An older adult client is experiencing hypovolemic shock. Which is the priority intervention for this client?
A) Administering analgesics for control of pain
B) Assessing the cause of bleeding
C) Providing replacement of volume
D) Establishing invasive cardiac monitoring
Answer: D
With aging, there is a decrease in cardiac sympathetic activity. Older clients can have secondary volume depletion because of diuretics or malnutrition, and if prescribed a beta blocker, tachycardia may not occur as an early sign of hypovolemic shock. The older client will require early invasive monitoring in order to avoid excessive or inadequate volume restoration. This should be done early in the treatment phase. Replacement of volume would occur after invasive cardiac monitoring is established. Pain would be a consideration but would not be attended to as a first priority. Assessing the cause of bleeding would also occur after establishing invasive cardiac monitoring.
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