What is hypovolemic shock?
Occurs when there is a loss of intravascular fluid volume.
Results when fluid is lost through hemorrhage, GI loss (vomiting, diarrhea), fistual drainage, diabetes insipidus, hyperglycemia, or diuresis.
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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