Mr. Patton was admitted due to myocardial infarction. Two hours after the admission, his skin became cool and clammy. Latest BP shows a decrease in the systolic blood pressure. His heart rate and respirations are gradually increasing, and his urine output is decreasing. Mr. Patton is experiencing cardiogenic shock due to myocardial infarction. Show
What is Cardiogenic Shock?Cardiogenic shock is also sometimes called “pump failure”.
PathophysiologyThis is what happens in cardiogenic shock:
ClassificationThe causes of cardiogenic shock are known as either coronary or non-coronary.
Statistics and IncidencesCardiogenic shock could be fatal if left untreated.
CausesCardiogenic shock can result from any condition that causes significant left ventricular dysfunction with reduced cardiac output.
Clinical ManifestationsCardiogenic shock produces symptoms of poor tissue perfusion.
Assessment and Diagnostic FindingsDiagnosis of cardiogenic shock may include the following diagnostic tests:
Medical ManagementThe aim of treatment is to enhance cardiovascular status by:
Pharmacologic TherapyDrug therapy may include:
Surgical ManagementWhen the drug therapy and medical procedures don’t work, then the last option is for surgical procedure.
Nursing ManagementCardiogenic shock needs rapid, accurate nursing management. Nursing AssessmentThe nurse should assess the following:
Nursing DiagnosisBased on the assessment data, the major nursing diagnoses are:
Nursing Care Planning & GoalsMain Article: 5 Cardiogenic Shock Nursing Care Plans The major goals for the patient are:
Nursing InterventionsThe appropriate nursing interventions for a patient with cardiogenic shock includes:
EvaluationExpected outcomes include:
Discharge and Home Care GuidelinesLifestyle changes must be made to avoid the recurrence of cardiogenic shock.
Documentation GuidelinesThe focus of documentation include:
Practice Quiz: Cardiogenic ShockHere are some practice questions for this study guide. Please visit our nursing test bank page for more NCLEX practice questions. 1. A person comes into your ER room with a very weak pulse after a suffering a heart attack. You suspect: A. The weak pulse has nothing to do with shock or the heart attack, so send him home. 1. Answer: D. A late stage (decompensated) shock, the most life-threatening stage of shock.
2. Which of the following would make the most sense as a more specific diagnostic test of shock? A. A CSF (spinal) tap to check for meningitis. 2. Answer: D. The measurement of serum lactate, elevated levels of which are an indicator of shock.
3. What are characteristics of the irreversible stage of shock? A. The worsening of tissue hypoperfusion and the onset
of worsening circulatory and metabolic imbalances, including acidosis. 3. Answer: D. Tissue and cell damage are too great tissue and necrosis of the tissue will occur even if the underlying hemodynamic defect is corrected.
4. Cardiogenic shock occurs as a result of: A. Excessive vasodilation and possibly increased capillary permeability. 4. Answer: D. Myocardial dysfunction.
5. Which characteristic often distinguishes cardiogenic shock from hypovolemic shock? A.
Tachycardia. 5. Answer: C. Narrow pulse pressure.
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[sc name=”Affiliate_MedicalSurgical”] What is the primary goal for the care of a client who is in shock?The objective in managing shock is to prevent anaerobic metabolism in the tissue. In the resuscitation of the acutely hypovolemic patient, volume resuscitation is the key. Drugs are seldom needed to accomplish this goal.
Which of the following is the highest priority of collaborative management for septic shock?The management of septic shock is best done with an interprofessional team that includes ICU nurses. The key is early diagnosis and resuscitation to maintain end-organ perfusion.
Which complication will the nurse anticipate when caring for a client in late hypovolemic shock?As mentioned above, one of the most feared complications of hypovolemic shock is circulatory failure leading to MOF and death.
Which change in the client's lab results indicates that the client is in septic shock?Septic shock is defined by persistent hypotension requiring vasopressors to maintain mean a arterial pressure of 65 mm Hg or higher and a serum lactate level greater than 2 mmol/L (18 mg/dL) despite adequate volume resuscitation.
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