Shock States and Fluid Resuscitation · NCLEX Exam

Why might the central venous pressure (CVP) trend downward despite isotonic saline therapy in a patient with hypovolemic shock?

  1. The fluid is hypertonic and shifts water intracellularly
  2. The patient keeps losing volume or fluid isn't reaching the intravascular space
  3. CVP always trends downward naturally during fluid treatment
  4. A fluid bolus invariably produces an immediate, sustained CVP rise
Show answer and explanation

Correct answer: The patient keeps losing volume or fluid isn't reaching the intravascular space

In hypovolemic shock, if CVP continues to decline despite isotonic fluid, the cause may be ongoing fluid losses or inadequate intravascular refill, indicating the need for further volume correction.

Difficulty: Hard Question 10 of 18

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