathlessness on post-operative day [three], pressure [78/52], heart rate [128], saturation [87] percent on [6] liters, jugular venous pressure near [10] cm, clear lungs, mottled knees, lactate [4.4] mmol/L and urine output below [20] mL an hour. Next comes a classification table with four rows, one per shock state, and columns for filling pressure, pump output, vascular resistance, skin and the discriminating finding. Her values are placed in the table cell by cell. Two states survive, cardiogenic and obstructive, and a section separates them with a bedside echocardiogram: a dilated right ventricle, a flattened septum and an underfilled left ventricle. Treatment appears only on the last page, framed by the 2019 ESC pulmonary embolism guideline (Konstantinides and colleagues).
How a NU656 Unit 2 example is structured
The paper's order enforces its rule. Physiology comes first and drugs last, so no treatment can be chosen before the state is named. The table uses the three variables every shock state disturbs differently, and the paper cites Vincent and De Backer (NEJM, 2013) for the relative frequency of each, noting that obstructive shock is the rarest and therefore the easiest to overlook. Her data rule out distributive shock, since her skin is cold and her tone high, and hypovolemic shock, since her neck veins are full. Cardiogenic and obstructive shock share high filling, low output and high tone, which is why a fourth column exists. Clear lungs argue against a failing left ventricle; the echocardiogram settles it. Only then does the last page reach reperfusion, where recent surgery changes the options.
Three variables, four states
Filling pressure, pump output and vascular resistance form the table's columns, with skin temperature and a discriminator beside them. Each row holds the pattern expected for one state, so the patient's values can be laid against all four at once.
Rows struck out
Cold, mottled skin with a high calculated resistance excludes distributive shock, and a jugular pulse at [10] cm excludes simple volume loss. The paper crosses out each row with the finding that eliminated it.
The pair that look alike
Cardiogenic and obstructive states both show full veins, low output and vasoconstriction. Clear lung fields, no new murmur and a troponin only mildly raised at [0.09] ng/mL tilt the paper toward the right side of the heart before any image.
What the echo adds
A right ventricle larger than the left, septal flattening and a small, vigorous left ventricle name the state as obstructive. The paper treats the image as confirmation of a typing already argued, not as the argument itself.
Treatment, last and constrained
High-risk embolism would ordinarily call for systemic thrombolysis, but major surgery in the preceding [21] days appears among the guideline's contraindications. Surgical embolectomy or catheter-directed therapy is proposed instead, with cautious fluid and norepinephrine for pressure, doses bracketed.
Where marks go in NU656 Unit 2
Typing carries the grade. A paper that reaches for fluids or a vasopressor before naming the state has skipped the decision this unit centers on, and instructors tend to stop awarding reasoning credit at that point. The table is checked cell by cell; placing high filling under distributive shock, or low resistance under cardiogenic shock, is an error that undoes the argument built on it. Separating the two cold, congested states is where the reasoning is really tested, so a paper that jumps from low pressure to embolism without explaining why the left ventricle is not the problem earns less. Treatment is read for fit: thrombolysis proposed [three] days after major surgery, with no mention of the contraindication, is marked as unsafe. Unlabeled units and a missing frequency source draw minor comment.
Get a NU656 Unit 2 example written to your instructions
Whatever hemodynamic data the NU656 Unit 2 case lists, the typing is built from them; include your rubric and any classification table the section prefers. Free on a first request and back within 24-48h, the paper sorts the patient into one of four shock states using pressures, pump output and vascular resistance, and only then turns to drugs.
NU656 Unit 2 questions, answered
What if the case gives no cardiac output number?
Most bedside cases do not. The sample estimates output from skin temperature, capillary refill, urine output, lactate and pulse pressure, and says plainly that it is estimating. A narrow pulse pressure with cold extremities suggests low output; warm skin with a wide pulse pressure suggests the opposite. If your case supplies echo or catheter data, the table uses them directly.
Why does the echo come after the table instead of before it?
Because the typing should stand on bedside data any clinician can gather, and the image then confirms or overturns it. A paper that opens with the echo tends to skip the reasoning a grader is looking for. In practice both happen within minutes, and the sample says so; the order on the page reflects the argument, not the clinical timeline.
Can a patient have more than one shock state at once?
Yes, and mixed states are common in intensive care: a septic patient with a weakened heart, or a bleeding patient who is also vasodilated. The sample names a single dominant state because this case supports one, and it states what would suggest a second, such as falling resistance after reperfusion. A prompt with a mixed picture would get a table showing both.