How should a nurse interpret rising central venous pressure in a patient with fluid overload?

• A. Suggests increased filling pressures; may indicate fluid overload or reduced cardiac function; consider diuresis
• B. Indicates improved venous return
• C. Indicates dehydration
• D. Indicates infection

Answer: (A)

Rising central venous pressure reflects increased filling pressures and venous congestion, meaning the right atrial/preload load is higher than what the heart can handle. In a patient with fluid overload, this elevation suggests there is too much intravascular volume or the heart is not effectively pumping it forward, leading to congestion in the venous system and potential edema or pulmonary edema. The appropriate response is to reduce preload with diuresis and adjust fluid management, while continuing to monitor perfusion and kidney function and correlate with other signs like edema and lung crackles. This measure doesn’t indicate improved venous return, dehydration, or infection in this context.