Essay Example: Nursing Diagnosis for Hypovolemic Shock

Medical diagnosis entails determining or identifying which specific disease or condition explains the signs and symptoms indicated by a patient. During the procedure, healthcare professionals conduct an in-depth evaluation of the signs and symptoms portrayed by a patient to identify clues that will assist in the determination of the most likely illness. Besides, nurses and physicians also analyze the patient's health history to generate the necessary information for the diagnosis process. However, this pathological process is challenging to conduct since several signs and symptoms, such as headaches and tiredness, are non-specific. Meaning, that they are signs that apply to a wide range of disorders, thereby not telling healthcare providers exactly what disease it is. Therefore, differential diagnosis is necessary to compare and contrast the symptoms, narrow down the possible diagnostic alternatives, and propose an appropriate treatment. The analysis conducted in this article focuses on providing nursing diagnoses for hypovolemic shock and the risk factors and safety concerns.

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Provide 3 Nursing Diagnosis for the Patient

Hypovolemic shock does not provide prior warnings, and its symptoms tend to appear only after experiencing the condition. The easiest way for medical professionals to diagnose hypovolemic trauma is through physical examination and observation. The nursing diagnosis for the Louise Cousin include:

1. Ineffective tissue perfusion can be related to decreased stroke volume, preload, and severe blood loss (Martin, 2017).
2. Depression and anxiety are mainly because of fear of death, unfamiliar medical environment, and alterations in the health status.
3. Reduction in cardiac output because of changes in heart rates and rhythm.
4. List of Health Assessment Priorities for the Nursing Diagnosis
5. The health professionals will assess for signs and symptoms of ineffective tissue perfusion and monitor the pulse rate and oxygen saturation.

Rationale: Signs and symptoms of hypovolemic shock occur as a result of several risk factors; therefore, assessing these aspects facilitates comparison (Martin, 2017). Also, pulse oximetry provides feedback concerning the necessity for breathing interventions, including the use of ventilators and oxygen therapy.

For anxiety nursing diagnosis, the caregivers will assess Cousins’ level of anxiety and previous techniques to deal with stress. Furthermore, the healthcare providers will not only encourage the patient to share her inner emotions, but also accept her anxiety, and create a conducive environment for recovery.

Rationale: Determining and understanding the patient’s previous anxiety management methods enables health care providers to develop strategies consistent with her initial techniques. Creating a conducive recovery environment involves the removal of external stimuli that threaten to increase the levels of anxiety.

Healthcare providers should assess Cousins’ blood pressure, respiratory rate and rhythm, changes in the level of consciousness, and heart rate to establish the cardiac output level.

Rationale: Assessment of the patient’s blood pressure and heart rate enables the physicians and nurses to determine the level of the disorder and, therefore, maintain a sufficient cardiac output (Martin, 2017). On the other end, assessing the level of consciousness and respiratory rate enables the caregivers to establish the severity of the disease. It is because respiratory changes such as rapid and shallow breathing are the mild symptoms and early stages of hypovolemic shock, while the loss of consciousness indicates the extreme conditions (Martin, 2017).

Explain Evidence-based Practice Interventions for each Nursing Diagnosis

Ineffective Tissue Perfusion Nursing Diagnosis

Interventions:

Louise Cousins is likely to experience dizziness when getting up, which is a sign of the diseases caused by orthostatic hypotension. Therefore, the nurse should direct her to remain seated for some minutes before standing (Wayne, 2019). Also, healthcare professionals should advise the patient to flex her feet upwards while still seated and begin standing up slowly.

Rationale: Orthostatic hypotension leads to short-lived decreased cerebral perfusion, and this nursing intervention assists in reducing the impacts such as dizziness.

Nurses must assist with position changes to reduce peripheral ineffective tissue perfusion (Wayne, 2019). It includes, gently repositioning her to a standing or sitting position after some period of a supine position.

Rationale: In doing so, healthcare professionals reduce the risks of causing orthostatic blood pressure alterations.

Depression and Anxiety Nursing Diagnosis

Interventions:

The health providers should create a calming environment with minimal stimuli such as small rooms, few people, and dim lighting.

Rationale: Complications related to anxiety require treatment in an environment that puts the patient at ease rather than posing a threat. Therefore, this intervention eliminates any form of risk and distraction, which speeds up the recovery process.

Also, the nurses and physicians must establish a positive relationship with Louise, a connection characterized by trust, attention, and valuing one's opinions and stories.

Rationale: The technique will enable her to open up to the healthcare team and share inner feelings about her health status. Furthermore, trust and respect will facilitate clarification of concepts and a better understanding of the condition, leading to better outcomes.

Reduction in Cardiac Output Nursing Diagnosis

Interventions:

The nurses should inspect the patient’s skin color and temperature for paleness, blue color, and clamminess. Also, healthcare providers must monitor urine output while noting the concentration of the urine and reducing production.

Rationale: Pallor is an essential indicator of decreased peripheral perfusion, secondary to low cardiac output. Also, monitoring of urine output enables the health providers to determine the severity of the disease. It is because kidneys respond to this condition by retaining sodium and water.

Explain Lab Work that is required to give a Medical Diagnosis

As previously indicated, some hypovolemic shock cases are easily recognized, especially those involving heavy external bleeding. However, in some instances, such as internal bleeding, the disorder goes undetectable until the patient portrays observable signs and symptoms. In such cases, healthcare professionals will diagnose the disease through several laboratory tests such as:

Blood testing.

The procedure aims at checking for the electrolyte imbalances in crucial body organs such as the liver and kidney (Nall, 2015). The electrolytes that are under test are sodium, chloride, potassium, and bicarbonate. While sodium is responsible for the control of fluid in the body, potassium helps ensure that the cardiac muscles perform effectively. On the other end, chloride helps in maintaining healthy blood volume and pressure, and bicarbonate is responsible for striking a balance between acid and base in the body.

Computed Tomography (C.T. Scan)

C.T. scan involves using computerized X rays to generate cross-sectional images of the body organs (Nall, 2015). A narrow beam of x-rays is projected to the patient's body and rotated continuously throughout the body to capture all the organs. Hypovolemic shock tends to damage some organs and make them appear different compared to the initial outlook. Therefore, the lab procedure enables physicians and nurses to visualize the organs and determine the affected ones.

Echocardiography and electrocardiogram

The test utilizes the sound waves to generate images of the heart, echocardiography (Nall, 2015). The technique is useful in the diagnosis, treatment, or management, and also monitoring the progress. The strategy helps the health professionals detect blood clots in the heart’s chambers, its pressures, and complications associated with the various parts and structures of the heart. On the other end, an electrocardiogram focuses on determining the heart's pulsing beat and assessing her heart rhythm. The two techniques are easy to conduct because they are easy to understand and administer, and non-evasive nature.

Urinary Catheter

The intervention strategy involves administering a tube aimed at collecting urine from the bladder to a drainage bag. Doctors recommend this strategy when patients cannot control their urinary process or even have urinary retention. These are mainly caused by kidney stones, blood clots in the urine, or injuries to the bladders' nerves resulting from hypovolemic shock. In the laboratory, doctors are likely to propose one of the three main types of urinary catheters; indwelling, short term or intermittent, and external catheters (Lillis, 2019). The indwelling catheters reside in the bladder and its often used for both short- and long-term purposes. Unlike the indwelling types, the intermittent catheters are thin, flexible tubes inserted in the bladder via the urethra, specifically for a short period. Lastly, the external types are condom-like and are placed outside the body, specifically over the penis for men.

Interview Objectives/Questions

• What brings you here today?
• What events led to the condition?
• Do you feel any pain? If so, where do you feel it?
• What symptoms have you experienced over the recent days?
• What is your history of trauma?
• What is your history of high blood pressure?
• What medications or treatments have you tried in the past?
• Did you experience any allergic reactions to the treatment method?
• Have you undertaken any surgical procedures recently?
• Do you receive any support from your family members?

Explain the Patient's Risks

Computed tomography uses ionizing radiation to create a detailed cross-sectional visual of the body organs. Despite allowing doctors to obtain more accurate and early disease diagnoses, the strategy exposes the patient to risks of developing cancer (Shao et al., 2019). Excessive doses of ionizing radiation increase the chances of developing leukemia among children and adolescents and thyroid cancer. On the other end, the use of different urinary catheters presents various risks and side effects to the patient. For instance, intermittent catheters are commonly associated with the development of urinary tract infections (UTIs) if used for an extended period (Lillis, 2019). Also, this option is likely to cause hematuria, a red or brown appearance of urine resulting from red blood cells present in it.

The risks associated with indwelling catheters include discomfort and pain for patients who have used them for a long time. Also, the patient is likely to experience blockage of the catheter tubes due to significant mineral deposits, which can prevent drainage. If they are not cleaned regularly, then the patient is at risk of developing UTIs. The external catheters do not enter the urethra of the patient, and therefore they are likely to cause minimal irritations. However, some patients are at risk of experiencing skin discomfort due to an allergic reaction to the latex materials used in the catheter. Also, they are capable of causing physical injuries to the penis due to friction with the condom-like tubes. Lastly, despite not using radiations and being considered the safest procedure, echocardiogram carries patients risks such as allergic reactions, throat irritations, and esophageal perforation.