Patient with cardiogenic shock

Patient With Cardiogenic Shock

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Instructions:

Please complete the following case study: Chapter 66 :: Patient With Cardiogenic Shock and submit your assignment here by the due date December 3rd 1159pm.

Answer each objective thoroughly below in your own words, you will receive a zero for copy and pasting
Cite all references. References must be from a Medical Surgical Nursing Textbook
Please reply by evaluating 1 other students’ post; what you learned from the post, identify important facts or key issues or add additional relative information

Overview
Shock is a syndrome characterized by decreased tissue perfusion and impaired cellular metabolism, resulting in an imbalance between the supply of and demand for oxygen and nutrients. Cardiogenic shock occurs when dysfunction of the myocardium, caused by a variety of precipitating factors, results in severely compromised cardiac output. The clinical manifestations of cardiogenic shock initially mimic those of acute decompensated heart failure. However, the symptoms increase in severity as the patient progresses through the shock continuum from the initial stage to the final (irreversible) stage.

Prompt intervention in the early stages of shock may prevent the decline to the progressive or refractory stage. Interventions to treat cardiogenic shock are aimed at improving oxygenation and perfusion while preventing organ dysfunction. Drug and surgical therapies may be used to treat these patients.

Objectives

1. Discuss the etiology and pathophysiology of cardiogenic shock.

2. Prioritize the plan of care for a three-patient assignment.

3. Evaluate results of diagnostic testing in a patient with cardiogenic shock.

4. Identify relevant assessment data for a patient with cardiogenic shock.

5. Prioritize nursing care of a patient with cardiogenic shock.

6. Appropriately delegate nursing care of a patient with cardiogenic shock.

7. Accurately calculate dosage and rate for critical care medication infusions.

8. Describe the inter professional care of a patient with cardiogenic shock.

9. Select appropriate nursing interventions for a patient with hemodynamic monitoring and intra aortic balloon pump therapy.

Case Study

L.V. is a 68-year-old male admitted to the coronary care unit 24 hours ago with an anteroseptal myocardial infarction (MI). His past medical history includes two other MIs within the last 5 years, obesity, hypertension, hyperlipidemia, and sleep apnea. L.V. had chest pain at home for 12 hours before seeking medical treatment. Lab results note troponin I at 5.2 ng/mL.

L.V. is currently pain free with stable VS. The heart monitor shows sinus rhythm with occasional, unifocal premature ventricular contractions and a heart rate (HR) in the 90s. His blood pressure (BP) is 130/70, respiratory rate (RR) is 24 breaths/minute and O2 saturation is 93% on O2 via nasal cannula at 2 L/min. He has a heparin drip infusing at 1200 U/hr and IV nitroglycerin infusing at 20 mcg/min. You are assigned to care for L.V. as part of a two-patient assignment.

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