Carlos Adams was involved in a motor accident andsuffered blunt trauma to his abdomen. Upon presentation toemergency department, his vital signs are as follows:
Temperature, 100.9degrees Ferihieght, heart rate,120bpm,respiratory rate, 20 breast/min, and blood pressure, 90/54mmHg.Hisabdomen is firm,with bruising around the umblicus. He is alert andoriented, but complains of dizziness when changing positions. Thepatient is admitted for management of suspected hypovolemicshock.The following orders are written for the patient:
place two large-bore IVs and infuse 0.9% NS at 125mL/hr/line.
Obtain complete blood count, serum electrolytes oxygen at 2L/minvia nasal cannula.
Type and cross for the 4 units of blood.
Flat plate of the abdomen STAT (Learning objective 1,4,and5).
a. Describe the pathophysiologic sequence of events seen withhypovolemic shock.
b. What are the major goals of medical management in thispatient?
c. what is the rationale for placing two large-bore IVS?
d. what are the advantages of using 0.9% NS in this patient?
e. What is the rationale for placing the patient in a modifiedTrendelenburg position?
