College

What will the nurse identify as symptoms of hypovolemic shock in a patient?

1. Temperature of 97.6 °F (36.4 °C)
2. Restlessness
3. Decrease in blood pressure of 20 mm Hg when the patient sits up
4. Capillary refill time greater than 3 seconds
5. Sinus bradycardia of 55 beats per minute

Answer :

Final answer:

Symptoms of hypovolemic shock typically include restlessness, a significant decrease in blood pressure upon sitting up, and a capillary refill time of greater than three seconds. While a temperature of 97.6 °F may indicate hypothermia, and a sinus bradycardia could be present, they are not definitive signs of hypovolemic shock.

Explanation:

The nurse will identify symptoms of hypovolemic shock in a patient, which include restlessness, a decrease in blood pressure such as a drop of 20 mm Hg when the patient sits up, and capillary refill time greater than 3 seconds. A sinus bradycardia of 55 beats per minute may not be directly indicative of hypovolemic shock, as typically a rapid heart rate is expected. A temperature of 97.6 °F (36.4 °C) might indicate hypothermia, which can be associated with shock but is not a definitive sign by itself.

Hypovolemic shock occurs when there is a significant loss of blood or fluid in the body, leading to inadequate circulation and oxygen delivery to tissues. The body responds by increasing heart rate to try to maintain blood pressure and blood flow to vital organs, while peripheral blood vessels constrict, leading to cool, clammy skin and delayed capillary refill. Other signs and symptoms include rapid, shallow breathing, hypothermia, thirst, dry mouth, and a weak, thready pulse.

Treatment focuses on addressing the cause of the fluid loss and restoring circulating volume. This usually involves the administration of intravenous fluids and may include blood transfusions if blood loss is severe. Additionally, medications such as dopamine, epinephrine, and norepinephrine may be used to support blood pressure. Recognizing the signs of hypovolemic shock early is critical as it can worsen rapidly and become life-threatening, entering a positive-feedback loop that can lead to organ failure and death.