Hemorrhagic Shock After a Crash
A 27-year-old restrained driver is brought in after a high-speed collision. The client is awake but restless and reports severe left upper abdominal pain.
Recognize cues
Vital signs: BP 84/52, HR 138, RR 28, SpO2 95% on 2 L/min, temperature 36.2 C. Skin is cool and clammy, capillary refill is 4 seconds, the abdomen is rigid and distended, and the client has not voided since arrival.
Which finding requires the most immediate follow-up?
Take action
The provider orders two large-bore IV catheters, a rapid 1 L isotonic crystalloid bolus, type and crossmatch for 4 units, and an emergent surgical consult.
Which two actions should the nurse take first?
Evaluate outcomes
After fluids, blood products and splenectomy: BP 116/70, HR 88, urine output 50 mL per hour, skin warm and dry, and the client is alert and oriented.
Which finding best indicates the treatment is working?
Ready to answer this case?
Practice the full Hemorrhagic Shock After a Crash case — with answer choices and rationales for every part — in the Critical Care quiz.
Practice this case