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Hypovolemic Shock: Test Questions and Answers for NRSG 327 Week 5, Exams of Nursing

Montana State UniversityNursing

A series of questions and answers related to hypovolemic shock, a critical medical condition characterized by inadequate blood volume. It covers key aspects of hypovolemic shock, including its causes, risk factors, clinical signs, and treatment strategies. Designed to help students in nursing programs understand and retain important information about this medical emergency.

Typology: Exams

2024/2025

Available from 03/14/2025

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NRSG 327 WEEK 5 - HYPOVOLEMIC SHOCK; TEST QUESTIONS
WITH VERIFIED ANSWERS
What is hypovolemic shock? -- Answer ✔✔ Shock caused by hypovolemia - either due
to absolute or relative hypovolemia.
What are the risk factors of hypovolemia? -- Answer ✔✔ 1. Surgery/ trauma
2. Nausea/ Vomiting
3. Diarrhea
4. Young and old age
5. Heart failure
6. Kidney/ renal failure
What causes absolute hypovolemia? -- Answer ✔✔ Any fluid loss through:
1. Hemorrhaging
2. GI Vomiting/ diarrhea
3. Fistulas
4. Diabetes insipidus (the diabetes that makes you urinate lots)
5. Diuresis
6. Hyperglycemia (increased fluid loss d/t glucose attracting water into urine)
7. Burns (only 3rd degree due to its visceral nature)
(NOTE: Absolute hypovolemia is caused by EXTERNAL fluid loss).
What causes relative hypovolemia? -- Answer ✔✔ Leakage of fluid from the
intravascular space into the interstitial space DUE TO:
1. Increased capillary permeability (lots of leaks)
1.a. Could be said that the lack of albumin also causes this.
2. Sepsis
3. Burns (only 1st to 2nd degree due to its superficial nature)
4. Ascites (caused by liver impairment)
5. Hemothorax (blood in lungs)
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NRSG 327 WEEK 5 - HYPOVOLEMIC SHOCK; TEST QUESTIONS

WITH VERIFIED ANSWERS

What is hypovolemic shock? -- Answer ✔✔ Shock caused by hypovolemia - either due to absolute or relative hypovolemia. What are the risk factors of hypovolemia? -- Answer ✔✔ 1. Surgery/ trauma

  1. Nausea/ Vomiting
  2. Diarrhea
  3. Young and old age
  4. Heart failure
  5. Kidney/ renal failure What causes absolute hypovolemia? -- Answer ✔✔ Any fluid loss through:
  6. Hemorrhaging
  7. GI Vomiting/ diarrhea
  8. Fistulas
  9. Diabetes insipidus (the diabetes that makes you urinate lots)
  10. Diuresis
  11. Hyperglycemia (increased fluid loss d/t glucose attracting water into urine)
  12. Burns (only 3rd degree due to its visceral nature) (NOTE: Absolute hypovolemia is caused by EXTERNAL fluid loss). What causes relative hypovolemia? -- Answer ✔✔ Leakage of fluid from the intravascular space into the interstitial space DUE TO:
  13. Increased capillary permeability (lots of leaks) 1.a. Could be said that the lack of albumin also causes this.
  14. Sepsis
  15. Burns (only 1st to 2nd degree due to its superficial nature)
  16. Ascites (caused by liver impairment)
  17. Hemothorax (blood in lungs)
  1. Closed fractures (NOTE: Relative hypovolemia is caused by INTERNAL fluid loss). Decreased circulating fluid (regardless if it is absolute or relative) causes ____________________________ to the heart. -- Answer ✔✔ 1. Decreased SV (stroke volume)
  2. Decreased CO (cardiac output)
  3. Decreased preload (d/t hypovolemia)
  4. Decreased venous RETURN to the heart (d/t decreased CO).
  5. Tachycardia (compensatory) A patient loses 15% of their total blood volume - what can you expect their body to do? -- Answer ✔✔ Compensate - it will compensate for the fluid loss (i.e., raised HR and RR, and RAAS system). A patient loses 15%-30% of their total blood volume - what can you expect their body to do? -- Answer ✔✔ Aggressive compensation - more sympathetic responses (i.e., tachycardia, tachypnea, increased resp. depths, RAAS system). A patient loses 30%-40% of their total blood volume - what can you expect their body to do? -- Answer ✔✔ Compensatory mechanisms fail. This is where the patient REQUIRES fluid replacement A patient loses >40% of their total blood volume, what can you expect their body to do? -- Answer ✔✔ Irreversible tissue damage, and zero microcirculation (blood flow to the smallest vessels)
  1. Fatigue What are the clinical signs of hypovolemic shock: To the GI system? -- Answer ✔✔ 1. NO bowel sounds
  2. Ischemia causing:
  3. Paralytic ileus
  4. Ulceration
  5. Possibly sepsis due to ulceration What are the lab results best associated with hypovolemic shock? -- Answer ✔✔ 1. Hemoglobin (decreased)
  6. Hematocrit (decreased)
  7. Electrolytes (imbalanced)
  8. Lactate (increased)
  9. ABG (arterial blood gasses) (most likely decreased)
  10. Urine gravity/ renal panels IN GENERAL
  11. Coagulation factors (low) What are the treatments for hypovolemic shock? -- Answer ✔✔ 1. Fluid resuscitation via 1.a. Blood products (Whole blood). 1.b. Colloids (Albumin - especially for relative hypovolemia) (blood part). 1.c. Crystalloids (IV solution) (i.e., Isotonic, hyper/hypotonic). 1.d. Hypertonic fluids (especially for relative hypovolemia)
  12. Stopping the bleeding

2.a. Antifibrinolytics (tranexamic acid) What is the cautionary part when using colloids for HYPOVOLEMIC shock? -- Answer ✔✔ Colloids are to be used with caution IF the PRELOAD is ABNORMAL. (Preload dysfunction is separate to interstitial fluids). (If the PRELOAD is NORMAL, then colloids can be used). What should you watch out for when using an isotonic crystalloid? -- Answer ✔✔ The risk of hypervolemia What should you watch out for when using a hypertonic crystalloid? -- Answer ✔✔ The risk for intravascular overload What should you watch out for when using a hypotonic crystalloid? -- Answer ✔✔ Lower serum electrolytes How does whole blood differ from PRBC? -- Answer ✔✔ 1. Whole blood has a 1:1: ratio of the blood components: i.e., 4 units of RBC i.e., 4 units of Plasma i.e., 4 units of Platelets

  1. Whole blood has a lower chance of causing DIC as opposed to PRBCs How is effectiveness of treatment measured? -- Answer ✔✔ 1. Blood pressure (has it improved)
  2. HR
  3. RR
  4. Urine output
  5. LOC (an improvement)
  6. Central venous pressure
  7. Cardiac output (CO)