[Expert Solution]: You perform a physical exam on the patient…

You perform a physical exam on the patient while your partner prepares an IV setup. Your physical exam reveals the following findings: jugular venous distention, accessory muscle use, pitting edema of both lower extremities, and an area surrounding the shunt site on the right arm approximately 4 cm in diameter that is red, swollen, and hot to the touch. As you are completing your assessment, the patient begins to complain of feeling light-headed. You lower the head of the dialysis chair to a 60°angle, initiate an IV using a 18-gauge catheter in the left antecubital space, and begin a fluid bolus of 200 mL, after checking for pulmonary edema. Is the patient going into shock? If so, what type? Is a fluid bolus appropriate here? Why or why not?