Health Assessment

Introduction to Hypovolemic Shock

According to Gulati (2016), as the heart chambers relax, the blood flows from veins into atria. Then, the blood will passively move into ventricles. Through the pulmonic valve, the blood enters the lungs and enters the pulmonary artery to small vessels in the lungs where CO₂ is released in the lungs and O₂ enters the blood. This oxygenated blood enters the heart through a pulmonary vein in the right atria and then distributed to various parts in the body to supply oxygen for cellular functions. When the blood vessels dilate, the blood pressure decreases so blood flow is shut; this disrupts homeostasis resulting in hypovolemic shock.

Discussion on Hypovolemic Shock

As the blood vessels dilate, the cardiac output is decreased resulting in low systolic pressure. Hypovolemic shock results from loss in fluid in the body. The body compensates for this volume loss by increasing the contractility, increasing heart rate with the action of baroreceptors. This results in activation of the peripheral constriction and the sympathetic nervous system The baroreceptors are activated in response to the stretch of blood vessels and spend signals to cardiovascular center in the brain to regulate blood pressure to maintain homeostasis (El Ayadi et al., 2016). The heart also detects the blood volume change and then the kidney hormonal mechanism of the renin-angiotensin-aldosterone system (RAAS) regulates blood volume. This system increases extracellular fluid volume in the body that results in increased blood pressure by constricting the blood vessels (Guillaumin & DiBartola, 2020).

According to Bak & Tsiami (2016), the RAAS system elevate the arterial tone and the blood volume in a prolonged manner. It is achieved by increasing the reabsorption of water, sodium, and vascular tone. Moreover, an elevated respiratory rate helps in the removal of excess carbon dioxide in the body. According to Siddall et al. (2017), increased dehydration, vomiting, and diarrhea cause intravascular volume loss. Loss of blood results in a low filling of the right heart and low filling of the pulmonary vasculature. This results in inefficient filling of left atrium and ventricles resulting in arterial blood pressure decline. If this occurs then it is expected that cardiac output is low so the cells or major organs will not get sufficient blood supply. Therefore, the tissues and cells will not get sufficient oxygen resulting in tissue perfusion, impaired cellular metabolism, or organ failure. Hypovolemic shock is a life-threatening condition that makes the heart unable to pump an ample amount of blood to the body ending up with organ failure. The other expected outcomes of this health issue are gangrene of legs or arms, damage to the kidney or brain, and heart attack.

A concept map is provided below to understand the normal functioning and the disturbed functioning that lead to hypovolemic shock.

Topic for Concept Map: Describe the processes by which blood flows from the heart, to the lungs and back to the heart. Explain how changes in pressure within different chambers of the heart push blood throughout the chambers and to/from the lungs mentioning the valves involved in this process. Explain how hypovolemic shock would alter systolic blood pressure and breathing.

References for Hypovolemic Shock

Bak, A., & Tsiami, A. (2016). Review on mechanisms, importance of homeostasis and fluid imbalances in the elderly. Current Research in Nutrition and Food Science4(S3), 1-7. https://doi.org/10.12944/CRNFSJ.4.Special-Issue-Elderly-November.01

El Ayadi, A. M., Nathan, H. L., Seed, P. T., Butrick, E. A., Hezelgrave, N. L., Shennan, A. H., & Miller, S. (2016). Vital sign prediction of adverse maternal outcomes in women with hypovolemic shock: The role of shock index. PLoS One11(2), e0148729. https://doi.org/10.1371/journal.pone.0148729

Guillaumin, J., & DiBartola, S. (2020). Disorders of sodium and water homeostasis. Clinical Small Animal Internal Medicine, 1067-1077. https://doi.org/10.1002/9781119501237.ch118

Gulati, A. (2016). Vascular endothelium and hypovolemic shock. Current Vascular Pharmacology14(2), 187-195.

Siddall, E., Khatri, M., & Radhakrishnan, J. (2017). Capillary leak syndrome: Etiologies, pathophysiology, and management. Kidney International92(1), 37-46. https://doi.org/10.1016/j.kint.2016.11.029

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