question archive 43- A client with multiple injuries from a motorcycle accident is admitted to the intensive care unit with a left flail chest, liver laceration, and fractured left femur
43- A client with multiple injuries from a motorcycle accident is admitted to the intensive care unit with a left flail chest, liver laceration, and fractured left femur
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43- A client with multiple injuries from a motorcycle accident is admitted to the intensive care unit with a left flail chest, liver laceration, and fractured left femur. The nurse records the client's vital signs and urine output. Which assessment provides the earliest indication to the nurse that the client is manifesting signs of hypovolemic shock?
a. Heart rate 120 beats/ minute.
b. Respiratory rate less than 20 breaths/minute.
c. Urine output less than 30ml/hour.
d. Systolic blood pressure less than 90mmHg.
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c. Urine output less than 30ml/hour.
Step-by-step explanation
Autoregulatory pathways shunt blood flow preferentially to the brain, heart, and adrenal system in the early phase of hypovolemic shock. Patients can present initially with cold or mottled extremities, reduced urine production, and of note, normal blood pressure since flow is redirected from less vital organs.
