Medical/Surgical Pathophysiology Sheet Disease Process/Pathophysiology: Hypovolemic shock Body System involved and its Function: Hypovolemic shock

affects the whole body. Hypovolemic Shock occurs when too little circulating blood volume causes a MAP (mean arterial pressure) decrease, resulting in the bodys total need for oxygen not being met. Risk Factors/Incidence/Etiology: The main trigger leading to hypovolemic shock is a sustained decrease in MAP that results from decreased circulating blood volume. The causes of hypovolemic shock: body fluid depletion, hemorrhage (internal & external) and dehydration. The external hemorrhage is common after trauma and surgery. Internal hemorrhage occurs with blunt trauma, GI ulcers, and poor control of surgical bleeding. External and internal hemorrhage can be caused by any problem that reduces levels of clotting factors. Hypovolemia as a result of dehydration can be caused by any problem that decreases fluid intake or increases fluid loss. Signs and Symptoms: 1. extreme thirst 2. change in renal function 3. anxiety 4. change in mental status 5.) changes in skin 6.) increased heart rate 7.) abnormal ABGs 8.) restlessness 9.) lethargy 10.) change in LOC Expected Medical Management:

Possible blood transfusions Drug treatments, 02 therapy, fluid replacement therapy, Lab and Diagnostic Tests/Procedures (and what you would expect to see on them with this disease): H & H elevated (by dehydration), abnormal ABGs, H&H levels decrease (by hemorrhage)

Most Likely Complications: Symptoms of Complications: Cardiovascular change arterial pressure) Continuous thirst mouth Hemorrhage Vasoconstriction Acidosis

Signs and Decrease in MAP (mean Patient asking for fluids, dry Heavy bleeding Cool, clammy skin rapid respirations and SOB

Possible Nursing Diagnosis for this Condition: 1. Ineffective tissue perfusion r/t hypovolemia 2. Deficient fluid volume r/t active fluid loss 3. Decreased cardiac output r/t hypovolemia 4. Anxiety r/t potential for death 5. Disturbed though processes r/t decreased cerebral perfusion Nursing Interventions: Assess/Monitor: 1. monitor pulse oximetry, vital signs, blood pressure, pulse, respirations 2. give o2 immediately checking with doctors orders first 3. circulatory status ( heart rate, capillary refill, heart sounds) 4. monitor input and output, daily weights Do:

1. have patient rest in supine position with legs lifted up 2. Infusions of electrolyte solutions that balance the fluid lost. 3. Give supplementary O2 therapy to start replacement of fluids via the IV route. 4.prepare the patient for possible CT scans, x-rays. Teach: 1. call for medical attention as soon as signs become evident 2.to recognize the early signs of shock 3. to consume fluids at all times Health Promotion/Prevention Measures for this Disease: Primary prevention is possible. Teach patient to prevent dehydration by increasing fluid intake during exercise or when in dry, hot climates. Using safety equipment such as use of helmets can lower the risk of serious falls and hemorrhage in the brain. Teach patient to seek immediate help for heavy bleeding, decreased urinary output, lightheadedness, or sense of looming doom.

Surgical Procedure Performed (if surgical): Closing of hemorrhaged ulcers, surgical homeostasis of chief wounds, vascular fixings or adjustments