Trauma Nurse Core Course (TNCC) Practice Exam

Which pulse pressure description indicates early hypovolemic shock?

1. Widened

2. Narrowed

3. Bounding

4. Weak

The correct answer is: Narrowed

A narrowed pulse pressure is indicative of early hypovolemic shock due to the physiological changes that occur when the body is experiencing decreased blood volume. In this state, there is a decrease in the systolic blood pressure due to reduced cardiac output from a lack of circulating volume, while the diastolic pressure may remain relatively normal or decrease less significantly. This leads to a smaller difference between systolic and diastolic blood pressures, resulting in a narrowed pulse pressure. In early hypovolemic shock, the body attempts to compensate for the loss of blood volume through mechanisms such as increased heart rate and vascular constriction to maintain perfusion to vital organs. However, if fluid loss is significant enough, the compensatory mechanisms will start to fail, and further monitoring of vital signs becomes critical in managing the patient. Understanding pulse pressure changes is an important component of assessing hemodynamic status in trauma patients, and recognizing a narrowed pulse pressure can alert healthcare providers to the potential for worsened perfusion and the requirement for intervention.