— 生理適應 · HARD · MCQ —
病人出現低血容性休克徵象。護理師應預期哪項血流動力學測量結果？
A client presents with signs of hypovolemic shock. Which hemodynamic measurement should the nurse anticipate?
- AIncreased pulmonary artery wedge pressure (PAWP)肺動脈楔壓 (PAWP) 升高
- BIncreased cardiac output心輸出量增加
- CDecreased central venous pressure (CVP)✓ 正解中心靜脈壓 (CVP) 降低
- DDecreased systemic vascular resistance全身血管阻力降低
— Explanation · 中文詳解 —
低血容性休克主要原因是循環血量減少，導致靜脈回流減少。中央靜脈壓（CVP）反映右心房壓力，會隨血量不足而下降。心輸出量（CO）減少，系統血管阻力（SVR）為了代償會升高，PAWP 亦會因前負荷不足而下降。
Hypovolemic shock results from decreased circulating volume and reduced venous return. CVP reflects right atrial pressure and decreases with volume loss. Cardiac output also decreases, SVR increases as a compensatory response, and PAWP decreases due to inadequate preload.
✦ 台美臨床差異
美國 ICU 常規監測 PAWP；台灣目前的臨床趨勢已轉向使用非侵入性心輸出量監測（如 FloTrac 等）。