What are the nursing interventions for cardiogenic shock?
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You can read the details below. By accepting, you agree to the updated privacy policy. Thank you! View updated privacy policy We've encountered a problem, please try again. Cardiogenic Shock Nursing Care Plans Diagnosis and InterventionsCardiogenic Shock NCLEX Review and Nursing Care Plans Cardiogenic shock is a serious condition that occurs when the heart is unable to supply the body with enough oxygen-rich blood to meet its demands. When the organs fail due to a lack of oxygen, it might be fatal. This is a life-threatening situation that demands quick medical attention. A heart attack or heart failure are the most common causes of cardiogenic shock. A systolic blood pressure that is less than or equal to 90 mm Hg for more than or equal to 30 minutes, or support to maintain a systolic blood pressure less than or equal to 90 mm Hg and urine output less than or equal to 30 mL/hr, or chilly extremities are among the clinical requirements. The two hemodynamic criteria include a low cardiac index (less than or equal to 2.2 liters per minute per square meter of body surface area) and a high pulmonary-capillary wedge pressure (higher than 15 mm Hg). Cardiogenic shock is a condition that results in end-organ hypoperfusion and tissue hypoxia due to a low cardiac output state of circulatory failure. Acute myocardial infarction is the most prevalent cause of cardiogenic shock, however, various illnesses affecting the myocardium, valves, conduction system, or pericardium can also induce cardiogenic shock. Despite breakthroughs in reperfusion therapy and mechanical circulatory support, morbidity and mortality among cardiogenic shock patients remain high. Signs and Symptoms of Cardiogenic Shock
Cardiogenic shock might also cause the following symptoms:
Causes of Cardiogenic ShockHeart attack is the leading cause of cardiogenic shock. The main pumping chamber of the heart can be damaged by a major heart attack (left ventricle). the body can’t get enough oxygen-rich blood when this happens. The bottom right chamber of the heart (right ventricle) is injured in rare cases of cardiogenic shock. The right ventricle is responsible for pumping blood to the lungs, where it receives oxygen before continuing on to the rest of the body. Cardiogenic shock can also be caused by other disorders that weaken the heart such as:
Cardiogenic shock’s mechanism is complex and poorly understood. Ischemia to the myocardium causes both systolic and diastolic left ventricular function to be disrupted, resulting in a significant reduction in myocardial contractility. This, in turn, sets off a potentially fatal and vicious cycle of decreased cardiac output and low blood pressure, sustaining coronary ischemia and contractility degradation. Several compensatory physiologic processes emerge. Among them are:
Risk Factors to Cardiogenic ShockCardiogenic shock can occur in around 5% to 8% of ST-elevation myocardial infarction (STEMI) cases and 2% to 3% of NON-STEMI cases. In the United States, this can amount to 40,000 to 50,000 cases per year. Cardiogenic shock occurs more frequently in the following patient groups:
In patients with cardiogenic shock, timely diagnosis, supportive care, and coronary artery revascularization are critical for optimal results. Thorough history taking by eliciting any current or recent symptoms experienced by the patient and physical examination are helpful in the diagnosis of cardiogenic shock. Healthcare providers may discover the following indicators of cardiogenic shock during a physical examination:
Several tests can be used to determine whether or not the patient has cardiogenic shock. Among these tests are:
Treatment for Cardiogenic ShockCardiogenic shock is a life-threatening disorder that requires immediate medical attention. To avoid injury, the most important component of treatment is to improve the flow of blood and oxygen to the main organs. The most critical intervention and standard therapy for patients with cardiogenic shock due to myocardial infarction is the early restoration of coronary blood flow. This can sometimes be accomplished by medicine. Support devices may be required in more severe cases to assist the heart. In a hospital emergency room or intensive care unit, treatment may include:
Prevention of Cardiogenic ShockMaking lifestyle modifications to keep the heart healthy and the blood pressure in check is the greatest strategy to avoid cardiogenic shock.
Because cardiogenic shock is usually caused by a heart attack, seeking quick treatment for a heart attack is the best method to avoid it. Consult the doctor to determine the risk of heart disease and take steps to enhance the cardiovascular health. If the patient have coronary artery disease, consult the doctor as soon as possible and follow the treatment plan to the letter (medications, lifestyle changes, etc.). Cardiogenic Shock Nursing DiagnosisNursing Care Plan for Cardiogenic Shock 1Excess Fluid Volume Nursing Diagnosis: Excess Fluid Volume related to decreased renal perfusion, increased water retention and sodium retention, and plasma proteins increases or decreases hydrostatic pressure secondary to cardiogenic shock as evidenced by alteration of mental status, cough, crackles, dyspnea, edema, distended jugular vein, orthopnea, respiratory congestion, difficulty of breathing, and weight gain. Desired Outcome: The patient will demonstrate a stable fluid volume, as manifested by balanced intake and output, stable weight, normal vital signs, and the absence of edema.
Nursing Care Plan for Cardiogenic Shock 2Decreased Cardiac Output Nursing Diagnosis: Hyperthermia related to cardiac muscle dysfunction, dysrhythmias, preload or afterload has been increased or lowered, contractility of the left ventricle (LV) is impaired, septal abnormalities, and dysfunction of the valves secondary to cardiogenic shock as evidenced by altered level of consciousness, dyspnea, crackles, and pulmonary congestion, the extremities have mottling and cyanosis, metabolic acidosis, anuria and/or oliguria, skin that’s pale, cold, and clammy, respiratory alkalosis, hypotension that persists with a narrowing of the pulse pressure, and tachycardia. Desired Outcome: The patient will exhibit strong peripheral pulses, HR of 60 to 100 beats per minute with a regular rhythm, systolic BP within 20 mm Hg of baseline, urine output 30 ml/hr or greater, warm and dry skin, and normal state of consciousness that is congruent to a person with adequate cardiac output.
Nursing Care Plan for Cardiogenic Shock 3Ineffective Tissue Perfusion Nursing Diagnosis: Ineffective Tissue Perfusion related to abnormal ABG levels and altered mental status secondary to cardiogenic shock, as evidenced by a capillary refill time of more than 3 seconds, cyanosis, dysrhythmias, dyspnea, and oliguria clients’ expressions of great dread and anxiety, agitation, hyperventilation, crying, and irritability. Desired Outcomes: The patient will exhibit strong peripheral pulses, HR of 60 to 100 beats per minute with regular rhythm, systolic BP within 20 mm Hg of baseline, balanced intake and output, warm and dry skin, and alert/oriented that is congruent to enhanced perfusion.
Nursing Care Plan for Cardiogenic Shock 4Impaired Gas Exchange Nursing Diagnosis: Impaired Gas Exchange related to the alveolar-capillary membrane changes, and ventilation-perfusion dysfunction secondary to cardiogenic shock as evidenced by altered arterial blood gasses (ABGs), altered level of consciousness, abnormal breathing rate, depth, and rhythm, crackles, cyanosis, headache, hypercapnia, hypoxia, and tachycardia. Desired Outcomes: The patient will have ABGs within the normal range, oxygen saturation of 90% or above, attentive responsive mental status or no further drop in the level of consciousness, relaxed breathing, and baseline HR for the client that is congruent with a person who has adequate gas exchange.
Nursing Care Plan for Cardiogenic Shock 5Anxiety Nursing Diagnosis: Anxiety related to unfamiliar environment, change in health status, and fear of death as evidenced by increased questioning, increased alertness, sympathetic stimulation, verbalized anxiety, uncooperative behavior, and agitation. Desired Outcomes:
Nursing ReferencesAckley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon Disclaimer:Please follow your facilities guidelines, policies, and procedures. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. What is the treatment priority for cardiogenic shock?The goal of cardiogenic shock treatment is to quickly restore blood pressure and heart function. This often requires a series of emergency treatments that are given in an ambulance or the Emergency Department. Other treatments may include medications or temporary support devices to restore blood flow.
Which intervention will the nurse give the highest priority for a patient who has cardiogenic shock?Early restoration of coronary blood is the most important intervention and is the standard therapy for patients with cardiogenic shock due to myocardial infarction. The goal of medical management is to restore cardiac output and prevent irreversible end-organ damage rapidly.
What is the nursing management for the shock patient?The nursing role in managing the patient with shock
Common interventions include adequate oxygen, fluid and/or drug therapy. In all cases the nurse needs to provide a safe environment for the patient who may be at risk due to a reducing level of consciousness and deteriorating vital signs.
What are the nursing diagnosis of cardiogenic shock?Diagnosis of Cardiogenic Shock
A sluggish pulse. Cold, clammy skin. Low blood pressure. Irregular heart rhythm or cardiac murmur upon auscultation.
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