A 58-year-old male patient is admitted to the emergency department with symptoms of chest pain, dyspnea, and diaphoresis. On assessment, the nurse notes hypotension, tachycardia, and decreased urine output. The ECG reveals ST-segment elevation. The patient’s clinical presentation is consistent with cardiogenic shock. What is the primary cause of cardiogenic shock in this patient?
A) Hypovolemia
B) Myocardial infarction
C) Pulmonary embolism
D) Cardiac tamponade
Rationale: Cardiogenic shock is often a result of decreased cardiac output due to myocardial infarction. In this patient, the ST-segment elevation on the ECG, along with classic symptoms like chest pain and diaphoresis, suggests acute myocardial infarction. The compromised cardiac function leads to inadequate tissue perfusion, resulting in hypotension and tachycardia.
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A 72-year-old female with a history of heart failure presents to the clinic with worsening shortness of breath and fatigue. On examination, the nurse notes bilateral crackles, elevated jugular venous pressure, and peripheral edema. The patient is at risk for developing cardiogenic shock primarily due to:
A) Hypertension
B) Left ventricular failure
C) Chronic obstructive pulmonary disease (COPD)
D) Dehydration
Rationale: Cardiogenic shock can result from left ventricular failure, where the heart is unable to pump blood effectively. In this case, the patient’s symptoms of heart failure, such as bilateral crackles, elevated jugular venous pressure, and peripheral edema, indicate impaired left ventricular function, putting her at risk for cardiogenic shock.
NCLEX Review: Cardiogenic Shock Treatments
A 65-year-old male patient presents with signs of cardiogenic shock, including severe hypotension, cyanosis, and altered mental status. The nurse anticipates that which hemodynamic parameter will be elevated in cardiogenic shock?
A) Systemic vascular resistance (SVR)
B) Cardiac output
C) Pulmonary artery pressure
D) Stroke volume
Rationale: In cardiogenic shock, the heart’s inability to pump effectively leads to decreased cardiac output. As a compensatory response, the systemic vascular resistance (SVR) increases to maintain blood pressure. This elevation in SVR contributes to the hypotension seen in cardiogenic shock.
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NCLEX Questions Critical Thinking: Cardiogenic Shock Symptoms
A 50-year-old male with a history of coronary artery disease is admitted with cardiogenic shock. The nurse identifies an early sign of inadequate tissue perfusion in this patient. What finding supports this assessment?
A) Increased urine output
B) Warm and dry skin
C) Capillary refill less than 2 seconds
D) Altered mental status
Rationale: Altered mental status is an early sign of inadequate tissue perfusion in cardiogenic shock. The decreased perfusion affects cerebral blood flow, leading to changes in mental status. As the condition progresses, more severe manifestations, such as hypotension and organ dysfunction, may occur.
NCLEX Focus Exploring Cardiogenic Shock: Causes and Diagnosis
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A 60-year-old female is receiving treatment for cardiogenic shock. The nurse monitors the patient closely for a potential complication associated with inotropic therapy. What complication is the patient at risk for during inotropic support?
A) Hypokalemia
B) Bradycardia
C) Hypertension
D) Arrhythmias
Rationale: Inotropic therapy is often used in cardiogenic shock to improve cardiac contractility. However, it carries the risk of arrhythmias as an adverse effect. Increased myocardial contractility may disrupt the normal electrical conduction system, leading to arrhythmias such as tachycardia or ventricular dysrhythmias. Regular cardiac monitoring is essential during inotropic support.
NCLEX Questions: Focus on Medications for Cardiogenic Shock
A 45-year-old male is admitted to the intensive care unit with a diagnosis of cardiogenic shock. The nurse assesses the patient’s skin, noting cool and clammy extremities. The nurse understands that this finding is primarily related to:
A) Peripheral vasoconstriction
B) Increased cardiac output
C) Hyperthermia
D) Hypervolemia
E) Peripheral vasodilation
Rationale: In cardiogenic shock, the body activates compensatory mechanisms, including peripheral vasoconstriction. This response aims to redirect blood flow to vital organs in an attempt to maintain perfusion. However, it results in cool and clammy skin due to reduced blood flow to the extremities.
A 55-year-old female is diagnosed with cardiogenic shock following a myocardial infarction. The nurse is aware that the primary goal of treatment in cardiogenic shock is to:
A) Increase blood pressure
B) Enhance myocardial oxygen demand
C) Promote diuresis
D) Improve myocardial contractility
E) Decrease cardiac output
Rationale: The primary goal in managing cardiogenic shock is to improve myocardial contractility. This can be achieved through interventions such as inotropic therapy. By enhancing the heart’s pumping ability, systemic perfusion can be optimized, addressing the underlying cause of cardiogenic shock.
Understanding Cardiogenic Shock: NCLEX Priority Questions
A 60-year-old male with a history of heart failure presents with signs of worsening cardiogenic shock. The nurse identifies an important nursing intervention to improve oxygenation in this patient is:
A) Administering a diuretic to reduce fluid overload
B) Elevating the head of the bed to enhance lung expansion
C) Providing supplemental oxygen therapy
D) Encouraging ambulation to improve circulation
E) Administering a beta-blocker to decrease heart rate
Rationale: In cardiogenic shock, impaired cardiac function leads to inadequate oxygen delivery to tissues. Supplemental oxygen therapy helps improve oxygenation, relieving tissue hypoxia. While other interventions may be relevant, providing oxygen is a priority to address the immediate oxygen supply-demand imbalance.
Understanding Cardiogenic Shock: NCLEX Delegation Questions
Understanding Cardiogenic: NCLEX Focus
A 50-year-old male is admitted to the emergency department with cardiogenic shock. The nurse assesses the patient and notes decreased blood pressure, increased heart rate, and pulmonary congestion. Which medication is the most appropriate initial intervention for this patient’s condition?
A) Furosemide
B) Nitroglycerin
C) Epinephrine
D) Dopamine
E) Aspirin
Rationale: Nitroglycerin is a vasodilator that helps reduce preload and afterload, easing the workload on the heart. In cardiogenic shock, where there is impaired cardiac function, nitroglycerin can improve coronary blood flow and decrease pulmonary congestion. While other medications may have roles in managing cardiogenic shock, nitroglycerin is the most appropriate initial intervention to address the immediate hemodynamic concerns.
A 65-year-old female is diagnosed with cardiogenic shock secondary to a massive myocardial infarction. The healthcare provider orders an intra-aortic balloon pump (IABP) for hemodynamic support. What is the primary mechanism of action of an IABP in this situation?
A) Increasing afterload
B) Enhancing preload
C) Reducing myocardial oxygen demand
D) Augmenting cardiac output
E) Dilating peripheral blood vessels
Rationale: An intra-aortic balloon pump (IABP) is used in cardiogenic shock to augment cardiac output. The IABP inflates during diastole, improving coronary perfusion and reducing afterload, while deflating during systole, assisting with ejection of blood. This mechanism helps enhance cardiac output and improve tissue perfusion in the setting of compromised cardiac function.
A 55-year-old male with a history of hypertension presents with cardiogenic shock. The nurse monitors the patient closely for signs of fluid overload while receiving treatment. Which parameter is crucial to assess for fluid balance in this patient?
A) Serum creatinine
B) Urine specific gravity
C) Serum potassium
D) Blood glucose levels
E) Hemoglobin concentration
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Rationale: Urine specific gravity is a valuable indicator of fluid balance and renal function. In cardiogenic shock, maintaining an appropriate fluid balance is crucial. Monitoring urine specific gravity helps assess the concentration of urine and provides insights into the patient’s hydration status. Changes in urine specific gravity may indicate fluid overload or dehydration, guiding adjustments in fluid management.