Hypovolemic Shock

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What is hypovolemic shock?

Occurs when there is a loss of intravascular fluid volume.

Absolute hypovolemia

Results when fluid is lost through hemorrhage, GI loss (vomiting, diarrhea), fistual drainage, diabetes insipidus, hyperglycemia, or diuresis.

Relative hypovolemia

Caused by third spacing; bowel obstruction; ascites; loss of blood volume into a fracture site; burns.

Cardiovascular presentations from hypovolemic shock

Decreased: preload, stroke volume, capillary refill time.

Pulmonary effects from hypovolemic shock

Tachypnea to bradycardia (late)

Renal effects from hypovolemic shock

Decreased urine output.

Integumentary effects from hypovolemic shock

Pallor, cool, clammy

Neurologic effects from hypovolemic shock

Anxiety, confusion, agitation

Gastrointestingal effects from hypovolemic shock

Absent bowel sounds

Diagnostic findings in hypovolemic shock

Decreased h/h; Increased lactate and urine specific gravity; changes in electrolytes.

Effects of hypovolemic shock on hemodynamic parameters

Increase: HR, SVR, PVR
Decreased: Pulse pressure, BP, CVP, PAP, PAWP, CO, and ScvO2.

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