Hypovolemic Shock: Case Study, Analysis, and Evidence-Based Practice

This report presents a detailed analysis of a case study involving a 30-year-old male patient who sustained a traumatic brain injury and hypovolemic shock following a motorcycle accident. The report critically examines the related health problems, including the patient's vital signs, abnormal blood gas results, elevated troponin and creatinine levels, coagulopathy, and low hemoglobin. It explores the critical aspects of nursing and medical management, emphasizing the importance of oxygenation, blood loss control, medication administration, and cardiac monitoring. Furthermore, the report highlights the application of evidence-based practice, including the use of multi-disciplinary teams, blood testing, and various therapies. The conclusion summarizes the key findings, underscoring the complexities of the condition and the significance of prompt and effective interventions to improve patient outcomes. The report also references current literature to support the findings.

Hypovolemic
Shock

Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY..................................................................................................................................1
Critical analysis of the related health problem............................................................................1
Nursing management and medical management.........................................................................3
Evidence based practice...............................................................................................................4
CONCLUSION................................................................................................................................4
REFERENCES................................................................................................................................6

INTRODUCTION
Hypovolemic shock is a life-threatening condition that results when you lose more than 20
percent (one-fifth) of one’s body's blood or fluid supply. In this condition there occurs severe
fluid loss which makes difficult for the heart to pump and to carry the sufficient amount of blood
to the body. This can lay adverse impact on the health outcome of the individual who has been
suffering from it. Hypovolemic shock can also cause organ failure. It can also reduce the quality
of life of patients who are been suffering from this type of problem. Present report will lay
emphasis on a case study of acutely ill patient who has gone through a motor bike accident and is
facing chronic head injury. Report will lay emphasis on critically analysing with related health
problem related to nursing management and medical management. It will also explain use of
evidence based practice in the treatment of patient who has been going through Hypovelmic
shock.
MAIN BODY
Critical analysis of the related health problem
It has been analysed from the case study that a 30 year old male patient has gone through a
motor bike accident and is critically ill. He has also faced chronic health injury because of the
accident. Case study has provided with the detail that Blood pressure rate of patient is 132 per
hour. According to Malin,and et.al., (2018) chronic brain injury that has been faced by the
service user has affected the blood pressure in an individual’s body. The changes in rate of Blood
pressure during the first few hours of the injury can also have adverse effect. It has been analysed
that there are various problems which can be faced by patient because of the change in Blood
pressure (Hooper and Armstrong, 2018). There are 50% chances that patient can die as the heart
is unable to pump the blood. Patient because of the traumatic brain injury can face various signs
and symptoms such as confusion, coma, paralysis, difficulty swallowing. Service user can also
go through problems like inappropriate emotional responses. It has been analysed that
Hypovolemic shock can also make patient go through a problem like loss of bowel control of
bladder control. This can reduce the health outcome and quality of life of patients. The condition
of service users depends upon the intensity of Brain injury. They can also go through health
problem like droopy eyelid or facial weakness.
In the opinion of Xiang, Klemcke and Ryan, (2018) it has also been analysed that
respiratory rate of patient who has met with the accident and has faced brain injury has
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respiratory rate of 26. It is a very serious condition has the respiratory rate is quiet high. In this
patient has the highest risk of facing problem such as they can go through panic attack. It can
also lay deep negative emphasis on the psychological condition of patients. It has been analysed
that if the body temperature of patient increase the respiratory rate can also increase. This can lay
severe negative impact on the health outcome of service users. It is not considered as healthy if
respiratory rate among the individual is high they can face various health related problems and
increases their chances of the risk related to panic attacks.
In accordance with Gulati, (2016) this condition can lay severe impact on the health
outcome of patient. It can also reduce their quality of life. It has also been analysed from the case
study that stats of patient is 26. There are various risk factors that have been related to
Hypovolemic Shock. It occurs after the trauma or excessive bleeding that has been caused in
patient. In this condition service user has the 75% chances of losing the life as excessive blood is
been loss because of the traumatic injury. There occurs severe fluid loss which makes difficult
for the heart to pump and to carry the sufficient amount of blood to the body. This shock can be
occurring because of the serious brain injury in which excessive amount of blood is being is lost.
The symptoms are been dependent on the severity of blood loss. One of the major reasons for
going through this shock includes alteration in heart rate and rhythm. It can also be related to
decrease in ventricular filing.
In accordance with Dube, Bekker and Khine, (2019) Nursing care for patients with
Hypovolemic Shock focuses on assisting with treatment aimed at the cause of the shock and
restoring intravascular volume. It has also been analysed from the case study that the temperature
of the patient is 36.5 which is higher than the normal. It can be cause of the head injury that has
been faced by service user because of the accident which service user has met. It can also be
analysed from the case study that 30 year old male who has gone through accident also have
raised troponin level.
It means that the troponin level only rises because of the excessive stressed taken by the
service user. This is because the heart is not getting enough oxygen. This can lay adverse impact
on the health outcome of patient (Carvalho Pacagnella and Borovac-Pinheiro, 2019). It has also
been analysed that the large in troponin can make service use at the risk of problems such as
heart failure, kidney failure or any other organ failure. It can also increase the risk related to
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Hypovolemic shock. This information can be used by health care professionals for reducing the
serious illness from developing.
In the opinion of Escobar, and et.al., (2017) It has also been analysed from the case study
that the patient also ahve raised creatinine which means that patient has the high risk of impaired
kidney. It can be because of the failure of kidney. This can make patient condition even
worsening. It has also been analysed from the medical chart of service user that he also have
raised coagulopathy. It can be known because of the bleeding disorder. It can occur because of
the injury that has been faced by the patient. This also increases the risk of liver damage in
patient that can also reduce the health outcome of service users.
Nursing management and medical management
As per the view of Kalkwarf and Cotton, (2017) patient has been met with the accident that
has led to hypovelmic shock. Service user has faced chronic brain injury and excessive loss of
blood. Patient has been admitted in emergency department. In this situation nursing management
is of utmost important in order to save the life of service users as excessive blood has been lost.
It has been analysed that registered nurses must be involved in saving and protecting from the
further injury which can result in adverse health condition of patient.
Nurses must make sure that service users have been supplied with excessive oxygen by
making the appropriate ventilation available to them. This will help health care professionals in
improvising the condition of patient who has met with the brain injury. Registered also needs to
be engaged in increasing oxygen saturation so that the flow of blood in the body of patient can be
normalised (Taghavi and Askari, 2019). It will also help the heart to pump blood. It has also been
analysed that health care professionals can make use of multi-disciplinary team that can assist
them in enhancing the health outcome of patient. Registered nurses also need to be engaged in
having a control over the loss of blood. This will help them in protecting and making sure that
there has been safe administration of blood. Health care professionals also need to be engaged in
monitoring patients and provide them with appropriate medication so that blood loss can be
controlled and no further problem can be faced by the service users.
In accordance with Eperjesiova and et.al., (2019) medication management is also really
important for nurses in order to improve the health outcome of service users going through
Hypovolemic shock. Health care professional can also provide them with medicines such as
Dopamine, Dobutamine. This will help in strengthening the pumping rate of heart. There will
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also be the close cardiac monitoring which means that heart can be able to flow adequate level of
oxygen (Downie, Cheema and Campbell, 2018). Blood plasma transfusion can also be one of
the ways for treating this type of problem. It can assist in improvising the health outcome of
patient who has suffered from the brain injury. It has also been analysed that haemoglobin of the
service user is also low (Suresh and et.al., 2019). Health care professional can make patient go
through red blood cell transfusion process. This will assist them in improvising the health
outcome of patient.
Evidence based practice
As per the view of El Ayadi and et.al., (2016) In order to improve the health outcome of
patient suffering from chronic brain injury and Hypovolemic shock can make use of evidence
based practice. In this they will be engaged in making use of various strategies so that health
outcome of patient can be enhanced. In this they can engaged in making use of multi-disciplinary
team that includes physicians, nurses who can work together and improvise the health outcome
of patient. It has also been analysed that health care professionals must be engaged in doing the
blood testing which will be useful for analysing the flow of blood in patient. They will be able to
know if no further health related problem service user is facing.
It will help them in enhancing the physical and emotional abilities of the service users who
has been going through traumatic brain injury. There are various type of therapies can also be
given to patient who has met with the accident (Taghavi and Askari, 2019). Health care
professional can engage in providing them with blood plasma transfusion and cam also provides
the increase in red blood cells. Health care professionals must be engaged in making treatment
and diagnosis plan for enhancing the health outcome of patient. They need to also check upon
the abnormal arterial blood gases. They can also check upon if patient is not facing the problem
of decrease in flow of urine. It has also been analysed that evidence based practice can be used
by nurses; they will help them in changing in the level of consciousness. This will assist in
enhancing the health outcome of patients and also service user will not face any kind of adverse
situation.
CONCLUSION
From the above study it has been summarized that patient has been going through
Hypovolemic shock. It has been analysed that there are various problems which can be faced by
patient because of the change in Blood pressure. It has been summarised from the case study that
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patient has gone through an accident and because of which he has faced excessive blood loss. It
has also been analysed that the blood pressure of service user is very high that has made his
condition even more critical. It has also been analysed from the report that in order to take care
of the patient, nurses and health care professionals has also made use of evidence based practice
that has assisted them in improvising the health outcome of patient. It has also been analysed that
patient also have high level of Triponin. It means that service user has the increased risk of
facing other problems such as heart failure, renal failure or any other type of disease. It has also
analysed that the respiratory rate of patient has been high it means that patient can face problem
like panic attack. They have also made use of multi-disciplinary team so that health out come of
patient is increased.
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REFERENCES
Books and Journals
El Ayadi, A.M. and et.al., 2016. Vital sign prediction of adverse maternal outcomes in women
with hypovolemic shock: the role of shock index. PLoS One, 11(2).
Gulati, A., 2016. Vascular endothelium and hypovolemic shock. Current vascular
pharmacology, 14(2), pp.187-195.
Kalkwarf, K.J. and Cotton, B.A., 2017. Resuscitation for hypovolemic shock. Surgical
Clinics, 97(6), pp.1307-1321.
Dube, W.V., Bekker, L.C. and Khine, A.A., 2019. Simultaneous analysis of plasma lactate and
pyruvate in whole blood using a UV/visible spectrophotometer; application in
hypovolemic shock and hypoxia. The Journal of Medical Laboratory Science and
Technology of South Africa, 1(1), pp.29-32.
Eperjesiova, B. and et.al., 2019. Mortality Outcome of Patients in Septic and Hypovolemic
Shock Associated with Prolonged Norepinephrine, Phenylephrine, Epinephrine,
Vasopressin and/or Dopamine Use. In D51. CRITICAL CARE: THE FOUNTAINHEAD-
FLUIDS, MONITORING AND MANAGEMENT OF SHOCK (pp. A6698-A6698).
American Thoracic Society.
Xiang, L., Klemcke, H.G. and Ryan, K.L., 2018. The life-saving effect of “adenosine, lidocaine,
and magnesium” cocktail during hypovolemic shock: One stone, three birds?. Journal of
Trauma and Acute Care Surgery, 84(1), pp.215-216.
Escobar, M.F. and et.al., 2017. Experience in the use of non-pneumatic anti-shock garment
(NASG) in the management of postpartum haemorrhage with hypovolemic shock in the
Fundación Valle Del Lili, Cali, Colombia. Reproductive health, 14(1), p.58.
Taghavi, S. and Askari, R., 2019. Hypovolemic Shock. In StatPearls [Internet]. StatPearls
Publishing.
Rudkin, S.E. and et.al., 2018. Assessing Acid–Base Status in Circulatory Failure: Relationship
Between Arterial and Peripheral Venous Blood Gas Measurements in Hypovolemic
Shock. Journal of intensive care medicine, p.0885066618762335.
Tandon, P. and et.al., 2019. A rare presentation of hypovolemic shock secondary to Whipple’s
disease. European journal of gastroenterology & hepatology, 31(5), pp.642-645.
de Carvalho Pacagnella, R. and Borovac-Pinheiro, A., 2019. Assessing and managing
hypovolemic shock in puerperal women. Best Practice & Research Clinical Obstetrics &
Gynaecology.
Malin, S.W. and et.al., 2018. Food protein-induced enterocolitis syndrome causing hypovolemic
shock and methemoglobinemia. Case reports in critical care, 2018.
Suresh, M.R. and et.al., 2019. Unmasking the Hypovolemic Shock Continuum: The
Compensatory Reserve. Journal of intensive care medicine, 34(9), pp.696-706.
Downie, M.L., Cheema, S. and Campbell, D.M., 2018. An unusual case of hypovolemic shock in
a neonate.
Hooper, N. and Armstrong, T.J., 2018. Shock, Hemorrhagic.
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