The nurse recognizes that which patient would be most likely to develop hypovolemic shock? A patient with:
1. Decreased cardiac output
2. Severe constipation, causing watery diarrhea
3. Ascites
4. Syndrome of inappropriate ADH (SIADH)
3
Rationale 1: Although ECG changes reflect the effectiveness of the heart's pumping when circulating the blood, it is not a risk factor for hypovolemic shock, which reflects a decreased circulating volume from either blood or fluid losses within the intravascular system.
Rationale 2: Severe constipation does not affect the circulating blood volume.
Rationale 3: Third spacing shifts move the fluids from the intravascular space into the interstitial space, causing a drop in the circulating blood volume. Therefore, third spacing is a risk factor for the development of hypovolemic shock.
Rationale 4: Overhydration does not lead to hypovolemic shock. It leads to fluid overload, which might cause cardiogenic shock, congestive heart failure, and pulmonary edema.
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