What does a positive hepatojugular reflux test indicate regarding fluid status?

A positive hepatojugular reflux test indicates fluid overload. This test involves applying pressure to the liver area (the right upper quadrant of the abdomen), which typically causes the jugular veins in the neck to distend if there is excessive fluid in the bloodstream. When the heart is unable to manage the increased venous return due to heart failure or other cardiac conditions, this elevation in jugular venous pressure reflects fluid overload.

In fluid overload situations, the usual regulatory mechanisms of circulation are impaired, leading to excess fluid accumulation in the veins and tissues, resulting in symptoms such as edema and increased jugular venous distension. This test serves as a clinical marker, helping nurses and clinicians assess a patient's volume status and guide appropriate interventions in managing heart failure or other related conditions.