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Zorluk: ZorPhysiological Adaptation

A nurse is assessing a client who is 4 hours post-operative following an open abdominal surgery with significant intraoperative blood loss. Which of the following clinical findings indicate the client is experiencing the early (compensatory) stage of hypovolemic shock? (Select all that apply)

  1. Narrowing of the arterial pulse pressureCevap
  2. Resting heart rate increasing from 82 to 116 beats per minuteCevap
  3. C
    Arterial blood gas demonstrating a pH of 7.26 and bicarbonate of 14 mEq/L
  4. D
    Systolic blood pressure decreasing abruptly from 118 mm Hg to 78 mm Hg
  5. New onset of mild anxiety and restlessnessCevap

Cevap

The correct findings are a narrowing pulse pressure, increased heart rate, and new onset of mild anxiety and restlessness.
In the early (compensatory) stage of hypovolemic shock, the body attempts to maintain adequate tissue perfusion by activating the sympathetic nervous system. This response causes an increase in heart rate to maintain cardiac output. Peripheral vasoconstriction occurs, which raises the diastolic blood pressure and results in a narrowing of the arterial pulse pressure, while the systolic blood pressure is initially maintained. Additionally, early cerebral hypoxia and sympathetic stimulation manifest as mild anxiety and restlessness.

Adım Adım Çözüm

1
Identify the primary clinical risk for this client.
The client has a history of significant intraoperative blood loss, placing them at high risk for hypovolemic shock.
Establishing the underlying pathophysiology is necessary to anticipate the expected clinical progression.
2
Determine the physiological changes that occur during the early (compensatory) stage of shock.
The body activates the sympathetic nervous system to maintain cardiac output and tissue perfusion before blood pressure drops.
The compensatory stage is characterized by protective physiological mechanisms before frank hemodynamic collapse occurs.
3
Evaluate each finding to distinguish between early compensatory signs and late progressive signs.
Tachycardia, narrowing pulse pressure, and anxiety are early signs. Profound hypotension and metabolic acidosis are late signs.
Accurate identification of early signs allows for prompt, life-saving intervention before irreversible cellular damage happens.

Anahtar Kavram

Early (Compensatory) Stage of Hypovolemic Shock
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Konular

Physiological Adaptation

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