A post-delivery patient has a heart rate of 120/min and systolic blood pressure of 88 mmHg. Calculate the shock index and choose the appropriate management.

1. A

   Shock index 0.6 – Normal

2. B

   Shock index 0.8 – Start IV fluids

3. C

   Shock index 1.2 – Start IV fluids

4. D

   Shock index 1.36 – Start blood transfusion

Appeared in: NORCET 10 Prelims-2026

Explanation

Listen in Hindi

• The Shock Index (SI) is calculated by dividing the heart rate by the systolic blood pressure.
• In this case, SI = 120 / 88, which equals approximately 1.36.
• In obstetric patients, a normal shock index is generally considered to be less than 0.9.
• An SI greater than 1.1 is a strong predictor of the need for massive blood transfusion due to severe hemorrhage.
• Therefore, an SI of 1.36 indicates severe shock, and the priority management is to start a blood transfusion to restore circulating volume and oxygen-carrying capacity.

Why Other Options Were Wrong

• Option A: The calculated shock index is 1.36, not 0.6. An SI of 0.6 would be within the normal range for a non-pregnant adult and does not reflect the patient's critical condition.
• Option B: The calculated shock index is 1.36, not 0.8. An SI of 0.8 is at the upper end of normal for a postpartum patient and does not reflect the severity of this patient's condition.
• Option C: The calculated shock index is 1.36, not 1.2. While starting IV fluids is a necessary initial step, an SI of 1.36 indicates that fluid resuscitation alone is insufficient and blood transfusion is urgently required.

Related Visual

Clinical Relevance

• Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Calculation and clinical interpretation of the Shock Index in a postpartum patient in acute care settings.
• The Shock Index is a crucial tool for nurses as it can identify hypovolemic shock earlier than traditional vital signs alone. A rising SI is a red flag for decompensation.
• In postpartum hemorrhage (PPH), early recognition and intervention are key to preventing maternal mortality. The SI helps in triaging the severity and guiding the resuscitation strategy.
• What if? If the patient's heart rate was 100 and SBP was 105, the SI would be 0.95. In this case, the patient is borderline but showing signs of increased blood loss. The most appropriate action would be to start IV fluids and increase monitoring frequency, rather than an immediate blood transfusion.

How to Approach the Question

• First, identify the core task: calculate the Shock Index and select the correct management.
• Recall or look up the formula for the Shock Index: SI = Heart Rate / Systolic Blood Pressure.
• Substitute the given values into the formula: HR = 120, SBP = 88.
• Perform the calculation: 120 ÷ 88 ≈ 1.36.
• Scan the options to find the one that matches your calculated SI. Option D matches.
• Finally, evaluate the management proposed in that option. Based on clinical guidelines, an SI of 1.36 indicates severe shock, making blood transfusion the correct and necessary intervention.

Concept Tested & Keywords

• Concept Tested: Calculation and clinical interpretation of the Shock Index in a postpartum patient.
• Stem keywords: post-delivery, heart rate 120/min, systolic blood pressure 88 mmHg, shock index
• Lead-in keywords: Calculate, choose the appropriate management
• Clinical cues: The combination of tachycardia (HR 120) and hypotension (SBP 88) in a post-delivery patient is a classic sign of hypovolemic shock, likely from hemorrhage.

Question ID

Q7OOZng7xWrSVbspuHKhbg

Copy ID

Reference Book

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 652-654

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 113-115