Hypovolemic shock is an emergency condition in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body. Hypovolemic shock symptoms include: Breathing faster than normal. Feeling confused or anxious. Sweating a lot. Passing out. Having skin that feels cool. Feeling weak. Having a low temperature and low blood pressure. Having a fast pulse. The most common cause of hypovolemic shock is blood loss when a major blood vessel bursts or when you're seriously injured. This is called hemorrhagic shock. You can also get it from heavy bleeding related to pregnancy, from burns, or even from severe vomiting and diarrhea. Fluid resuscitation is the mainstay of therapy in patients with severe hypovolemia.

1. Group 4
HYPOVOLEMI
C

2. OVERVIE
W
Hypovolemic shock is a life-threatening condition
that occurs when the body loses a significant
amount of blood or fluids. This drastic reduction
in blood volume leads to insufficient oxygen
supply to organs and tissues, causing a medical
emergency. If left untreated, this can lead to
ischemic injury of vital organs, leading to multi-
system organ failure and death

3. OVERVIE
W
Globally, hypovolemic shock cases have been
on the rise due to various factors, including
accidents, trauma, severe dehydration, and
major surgeries. While improved access to
medical care has enhanced survival rates,
awareness, prevention, and rapid intervention
are still critical.

4. OVERVIE
W
This condition can be triggered by severe
bleeding from injuries, internal bleeding,
dehydration caused by factors like vomiting,
diarrhea, or inadequate fluid intake, and extensive
burns. Additionally, certain medical conditions,
such as severe infections, can also result in
hypovolemic shock.

5. OVERVIE
W
For management, early recognition and intervention play a pivotal
role in determining the outcome of hypovolemic shock. Urgent
medical treatment, including intravenous fluids and, if necessary,
blood transfusions, can stabilize the patient. The prognosis
depends on factors such as the underlying cause, the speed of
medical intervention, and the overall health of the individual. With
timely and appropriate care, many patients can fully recover from
hypovolemic shock.

6. DEFINITIO
N
Brunner & Suddath's textbook of medical surgical nursing:
Hypovolemic shock is the most common type of shock that
characterized by decreased intravascular volume. Body fluid is
contained in the intracellular and extracellular compartments.
Intracellular fluid accounts for about two thirds of the total body
water. The extracellular body fluid is found in on of two
compartments: intravascular (inside blood vessels) or interstitial
(surrounding tissues). The volume of interstitial fluid is about three
to four times that of intravascular fluid.

7. DEFINITIO
N
According to National Institute of health hypovolemic shock
is due to a critical loss in the effective circulating blood
volume with systemic hypoperfusion. If left untreated,
hypovolemic shock can lead to ischemic injury of vital organs,
leading to multi-system organ failure and death. The first step
in management is to rule out other forms of shock, which will
dictate treatment. Hypovolemic shock may be due to loss in
total body fluids versus bleeding.

8. DEFINITIO
N
Hypovolemic shock is an emergency condition in
which severe blood or other fluid loss makes the
heart unable to pump enough blood to the body.
This type of shock can cause many organs to stop
working as said by Midline plus.

9. DEFINITIO
N
As explained by Cleveland clinic,
Hypovolemic shock is a serious medical
problem that requires immediate treatment. A
large loss of blood or fluids prevents your
organs from getting the oxygen and nutrients
they need to function. This can lead to organ
failure and can be fatal

10. CAUSES
Dehydration: Infants are more
vulnerable to dehydration due to
their small size and relatively
higher body water content.
Causes of dehydration in infants
include:
Diarrhea
Vomiting
Reduce fluid Intake

11. CAUSES
Hemorrhage (Blood Loss):
Infants can experience blood
loss from various sources,
such as:
Surgical Procedures
Trauma

12. CAUSES
Medications: Medications,
such as anticoagulants, given
to infants inappropriately or
in incorrect dosages can
increase the risk of bleeding
and hypovolemic shock.

13. CLINICAL
MANIFESTATIONS:
Tachycardia:
Tachypnea
Cool and Pale Skin
Mottled or Bluish Skin

14. CLINICAL MANIFESTATIONS:
Lethargy
Sunken Fontanelle
Hypotension
Altered Mental
Status

15. Restore the intravascular volume.
IV fluids are given straight into a
vein through a drip. Administer
isotonic crystalloid solutions, such
as normal saline (NS) or lactated
Ringer’s (LR), to restore circulating
blood volume.
Intravenous Fluid

16. Nursing Responsibilities:
 Verify the Doctor’s order.
 Inform the client and explain the purpose
of IV therapy
 Instruct the patient that the procedure
may cause a little bit pain upon insertion.
 Practice aseptic technique.
 Check IV patency.
 Observe for potential complications.
Intravenous Fluid

17. Oxygen therapy is a treatment that provides
you with extra oxygen to breathe in.
Purpose:
To treat hypoxia or blood and tissue
oxygen deficiency.
To provide supplemental oxygen therapy
to people who have lower oxygen levels.
Oxygen therapy is a treatment that
provides you with extra oxygen to breathe
in.
Oxygen therapy

18. Purpose:
 To treat hypoxia or blood
and tissue oxygen deficiency.
To provide supplemental
oxygen therapy to people
who have lower oxygen
levels.
Oxygen therapy
Review chart for physician's order for oxygen to ensure that it includes method of delivery, flow rate, titration orders; identify client

19. Review chart for physician's order for
oxygen to ensure that it includes method
of delivery, flow rate, titration orders;
identify client
Assist client to semi- or high Fowler's
position, if tolerated.
Insert flowmeter into wall outlet. Attach
oxygen tubing to nozzle on flowmeter. If
using a high O2 flow, attach humidifier.
Attach oxygen tubing to humidifier.
Oxygen therapy
Review chart for physician's order for oxygen to ensure that it includes method of delivery, flow rate, titration orders; identify client

20. Turn on the oxygen at the prescribed rate.
Check that oxygen is flowing through
tubing.
Hold nasal cannula in proper position
with prongs curving downward.
Wrap tubing over and behind ears.
Adjust plastic slide under chin until
cannula fits snugly.
Place gauze at ear beneath tubing as
necessary.
Oxygen therapy
Review chart for physician's order for oxygen to ensure that it includes method of delivery, flow rate, titration orders; identify client

21. Pharmacologic Management
Acts as both a positive
inotrope and a
vasoconstrictor to improve
blood pressure and
perfusion.
Epinephrine
A positive inotrope
that can increase
cardiac contractility
and blood pressure.
Dopamine
Increases blood pressure
by constricting blood
vessels and improving
cardiac output.
Vasoactive Medications
Norepinephrine

22. Assess the site for infiltration as this medication can cause tissue
damage.
Monitor vital signs during infusion
Use cardiac monitor with patients receiving epinephrine IV. Have
full crash cart immediately available.
Check BP repeatedly when epinephrine is administered IV during
first 5 min, then q3–5min until stabilized.
Advise patient to report to physician if symptoms are not relieved
in 20 min or if they become worse following inhalation.
Advise patient to report bronchial irritation, nervousness, or
sleeplessness.
Nursing Management

23. Sodium
Bicarbonate
In the presence of severe acidosis, sodium
bicarbonate may be administered to correct the
pH imbalance.
Nursing Responsibilities:
Keep sodium bicarbonate ampules handy for
emergency administration.
Monitor vital signs, laboratory results and
level of consciousness frequently.
Watch out for signs of decreasing level of
consciousness.
Record intake and output accurately to
monitor renal function.

24. Antiarrhythm
ic Drugs
 Antiarrhythmic are medications that prevent
and treat a heart rhythm that’s too fast or
irregular. They can reduce symptoms and
help avoid life-threatening complications.

25. Antiarrhythm
ic Drugs
 Antiarrhythmic are medications
that prevent and treat a heart
rhythm that’s too fast or irregular.
They can reduce symptoms and
help avoid life-threatening
complications.

26. Antiarrhythm
ic Drugs
Nursing Responsibilities:
Assess your patient’s apical pulse
rate and rhythm before
administering an antiarrhythmic.
Monitor his cardiac rate and
rhythm continuously when
therapy starts or any time the
dosage is adjusted.
Check his vital signs frequently.

27. Other:
Antidiarrheal drugs. If
dehydration is due to diarrhea,
antidiarrheal medications are
administered.
Antiemetics. If the cause of
diarrhea is vomiting,
Antiemetics are given

28. NON PHARMACOLOGIC MANAGEMENT
Encourage breastfeeding on
demand for infants. Breast
milk is an ideal source of
nutrition and hydration for
infants.
BREASTFEEDING TEMPERATURE
CONTROL
Maintain the infant’s
body temperature
within the normal
range to prevent
hypothermia, which
can exacerbate shock.
PROPER NUTRITION
Ensure that infants receive
appropriate nutrition and caloric
intake, which is essential for
maintaining normal fluid
balance.

29. LABORATORY AND DIAGNOSTIC TEST
Lactic Acid Test
Purpose: It’s a test that measures the amount of lactic acid in your blood.
Normal Rage: 4.5 to 19.8 milligrams per deciliter (mg/dL)
Procedure:
Patient is usually assigned in sitting position with the left or right hand
stretched on a platform or table with the palm facing upward.
A tourniquet is applied to the area proximal to the vein (closer to the
central of the body that the vein itself) to the antecubital area to facilitate
pulling of blood.

30. LABORATORY AND DIAGNOSTIC TEST
 The skin overlying the vein is cleaned using alcohol pad. Then a needle inserted
through the area of cleansed skin into the vein below where the tourniquet is
applied
 The blood is then pulled from the vein via needle by gently pulling the plunger on
the syringe or by a connection of a needle into a special vacuum vial that collects
the blood.
 After that, the tourniquet is removed to facilitate venous return.
 A dry cotton ball was taped on the insertion site upon the removal of needle to
block the withdrawal of blood.
 The blood sample is then sent to the laboratory for analysis

31. LABORATORY AND DIAGNOSTIC TEST
Nursing interventions:
Check the Doctor’s Order.
Explain the procedure to the patient and its rationale.
Inform the patient that the puncture may cause a little pain.
Elevate the venipuncture site and pressure if there is continuous
bleeding
Report any result to the requesting health care provider, who will
discuss the report to the patient.

32. LABORATORY AND DIAGNOSTIC TEST
Electrocardiogram
Description:
The most commonly used test for evaluating cardiac status, graphically
records the electrical current (electrical potential) generated by the heart.
Purpose:
To help identify primary conduction abnormalities, cardiac arrhythmias.
To assess pacemaker performance

33. URINALYSIS
The urinalysis is used as a screening and/ or diagnostic tool
because it can help detect substance or cellular in the urine. It is
ordered widely and routinely to detect any abnormalities and manage
a wide range of disorders such as urinary tract infections, kidney
disease and diabetes. It involves the collection of urine sample in a
specimen cup and bring it to the laboratory for analysis.

34. URINALYSIS
Urine is collected in an unused disposable plastic cap with a tight fitting
lid. A randomly voided sample is suitable for routing urinalysis.
To collect a sample using the clean-catch method, it must be the midstream
of the voided urine.
Females should use a clean cotton ball moistened with lukewarm water (or
antiseptic wipes provided with collection kits) to cleansed the external
genital area before collecting a urine sample

35. URINALYSIS
Nursing Responsibilities:
Check the Doctor's order.
Empty drainage tube of urine. Sterile, disposable containers are recommended.
May be necessary to clamp off the catheter prior to urine collection.
Cleanse specimen port with antiseptic swab then aspirate urine with a gauge needle
and syringe.
Transfer urine to a sterile container
Cover all specimens tightly, label properly and send immediately to the Laboratory.

36. An arterial blood gas (ABG)
test measures oxygen and
carbon dioxide levels in your
blood. It also measures your
body’s acid-base (pH) level,
which is usually in balance
when you’re healthy.
ARTERIAL BLOOD GAS
Review chart for physician's order for oxygen to ensure that it includes method of delivery, flow rate, titration orders; identify client

37.  Patient Preparation
 Explain the arterial blood gas analysis
evaluates how well the lungs are delivering the
oxygen to the blood and eliminating carbon
dioxide.
 Tell the patient that the test requires a blood
sample.
 Explain to the patient, who will perform the
arterial puncture, when it will occur, and
where the puncture site will be; radial,
brachial, or femoral artery.
ARTERIAL BLOOD GAS
Review chart for physician's order for oxygen to ensure that it includes method of delivery, flow rate, titration orders; identify client

38.  After applying pressure to the puncture site for
3 to 5 minutes and when bleeding has stopped,
tape a gauze pad firmly over it.
 If the puncture site is on the arm, don’t tape
the entire circumference because this may
restrict circulation.
 If the patient is receiving anticoagulants or has
a coagulopathy, apply pressure to the puncture
site longer than 5 minutes if necessary.
 Monitor vital signs and observe for signs of
circulatory impairment.
ARTERIAL BLOOD GAS
Review chart for physician's order for oxygen to ensure that it includes method of delivery, flow rate, titration orders; identify client