Hypovolemic Shock- EXAM 4

Question 1

What is Hypovolemic shock

Answer 1

Inadequate perfusion
Total body fluid decrease

Question 2

HR and SV part in shock

Answer 2

HR is too high, beats too fast so SV is not being filled up as much bc heart beats too fast, this in turn causes less CO to be produced, causing their to be less blood in the heart

Question 3

Signs and Symptoms

Answer 3

Cool clammy skin
Weak rapid pulse
Hypotension
altered mental status
Decreased urinary output
Thirst!
Acidosis
All these occur during compensation phase, may not be seen in early stages of shock

Question 4

Hypovolemic shock causes

Answer 4

Hemorrhage
Burns
Decreased body fluids
GI loss: N&V, Diarrhea
DM
Surgery

Question 5

Early shock

Answer 5

Decrease in 10mmHg
Increased CO
Pulse is slightly elevated
Very subtle symptom but good to catch it early on

Question 6

Compensatory shock

Answer 6

10-15 mmHg loss
Chemical compensation occurs to maintain vital organs, BP and perfusion
Increased HR and Decreased pulse & urine output
THIRST kicks in
Tissue hypoxia occurs in nonvital organs
Treatment can stop process with no damage so is reversible

Question 7

Decompensation shock

Answer 7

Progressive phase
Decrease in >20mmHg
Compensatory mechanisms are active but can’t maintain sufficient oxygen for vital organs
Pallor, impending doom, rapid weak pulse and low BP and pH
Vital organs go through hypoxia and nonvital organs become anoxic
MODS
Unless treated rapidly, patient has poor chance of survial

Question 8

Irreversible shock

Answer 8

Rapid loss of consciousness, non palpable pulse, cold extremities, slow shallow breaths and unmeasurable oxygen saturation
Severe tissue hypoxia with ischemia and necrosis
No treatment can reverse damage
Widespread cellular death then Liver, heart, brain and kidneys lost first then death of body occurs

Question 9

First sign of Hypovolemic shock

Answer 9

Increased heart rate

Question 10

Prevention of HVS

Answer 10

Safety measure to prevent traumas
Recognizing shock and identifying patients at risk
Assess patients for obvious bleeding and those with persistent thirt

Question 11

Treatment

Answer 11

Treat underlying cause first!!
Oxygen therapy!
FLuid replacment
Medications:

Question 12

Diagnostic tests

Answer 12

Electrolytes, BUN, creatine and lactic acid

Question 13

Oxygen therapy

Answer 13

all patients with shock receive oxygen therapy even those with adequate respirations

Question 14

Fluids

Answer 14

IV fluids or blood
NS or LR
Cyrystalloid or colloid solutions
Albumin if 3rd spacing is the cause

Question 15

Medications

Answer 15

Vasoconstrictors
Diuretics
Inotropes
Vasodilators

Question 16

Implementation

Answer 16

Assess and monitor cardio function
BP, HR, Pulse ox, Pulses
Conduct baseline assessment to establish stage of shock
Use warm fluids for resuscitation
Promote skin perfusion
Relieve anxiety
Administer pain meds
Assess mental status
Monitor urinary output