HYPOVOLEMIC

SHOCK
PREPARED BY: ABBY PEARL A. ALLAGADAN
ROSED KUIPO A. AREVALO
 WHAT IS
HYPOVOLEMIC
SHOCK?
 It also known as hemorrhagic shock is a medical
condition resulting from a decreased blood volume caused
by blood loss, which leads to reduced cardiac output and
inadequate tissue perfusion.
It is a life-threatening condition that results when you
lose more than 20 percent (one-fifth) of your body’s blood
or fluid supply. This severe fluid loss makes it impossible
for the heart to pump a sufficient amount of blood to your
body.

HYPOVOLEMIC SHOCK
 STAGES OF
HYPOVOLEMIC
SHOCK
STAGE 1:
Skin is pale STAGE 2:
The patient loses 15 percent of Blood loss increases to up to 30
blood percent
Normal BP and breathing pattern Increased heart and breathing
patterns
Patient’s diastolic is raised
Sweating, Anxious and Restless
STAGE 3:
30-40 percent blood loss
Systolic of patient’s BP is 100 or lower
Increased heart rate and abnormally rapid breathing
STAGE 4:
Patient is in real danger
Blood loss is greater than 40 percent
Weak pulse and Rapid heart rate
DOB
BP reading is under 70 for diastolic
LOC, Sweaty, Cool to touch, Extremely pale
 ANATOMY
AND PHSIOLOGY
PATHOPHYSIOLOGY
Decreased blood volume

Decreased venous return

Decreased stroke volume

Decreased cardiac output

Decreased tissue perfusion

 RISK FACTORS
-BURNS
-VOMITING BLOOD
-SEVERE DIARRHEA
-BLEEDING DISORDERS
-GASTROINTESTINAL BLEEDING
-EXCESSIVE SWEATING
 CLINICAL MANIFESTATIONS
•Hypotension
•Tachycardia
•Rapid, shallow respirations
•Oliguria
•Clammy skin
Etiology
Hypovolemic shock results from
significant and sudden blood or
fluid losses within your body.
Blood loss of this magnitude can
occur because of:

 Bleeding from serious cuts or wounds

 Bleeding from blunt traumatic injuries due to accidents
 Internal bleeding from abdominal organs or
ruptured ectopic pregnancy
 Bleeding from the digestive tract
 Significant vaginal bleeding
In addition to actual blood loss, the loss of body fluids
can cause a decrease in blood volume. This can occur in
cases of:

 excessive or prolonged diarrhea

 severe burns
 excessive vomiting
 excessive sweating
The symptoms of hypovolemic shock vary with the
severity of the fluid or blood loss. However, all symptoms
of shock are life-threatening and need emergency
medical treatment. Internal bleeding symptoms may be
hard to recognize until the symptoms of shock appear, but
external bleeding will be visible. Symptoms of
hemorrhagic shock may not appear immediately. Older
adults may not experience these symptoms until the
shock progresses significantly.
 MILD SYMPTOMS
Mild symptoms can include:
1.) headache
2.) fatigue
3.) nausea
4.) profuse sweating
5.) dizziness
Severe symptoms, which must
be taken seriously and
warrant emergency medical SEVERE
attention, include: SYMPTOMS
 cold or clammy skin
 pale skin  weakness
 rapid, shallow breathing  weak pulse
 rapid heart rate  blue lips and fingernails
 little or no urine output  lightheadedness
 confusion
COMPLICATIONS
 Kidney damage
 Brain damage
 Gangrene of arms or legs, sometimes
leading to amputation
 Heart attack
 Severe shock can lead to death
Urinalysis
CBC Electrocardiogram
CT scan Endoscopy
Echocardiogram Right heart catheterization
Urinary catheter

DIAGNOSTIC EXAMS
Receiving of blood products and fluids
blood plasma transfusion
 platelet transfusion
 red blood cell transfusion
 Intravenous fluids

Pharmacological Treatment:
TREATMENT
 dopamine
 dobutamine
 epinephrine
 norepinephrine
 Antibiotics
 EMERGENCY CARE
AND FIRST AID
Untreated hypovolemic shock will lead to death. It is a medical
emergency.
1.) Call emergency number
2.)Have the person lie flat with their feet elevated about 12
inches
3.) Refrain from moving the person if you suspect a head, neck
or back injury
4.) Keep the person warm to avoid hypothermia
5.) Don’t give the person fluids by mouth
6.) Don’t elevate the head
7.) Remove any visible dirt or debris from the injury
site
8.) Do not remove embedded glass, knife,stick,arrow,
or any other object stuck in the wound
9.) If the area is clear of debris and no visible object
protrudes from it, tie fabric, such as shirt, towel, or
blanket around the site of injury to minimize blood
loss
10.) Apply pressure to the area
11.) Tie or tape the fabric to the injury
MANAGEMENT
 MEDICAL
1.)Volume Expansion
2.)Pneumatic antishock
garment
3.) Treat underlying cause
4.) Redistribution of fluid
 P rimary prevention of shock is an essential focus of nursing
care

 Assessment of the following is vital in hypovolemic shock:

 History. The history is vital in determining the possible causes
and in determining the work-up.
 Vital signs. Vital signs, prior to arrival at the emergency
department, should also be noted.
 Trauma. In patients with trauma, determine the mechanism of
injury and any information that may heighten suspicion of
certain injuries.
If fluid administration fails to reverse
hypovolemic shock, the following are given:
- Vasoactive drugs
- Insulin
- Desmopressin (DDAVP)
- Antidiarrheal drugs
- Antiemetics

PHARMACOLOGIC THERAPY
 NURSING DIAGNOSIS
-Risk for metabolic acidosis related to a
decrease in the amount of blood in the
capillaries
-Deficient fluid volume related to active fluid loss
-Ineffective tissue perfusion
-Self-care deficit related to physical weakness
 NURSING
INTERVENTIONS
Safe administration of blood. It is important to acquire blood specimens
quickly, to obtain baseline complete blood count, and to type and
crossmatch the blood in anticipation of blood transfusions.
Safe administration of fluids. The nurse should monitor the patient closely
for cardiovascular overload, signs of difficulty of breathing, pulmonary
edema, jugular vein distention, and laboratory results.
Monitor weight. Monitor daily weight for sudden decreases, especially in
the presence of decreasing urine output or active fluid loss.
Monitor vital signs. Monitor vital signs of patients with deficient fluid
volume every 15 minutes to 1 hour for the unstable patient, and every 4
hours for the stable patient.
Oxygen administration. Oxygen is administered to increase the amount
of oxygen carried by available hemoglobin in the blood.
THANK YOU!!
FOR
LISTENING TO
OUR REPORT…
WE
APPRECIATE
IT
-abbyganda
-kuipo