A narrow pulse pressure.
A narrow pulse pressure, which is the difference between the systolic Systolic
The phase of blood circulation in which the heart's pumping chambers (ventricles) are actively pumping blood. The ventricles are squeezing (contracting) forcefully, and the pressure against the walls of the arteries is at its highest. and diastolic Diastolic
The phase of blood circulation in which the heart's pumping chambers (ventricles) are being filled with blood. During this phase, the ventricles are at their most relaxed, and the pressure against the walls of the arteries is at its lowest. , is an early indication of shock. Look for hypovolemia hypovolemia /hy·po·vo·le·mia/ (-vol-em´e-ah) diminished volume of circulating blood in the body.hypovole´mic
See oligemia. or decreased cardiac output. Often the systolic pressure will start to fall as cardiac output decreases. A patient who is hypovolemic Hypovolemic
Having a low volume.
Mentioned in: Shock
pertaining to hypovolemia. See also hypovolemic shock, hypovolemic circulatory failure. , or a patient who has decreased cardiac output from an MI, will exhibit a decrease in the systolic pressure.
The body's compensatory mechanism and response to decreased cardiac output is to stimulate the sympathetic nervous system. This will cause vasoconstriction vasoconstriction /vaso·con·stric·tion/ (-kon-strik´shun) decrease in the caliber of blood vessels.vasoconstric´tive
n. and result in a rise in the diastolic pressure causing a narrowed pulse pressure.
A narrow pulse pressure in shock is consistent with hypovolemic and cardiogenic causes. Septic shock will cause a widened pulse pressure. One way to differentiate shock in your patients is to look at the pulse pressure. A narrow pulse pressure associated with hypovolemia would be hypovolemic. A narrow pulse pressure associated with volume overload would be cardiogenic. A wide pulse pressure associated with hypovolemic would be septic.
Watch for those changes and watch for those trends in the patient's vital signs. You may see the patient's blood pressure and you may see that pulse pressure narrowing before you start to see any other symptoms that your patient is developing shock.
Type--Pulse Pressure--Volume Hypovolemic--Narrow--Low Cardiogenic--Narrow--High Septic--Wide--Low David W. Woodruff, MSN, RN, CNS See Continuous net settlement.
See continuous net settlement (CNS). , CEN President, Ed4Nurses,