Question

A diabetic patient who has had vomiting and diarrhea for the past 3 days is admitted to the hospital with a blood glucose of 748 mg/ml (41.5 mmol/L) and a urinary output of 120 ml in the first hour. The vital signs are blood pressure (BP) 72/62; pulse 128, irregular and thready; respirations 38; and temperature 97° F (36.1°C). The patient is disoriented and lethargic with cold, clammy skin and cyanosis in the hands and feet. The nurse recognizes that the patient is experiencing the :

a. progressive stage of septic shock.
b. compensatory stage of diabetic shock.
c. refractory stage of cardiogenic shock.
d. progressive stage of hypovolemic shock.

Answer 1

The patient is experiencing the progressive stage of hypovolemic shock due to fluid loss from vomiting and diarrhea, compounded by uncontrolled diabetes. Treatment involves restoring blood volume through intravenous fluids and addressing the underlying cause.

Step-by-step explanation:

The patient is experiencing the progressive stage of hypovolemic shock.

Hypovolemic shock occurs when there is a significant loss of blood volume, leading to inadequate blood flow to the tissues. In this case, the patient has been experiencing vomiting and diarrhea, which can lead to fluid loss and dehydration. The high blood glucose level indicates uncontrolled diabetes, which can further contribute to fluid loss. The patient's vital signs, such as low blood pressure, rapid heart rate, and cold, clammy skin, are indicative of hypovolemic shock. The disorientation and lethargy are signs of inadequate oxygen and nutrient supply to the brain.

Treatments for hypovolemic shock generally involve restoring blood volume through intravenous fluids and medications to raise blood pressure. It is crucial to address the underlying cause of the shock, such as treating the diabetic ketoacidosis and stabilizing the patient's blood glucose levels.