Hypovolemic Shock NCLEX Questions With Answers

Explanation
Hypovolemic shock occurs when there is a significant loss of circulating volume in the body. This means that there is not enough blood or fluid to adequately supply oxygen and nutrients to the cells. This can happen due to various reasons such as severe bleeding, dehydration, or fluid loss from burns or excessive sweating. Without enough circulating volume, the cells are unable to function properly, leading to the symptoms of hypovolemic shock such as low blood pressure, rapid heart rate, and organ failure.

Explanation
The immediate treatment for hypovolemia is to administer a 250-500ml bolus of Hartmann's or sodium chloride over 15 minutes. This is done to rapidly restore fluid volume and increase blood pressure in cases of severe dehydration or blood loss. Gelofusin and albumin are also used for fluid resuscitation but are not the immediate treatment options mentioned in the question. Therefore, the correct answer is the 250-500ml bolus of Hartmann's or sodium chloride over 15 minutes.

Explanation
Fluid mismanagement can lead to pulmonary edema, which is the accumulation of fluid in the lungs, causing difficulty in breathing. Hyperkalaemia refers to high levels of potassium in the blood, which can disrupt normal heart function and potentially lead to cardiac arrest. Both of these conditions are potential risks of fluid mismanagement as they can result from an imbalance in fluid and electrolyte levels in the body.

Explanation
Surgery, vomiting, and diarrhea can increase a patient's risk for absolute hypovolemic shock. During surgery, there is a potential for significant blood loss, leading to a decrease in blood volume. Vomiting and diarrhea can cause fluid and electrolyte imbalances, resulting in a decrease in blood volume. These conditions can lead to a decrease in circulating blood volume, which can ultimately result in hypovolemic shock.

Explanation
The fluid balance of the patient group can be affected by various factors, leading to hypovolemia. Firstly, being nil by mouth from midnight means that the patients have not consumed any fluids since the previous night, which can result in a decrease in their overall fluid volume. Secondly, blood loss from drains can further contribute to fluid loss and a decrease in blood volume. Lastly, bypass, which refers to a procedure where blood is rerouted away from certain areas of the body, can also lead to a decrease in fluid volume. Therefore, all of the mentioned factors can affect the fluid balance and cause hypovolemia in the patient group.

Explanation
The correct answer is the renin-angiotensin-aldosterone system and anti-diuretic hormone. When blood pressure drops, the renin-angiotensin-aldosterone system is activated. Renin is released by the kidneys, which then converts angiotensinogen into angiotensin I. Angiotensin I is then converted to angiotensin II, a potent vasoconstrictor, by the enzyme ACE. Angiotensin II stimulates the release of aldosterone from the adrenal glands, which promotes sodium reabsorption and water retention, increasing blood volume and blood pressure. Anti-diuretic hormone (ADH), also known as vasopressin, is released by the pituitary gland in response to low blood pressure. ADH acts on the kidneys to increase water reabsorption, reducing urine output and conserving fluid. Together, these processes help to regulate urine output when blood pressure drops.

Explanation
The signs of hypovolemic shock include sweating a lot, passing out, higher breathing than normal, and feeling anxious. All of these symptoms indicate a decrease in blood volume, which can be caused by severe bleeding, trauma, or dehydration. Sweating is a common response to maintain body temperature, but excessive sweating can be a sign of shock. Passing out occurs when there is insufficient blood flow to the brain. Higher breathing than normal is the body's attempt to compensate for decreased oxygen delivery. Feeling anxious is a result of the body's stress response to low blood volume. Therefore, all of these symptoms are indicative of hypovolemic shock.

Explanation
Hypovolemic shock occurs when there is a low fluid volume in the intravascular compartment, not the interstitial compartment. The intravascular compartment refers to the blood vessels, while the interstitial compartment refers to the space between cells. Therefore, the statement is false.

Explanation
Hypovolemic shock occurs when a patient loses a significant amount of their blood volume. The correct answer is ">15%" because this indicates that the patient would need to lose more than 15% of their blood volume for hypovolemic shock to occur. This suggests that a substantial loss of blood is necessary to trigger this type of shock.

Explanation
Turner's sign is the presence of bruising around the flanks, while Cullen's sign is the presence of bruising around the umbilicus. These signs are typically associated with retroperitoneal bleeding, which can occur in acute pancreatitis. However, the presence of Turner and Cullen's sign does not necessarily indicate a higher chance of absolute hypovolemic shock. Hypovolemic shock is caused by significant fluid loss, such as from severe bleeding, and while retroperitoneal bleeding can contribute to fluid loss, it does not always lead to hypovolemic shock. Therefore, the statement is false.