Question

The nurse is caring for a mechanically ventilated patient being monitored with a left radial arterial line. During the inspiratory phase of ventilation, the nurse assesses a 20 mm Hg decrease in arterial blood pressure. What is the best interpretation of this finding by the nurse?

Answer 1

A 20 mm Hg decrease in arterial blood pressure during the inspiratory phase of ventilation for a mechanically ventilated patient is most likely indicative of pulsus paradoxus and can be a normal finding in mechanically ventilated patients. It reflects a temporary decrease in cardiac output due to increased intrathoracic pressure.

Step-by-step explanation:

The best interpretation of a 20 mm Hg decrease in arterial blood pressure during the inspiratory phase of ventilation for a mechanically ventilated patient is that this could be indicative of pulsus paradoxus, which can be a normal finding in mechanically ventilated patients. This decrease in pressure happens due to an increase in intrathoracic pressure during inhalation which can impede venous return to the heart, thereby temporarily lowering cardiac output and arterial blood pressure. Pulsus paradoxus is often more pronounced in conditions such as cardiac tamponade, asthma, or pericarditis but can also be seen in healthy individuals during mechanical ventilation. When assessing blood pressure, it is important to consider the diastolic pressure, which represents the minimal value corresponding to the pressure that remains during ventricular relaxation.