A patient is admitted to the ICU for observation of his grade II splenic laceration.Which of the following signs and symptoms would suggest that he has had a delayed rupture of his splenic capsule and is now in hemorrhagic shock?
A) BP, 110/70 mm Hg; HR, 120 beats/min; Hct, 42 mg/dL; UO, 40 mL/hr; skin that is pink, warm, and dry with capillary refill of 3 seconds
B) BP, 90/70 mm Hg; HR, 140 beats/min; Hct, 21 mg/dL; UO, 10 mL/hr; pale, cool, clammy skin; confused
C) BP, 100/60 mm Hg; HR, 100 beats/min; Hct, 35 mg/dL; UO, 30 mL/hr; pale, cool, dry skin; alert and oriented
D) BP, 110/60 mm Hg; HR, 118 beats/min; Hct, 38 mg/dL; UO, 60 mL/hr; flushed, warm, diaphoretic skin; agitated and confused

Question

Quizplus · Accepted Answer

The first set of vital signs is normal.Patients who are in hemorrhagic shock are significantly tachycardic with a narrowed pulse pressure and oliguric, and their skin is pale, cool, and clammy.They also have a low hematocrit and are confused.Hemodynamically stable patients may be monitored in the critical care unit by means of serial hematocrit values and vital signs.Progressive deterioration may indicate the need for operative management.

A Patient Is Admitted to the ICU for Observation of His