Review Question - QID 216713

A 78-year-old man is brought to the emergency department by ambulance for confusion. He lives in a nursing facility and the staff report that over the past 2 days, he has had frequent, small micturition episodes of cloudy-appearing urine. He began experiencing chills overnight. He has a history of rheumatoid arthritis and diabetes mellitus for which he takes methotrexate, metformin, and glipizide. The patient’s temperature is 103.3°F (39.6°C), blood pressure is 90/50 mmHg, pulse is 120/min, and respirations are 24/min. Physical exam reveals an ill-appearing man with suprapubic tenderness and warm extremities. A 2 L bolus of normal saline is given with no change in blood pressure. Which of the following sets of hemodynamic changes are most likely present in this patient early in the disease course (Figure A)?