A nurse is caring for a patient who has been admitted to a medical-surgical unit for evaluation of weakness and shortness of breath. Upon admission to the unit, the patient manifested the following vital signs: oral temperature 98.6°F, pulse 88 and regular, respiratory rate 16, and blood pressure 120/82 mmHg. A chest x-ray, complete blood count (CBC), basic metabolic panel (BMP), and urinalysis have been obtained, with results pending.
The nurse reassesses the patient thirty minutes later and finds the patient to be disoriented to time, place, and person. Vital signs are as follows: oral temperature of 101.3°F, pulse of 118 and regular, respiratory rate of 22, and blood pressure of 88/60 mmHg. The nurse knows that such changes in vital signs are possible manifestations of shock, a life-threatening condition that causes cells and organs not to receive adequate perfusion. The nurse notifies the health-care provider, who prescribes interventions to restore homeostasis and prevent further complications.
Early identification of the development of shock and initiation of appropriate treatment is key to full patient recovery. By conducting prompt assessments and reporting concerning changes in vital signs, such as a drop in blood pressure and an increase in heart rate, nurses can have a significant positive impact on patient outcomes. In this chapter, you will learn how to prevent, recognize, and treat one of the most life-threatening conditions a patient can encounter: shock.