Which patients would the nurse identify as being at increased risk for the development of hypovolemic shock? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply

Question

1. A patient with systemic lupus erythematosus
2. A patient who had a myocardial infarction
3. A patient with cirrhosis, ascites, and anasarca
4. A patient who was the unrestrained front-seat passenger in a multivehicle car crash
5. Patient with ruptured abdominal aortic aneurysm

Answer 1

3,4,5
Rationale 1: A patient treated for lupus typically takes immunosuppressing drugs such as corticosteroids, which place the patient at risk for septic shock.
Rationale 2: A myocardial infarction may lead to cardiogenic, not hypovolemic, shock.
Rationale 3: Patients at risk for hypovolemic shock include those with hemorrhage, GI bleeding, third spacing, and unreplaced fluid loss. Ascites and anasarca are examples of third spacing.
Rationale 4: Patients at risk for hypovolemic shock include those with chest and abdominal trauma.
Rationale 5: Patients at risk for hypovolemic shock include those with hemorrhage and GI bleeding.