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Nursing QUESTION #9229
Question 1
A patient in the ICU has a Central Venous Pressure (CVP) of \(2 \text{ mmHg}\) and a blood pressure of \(80/50 \text{ mmHg}\). The Charge Nurse administers a \(500 \text{ mL}\) normal saline bolus. What type of shock is most likely, and why is CVP low?
  • Cardiogenic shock — left ventricular failure reduces cardiac output
  • Distributive (septic) shock — vasodilation decreases venous return and CVP
  • Hypovolemic shock — reduced circulating blood volume decreases preload and CVP✔️
  • Obstructive shock — pulmonary embolism prevents blood flow to the left heart
Correct Answer Explanation
Correct Answer: C — Hypovolemic shock

CVP interpretation:
CVPInterpretation
\(0 - 5 \text{ mmHg}\)Low — hypovolemia, vasodilation
\(6 - 12 \text{ mmHg}\)Normal (mechanically ventilated: \(8-12\))
\(> 12 \text{ mmHg}\)High — fluid overload, right heart failure, tension pneumothorax
Shock Classification:
  • Hypovolemic: Low CVP, low CO, high SVR — fluid loss (hemorrhage, burns, diarrhea)
  • Cardiogenic: High CVP, low CO, high SVR — pump failure
  • Distributive: Low/normal CVP, high CO, low SVR — sepsis, anaphylaxis, neurogenic
  • Obstructive: High CVP, low CO — PE, cardiac tamponade, tension pneumothorax
CVP of \(2 \text{ mmHg}\) reflects reduced preload, consistent with hypovolemia. Fluid resuscitation is appropriate.