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    Obstetricspediatrics proctored exam

    A nurse is caring for a client who is postpartum. The nurse should identify which of the following finding as an early indicator of hypovolemia caused by hemorrhage?

    Explanation & Rationale

    A. Increasing pulse and decreasing blood pressure: Tachycardia is one of the earliest compensatory responses to hypovolemia, as the body attempts to maintain cardiac output despite reduced circulating volume. A subsequent drop in blood pressure indicates progressing volume loss and cardiovascular compromise. B. Dizziness and increasing respiratory rate: Dizziness and tachypnea may develop as blood loss continues, but these are slightly later manifestations reflecting decreased oxygen delivery and compensatory respiratory effort rather than the initial physiologic response. C. Cool, clammy skin, and pale mucous membrane: Peripheral vasoconstriction and pallor are compensatory mechanisms that appear after significant blood volume loss, indicating more advanced hypovolemia. D. Altered mental status and level of consciousness: Changes in consciousness occur later in hemorrhagic hypovolemia, reflecting cerebral hypoperfusion. These are not the earliest indicators and suggest severe, potentially life-threatening blood loss.

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