Inpatient Obstetric Nurse (NCC) Practice Exam

Which physiological changes may be noted in a patient experiencing significant blood loss?

1. Increased blood pressure, decreased heart rate, and increased LOC

2. Rising pulse rate, skin pallor, and falling blood pressure

3. Stable heart rate and normal respiratory rate

4. Increased urinary output and fever

The correct answer is: Rising pulse rate, skin pallor, and falling blood pressure

In the context of significant blood loss, the physiological changes typically reflect the body's compensatory mechanisms to maintain perfusion and oxygenation to vital organs. When an individual experiences considerable blood loss, the body's response involves an increase in heart rate, often observed as a rising pulse rate, in an attempt to compensate for the reduced blood volume and maintain cardiac output. Skin pallor is another manifestation, as blood flow is redirected from peripheral tissues to vital organs like the heart and brain in a process known as shunting. This results in a notable lack of perfusion to the skin, causing a pale appearance. Falling blood pressure is also a critical indicator, as significant blood loss decreases the overall circulating blood volume, leading to a drop in blood pressure—an important sign of hypovolemic shock. These alterations in vital signs, particularly the combination of rising pulse rate, skin pallor, and falling blood pressure, provide essential clues for healthcare providers to identify and manage the effects of significant hemorrhage effectively.