Which laboratory finding should cause the nurse to suspect that a patient is developing hypovolemic shock?
1. Serum sodium of 130 mEq/L (130 mmol/L)
2. Metabolic acidosis validated by arterial blood gases
3. Serum lactate of 3 mmol/L
4. SvO2 greater than 80%
2
Rationale 1: The sodium level in hypovolemic shock is elevated above the normal values of 135 to 145 mEq/L, not reduced.
Rationale 2: Metabolic acidosis is present due to an accumulation of carbonic acid, leaving a bicarbonate deficit from decreased tissue perfusion.
Rationale 3: Serum lactate is greater than 4 mmol/L as a result of tissue ischemia, hypoxia, and breakdown from decreased blood flow with hypovolemic shock.
Rationale 4: SvO2 (mixed venous oxygen saturation) would be less than 60% due to decreased circulating blood volume or decrease in cells to carry the oxygen. Therefore, O2 is carried less efficiently and decreased, not increased.
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