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Question 8
The AGACNP is managing a patient in the ICU who is being treated for a pulmonary
embolus. Initially the patient was stable, awake, alert, and oriented, but during the last
several hours the patient has become increasingly lethargic. At change of shift, the
oncoming staff nurse appreciates a profound change in the patient’s mental status from
the day before. Vital signs and hemodynamic parameters are as follows: BP 88/54 mm
Hg Pulse 110 bpm Respiratory rate 22 breaths per minute Sa02 93% on a 50% mask
Systemic vascular resistance (SVR) 1600 dynes . sec/cm5 Cardiac index 1.3 L/min
Pulmonary capillary wedge pressure (PCWP) 8 mm Hg This clinical picture is most
consistent with which shock state?
A. Hypovolemic
B. Cardiogenic C. Distributive
D. Obstructive