In hypovolemic shock, intravenous therapy is indicated to expand the blood volume and restore blood pressure. Oxygen is administered to deal with hypoxia due to pulmonary congestion, hypoventilation, and decreased cardiac output. Monitoring may include continuous electrocardiography and central venous and arterial pressure monitoring. Analgesics are administered to relieve pain associated with decreased tissue perfusion, but care must be taken that they do not cause arterial hypotension and respiratory depression. Acidosis frequently accompanies shock as a result of hypercapnia and increased production of lactic acid.
Sodium bicarbonate is administered intravenously to restore acid-base balance.
Vital signs are monitored at least every hour until the patient is stabilized. Urine output also is measured every hour to assess renal function. Intravenous fluids are given according to central venous and arterial pressure readings. Because of the possibility of pulmonary edema and congestion, the patient's respiratory status, arterial blood gases, and lung sounds are assessed. Oxygen is administered as prescribed.