A patient has an estimated blood loss of 2 liters and a mean arterial pressure ranging between 30 and 40 mmHg. If this patient's hemodynamic status is not corrected, what should the nurse realize can occur?
1. failure of sodium-potassium pump
2. cells shrinking
3. full and bounding peripheral pulses
4. metabolic alkalosis
Correct Answer: 1
With a blood loss of two liters and a mean arterial pressure below 60 mmHg, the body cells switch from aerobic to anaerobic metabolism. The lactic acid formed as a by-product of anaerobic metabolism contributes to an acidotic state at the cellular level. Adenosine triphosphate, the source of cellular energy, is produced inefficiently. Lacking energy, the sodium-potassium pump fails. Potassium moves out of the cells while sodium and water move inward. As this process continues, the cells swell, not shrink. Peripheral pulses may not be palpable. The body develops acidosis, not alkalosis.
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