BNKN602 PATHOPHYSIOLOGY EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS GRADED A++
What is Hypovolemic Shock
Body goes into state of shock due to loss of fluid volume from unexpected trauma.
Intravascular volume decreases by about 15% and body goes into shock.
Signs and symptoms of Hypovolemic shock
-Increased HR and BP.
-Poor skin turgor.
-Thirst.
-Oliguria.
-Low preload.
-Tachycardia and weak/thready pulse.
-Deterioration of mental status.
-Increased RR and WOB.
-Increased Temp.
-Diaphoresis.
-Facial flushing.
-Clammy skin.
-Orthopnoea.
Pathophysiology of Hypovolemic shock
,1) Intravascular volume has decreased by at least 15%.
2) Leads to decreased Pre-load.
3) Decreased cardiac output.
4) Causes release of catecholamine (adrenaline and noradrenaline).
5) Increases HR contractility.
6) Increases cardiac output.
7) Volume loss.
8) Decreased cardiac output.
9) Decreased tissue perfusion.
10) Impaired cellular metabolism.
11) Acute respiratory distress.
Aetiology of Hypovolaemic Shock
,-Whole blood loss (Haemorrhage)
-Plasma (burns)
Interstitial fluid loss (Diaphoresis, diabetes, emesis, diarrhoea or diuresis)
Nursing Diagnoses of Hypovolemic Shock
1) Decreased cardiac output r/t excess fluid loss and decreased ventricular filling
(preload)
2) Insufficient fluid volume and electrolyte imbalance r/t haemorrhage
3) Ineffective tissue perfusion r/t decreased stroked volume, preload and venous returns
as a result of severe blood loss
Assessment for Hypovolemic Shock
Airway patency
To determine maximum airflow
Assessment for Hypovolemic Shock
ECG
To monitor heart rhythm and volume and determine abnormalities
Assessment for Hypovolemic Shock
Peripheral Vascular Assessment
, To assess circulation to peripheries, may be impaired due to decreased stroke volume,
preload and venous return
Assessment for Hypovolemic Shock
Vitals signs/NZEWS
Assess for tachycardia and high BP, low SpO2
Assessment for Hypovolemic Shock
FBC
To assess urine output (oliguria as a secondary response to SNS activation)
Assessment for Hypovolemic Shock
Bristol stool chart
To assess for loose bowel movement causing excess fluid loss through
Nursing Intervention for Hypovolemic Shock
Encourage Fluids, administer IVF as prescribe
Rationale
To restore fluid/electrolyte balance and rehydrate
Nursing Intervention for Hypovolemic Shock
Administer prescribed antiemetics if patient is vomiting
ANSWERS WITH COMPLETE SOLUTIONS GRADED A++
What is Hypovolemic Shock
Body goes into state of shock due to loss of fluid volume from unexpected trauma.
Intravascular volume decreases by about 15% and body goes into shock.
Signs and symptoms of Hypovolemic shock
-Increased HR and BP.
-Poor skin turgor.
-Thirst.
-Oliguria.
-Low preload.
-Tachycardia and weak/thready pulse.
-Deterioration of mental status.
-Increased RR and WOB.
-Increased Temp.
-Diaphoresis.
-Facial flushing.
-Clammy skin.
-Orthopnoea.
Pathophysiology of Hypovolemic shock
,1) Intravascular volume has decreased by at least 15%.
2) Leads to decreased Pre-load.
3) Decreased cardiac output.
4) Causes release of catecholamine (adrenaline and noradrenaline).
5) Increases HR contractility.
6) Increases cardiac output.
7) Volume loss.
8) Decreased cardiac output.
9) Decreased tissue perfusion.
10) Impaired cellular metabolism.
11) Acute respiratory distress.
Aetiology of Hypovolaemic Shock
,-Whole blood loss (Haemorrhage)
-Plasma (burns)
Interstitial fluid loss (Diaphoresis, diabetes, emesis, diarrhoea or diuresis)
Nursing Diagnoses of Hypovolemic Shock
1) Decreased cardiac output r/t excess fluid loss and decreased ventricular filling
(preload)
2) Insufficient fluid volume and electrolyte imbalance r/t haemorrhage
3) Ineffective tissue perfusion r/t decreased stroked volume, preload and venous returns
as a result of severe blood loss
Assessment for Hypovolemic Shock
Airway patency
To determine maximum airflow
Assessment for Hypovolemic Shock
ECG
To monitor heart rhythm and volume and determine abnormalities
Assessment for Hypovolemic Shock
Peripheral Vascular Assessment
, To assess circulation to peripheries, may be impaired due to decreased stroke volume,
preload and venous return
Assessment for Hypovolemic Shock
Vitals signs/NZEWS
Assess for tachycardia and high BP, low SpO2
Assessment for Hypovolemic Shock
FBC
To assess urine output (oliguria as a secondary response to SNS activation)
Assessment for Hypovolemic Shock
Bristol stool chart
To assess for loose bowel movement causing excess fluid loss through
Nursing Intervention for Hypovolemic Shock
Encourage Fluids, administer IVF as prescribe
Rationale
To restore fluid/electrolyte balance and rehydrate
Nursing Intervention for Hypovolemic Shock
Administer prescribed antiemetics if patient is vomiting
