Hypovolemic shock can result from:

UP NHM CHO 7 Sept 2022 (Shift-2)

Medical & Surgical Nursing

Easy

Appeared in: UP NHM CHO 7 Sept 2022 (Shift-2)

Explanation

Hypovolemic shock is defined by a critical reduction in intravascular volume.
Vascular injury, such as from trauma, directly causes hemorrhage (loss of whole blood).
The rapid loss of blood volume decreases venous return to the heart, leading to a sharp drop in cardiac output and blood pressure.
This state of inadequate tissue perfusion due to blood loss is the hallmark of hemorrhagic hypovolemic shock.

Option A: Peritonitis, a severe intra-abdominal infection, is a classic cause of septic shock, which is a type of distributive shock. The infection leads to a massive inflammatory response and vasodilation, not primary volume loss.
Option B: A severe blood transfusion reaction typically causes anaphylactic shock (a type of distributive shock) due to a massive allergic response, or hemolytic shock. It does not directly cause hypovolemic shock.
Option C: Acidosis is a metabolic consequence of shock, not a primary cause. In any type of shock, inadequate oxygen delivery forces cells into anaerobic metabolism, which produces lactic acid, leading to metabolic acidosis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Hypovolemic Shock as background academic context rather than a clinical decision trigger.
A nurse must be able to rapidly identify the signs of hypovolemic shock: hypotension, tachycardia, cool/clammy skin, and altered mental status.
Immediate nursing interventions for suspected hypovolemic shock include ensuring a patent airway, administering oxygen, establishing large-bore IV access for fluid resuscitation, and applying direct pressure to any external bleeding.
What if? If a patient with a suspected femur fracture suddenly becomes tachycardic and hypotensive, the nurse should suspect internal bleeding causing hypovolemic shock and immediately notify the provider, preparing for massive transfusion protocols.

How to Approach the Question

First, identify the core concept in the question stem: 'Hypovolemic shock'. Recall its definition: shock due to low blood/fluid volume.
Analyze each option to see which one directly causes a loss of volume.
Evaluate 'Peritonitis'. This is an infection, which leads to septic shock (a distributive type), not primary volume loss.
Evaluate 'Blood transfusion reaction'. This is an allergic/immune response, causing anaphylactic shock (distributive), not primary volume loss.
Evaluate 'Acidosis'. This is a metabolic state. Recall that it's a result of shock (due to poor perfusion) rather than a cause.
Evaluate 'Vascular injury'. This directly causes bleeding (hemorrhage), which is a loss of blood volume. This perfectly matches the definition of hypovolemic shock.

Concept Tested & Keywords

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