Proceso de atención de enfermería en riesgo de shock hipovolémico mediante enfoque nanda noc y nic.

Abstract

Hypovolemic shock is the loss of blood or fluids from the body, about a fifth of the total volume corresponding to 20% of the amount of fluids, causing the heart to be unable to pump enough blood to the various parts of the body, is the complication Main in polytraumatized patients, uncontrolled bleeding causes between 30% to 40% of mortality in traumas and above 80% of deaths within the operating room, uterine atony is the main cause of bleeding between 75% to 90% . The factors that cause the state of shock can be hemorrhagic: gastrointestinal or vaginal bleeding, operative, some traumatic injury, rupture of an aortic artery aneurysm or chronic gastrointestinal bleeding; and non-hemorrhagic, due to a general lack of volume of body fluid or displacement of fluid to the extracellular space. The clinical manifestations are: tachypnea, tachycardia, cutaneous vasoconstriction, diaphoretic skin, hypotension, oliguria, altered state of consciousness. The objective of this research work is to determine the main risk of hypovolemic shock through the application of the nursing care process based on the NANDA NOC and NIC taxonomy, using the theory of the natural history of the disease and the functional patterns of Marjory. Gordon. The methodology used was by means of compilation of updated bibliographical sources of scientific articles of great impact. The application of nursing care will be aimed at the management and control of shock immediately to prevent sequelae and even death.