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In hypovolemic shock, reduced intravascular blood volume causes circulatory dysfunction and inadequate tissue perfusion. What is Hypovolemic Shock?Hypovolemic shock is one of the most common cardiac complications.
PathophysiologyThe pathophysiology of hypovolemic shock include the following processes:
CausesHypovolemic shock usually results from acute blood loss- about one-fifth of the total volume.
Clinical ManifestationsHypovolemic shock requires early recognition of signs and symptoms.
PreventionFor prevention of hypovolemic shock, the following must be implemented:
ComplicationsHypovolemic shock, if left untreated, would result to the following complications:
Assessment and Diagnostic FindingsNo single symptom or diagnostic test establishes the diagnosis or severity of shock.
Medical ManagementEmergency treatment measures must include prompt and adequate fluid and blood replacement to restore intravascular volume and raise blood pressure.
Pharmacologic TherapyIf fluid administration fails to reverse hypovolemic shock, the following are given:
Nursing ManagementPrimary prevention of shock is an essential focus of nursing care. Nursing AssessmentAssessment of the following is vital in hypovolemic shock:
Nursing DiagnosisBased on the assessment data, the major nursing diagnoses are: Nursing Care Planning & GoalsMain Article: 4 Hypovolemic Shock Nursing Care Plans The major goals for the patient are:
Nursing InterventionsNursing care focuses on assisting with treatment targeted at the cause of the shock and restoring intravascular volume.
EvaluationExpected outcomes for the patient include:
Documentation GuidelinesThe focus of documentation include:
Practice Quiz: Hypovolemic ShockLet’s test your knowledge about this study guide with this quiz. Please visit our nursing test bank page for more NCLEX practice questions. 1. A mainstay of therapy for virtually all forms of shock is: A. Intravenous fluids. 1. Answer: A. Intravenous fluids.
2. Which of the following intravenous solutions is least useful, and possibly harmful, as the initial resuscitation solution in a patient with a head injury who has blood loss? A. 5% dextrose in water. D. Hypertonic saline. 2. Answer: D. Hypertonic saline.
3. Which of the following causes of circulatory insufficiency can lead to shock as a result of decreased plasma volume? A. Penetrating trauma with blood loss. B. Gastrointestinal bleeding. C. Anaphylaxis because of medications. D. All of the above. 3. Answer: D. All of the above.
4. Which of the following medications is least likely to alter the usual presentation of patients presenting with hypovolemic shock? A. Metoprolol. 4. Answer: D. Cephalexin.
5. A patient who is in hypovolemic shock has the following clinical signs: Heart rate 120 beats/minute, blood pressure 80/55 mmHg and urine output 20ml/hr. After administering an IV fluid bolus, which of these signs if noted by the healthcare provider is the best indication of improved perfusion? A. Heart rate drops to 100 beats/minute. B. Right atrial pressure increases.
C. Urine output increases to 30mL/hour. 5. Answer: C. Urine output increases to 30mL/hour.
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