80 Case Study 5: Adolescent Client (continued)

1. After reviewing the vital sign record, identify the trends that you see.

The trends include a significant decrease in blood pressure, increase in pulse, and decrease in pulse force over 90 minutes. There is an increase in respiratory rate and a decrease in oxygen saturation. The temperature is slightly elevated, which is a common finding post-surgery. The temperature remained stable over the 90-minute period.

The changes in the above vital signs suggest hypovolemic shock, particularly in the context of recent abdominal surgery. Hypovolemic shock is a life-threatening condition that occurs with significant fluid loss such as blood. As part of diagnostic reasoning, healthcare providers recognize the indicators of hypovolemic shock as a decrease in blood pressure and an increase in pulse. The change in the respiratory rate is a compensating mechanism for blood loss and decreasing oxygen saturation: physiological factors stimulate increased respiratory rate to meet the oxygen demands of tissues as a result of decreasing blood pressure.

2. What should the healthcare provider’s next actions be?

This condition is a medical emergency that requires immediate intervention.

• Notify the most responsible provider (if you are not the most responsible provider).
• Anticipate fluid rehydration and continue to monitor the client closely.