Which statement correctly describes push dose phenylephrine in this protocol?

• A. It is used in hypovolemic shock without a fluid bolus
• B. Hypovolemic shock is a relative contraindication; address with a fluid bolus before administering
• C. There are no contraindications
• D. It is a beta-adrenergic agonist

Answer: (B)

Push-dose phenylephrine raises blood pressure by constricting blood vessels through alpha-1 receptors, increasing systemic vascular resistance and mean arterial pressure. It doesn’t add volume or directly boost heart pumping, so in a patient with hypovolemia the problem is lacking circulating blood. If you constrict the vessels when volume is depleted, perfusion can worsen rather than improve. That’s why hypovolemic shock is considered a relative contraindication, and the preferred first step is to give a fluid bolus to restore intravascular volume before relying on a vasopressor. Only after volume expansion would vasopressor support be considered if hypotension persists.

Also, push-dose phenylephrine is not a beta-adrenergic agonist, and there are indeed contraindications related to volume status and other conditions; it isn’t correct to say there are no contraindications.