A Head Nurse notes a patient's pulmonary artery wedge pressure (PAWP) is 22 text mmHg . What does this MOST likely indicate in the context of a hypotensive ICU patient?

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Nursing QUESTION #9241

Question 1

A Head Nurse notes a patient's pulmonary artery wedge pressure (PAWP) is \(22 \text{ mmHg}\). What does this MOST likely indicate in the context of a hypotensive ICU patient?

Hypovolemia — fluid resuscitation is needed
Pulmonary arterial hypertension
Left ventricular failure with pulmonary congestion✔️
Right ventricular failure — start inhaled nitric oxide

Correct Answer Explanation

Correct Answer: C — Left ventricular failure with pulmonary congestion

PAWP (Pulmonary Artery Wedge Pressure) Interpretation:

PAWP	Interpretation
\(< 8 \text{ mmHg}\)	Hypovolemia — aggressive fluid resuscitation
\(8 - 12 \text{ mmHg}\)	Normal
\(12 - 18 \text{ mmHg}\)	Mild-moderate elevation — monitor
\(> 18 \text{ mmHg}\)	LV failure / pulmonary congestion
\(> 25 \text{ mmHg}\)	Severe LV failure / cardiogenic pulmonary edema

PAWP (also called PCWP) reflects left atrial pressure and left ventricular end-diastolic pressure (preload). PAWP \(= 22 \text{ mmHg}\) indicates fluid overload or LV failure. Hypotension with elevated PAWP = cardiogenic shock. Management: diuretics, inotropes (dobutamine), vasopressors.

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