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Questions and Answers
Which hemodynamic parameter is typically elevated in cardiogenic shock as a compensatory mechanism?
Which hemodynamic parameter is typically elevated in cardiogenic shock as a compensatory mechanism?
- Systemic Vascular Resistance (SVR) (correct)
- Central Venous Pressure (CVP)
- Pulmonary Capillary Wedge Pressure (PCWP)
- Cardiac Output (CO)
A patient presents with hypotension, cool clammy skin, and altered mental status. Which of the following acid-base imbalances is most likely present?
A patient presents with hypotension, cool clammy skin, and altered mental status. Which of the following acid-base imbalances is most likely present?
- Metabolic Acidosis (correct)
- Respiratory Alkalosis
- Metabolic Alkalosis
- Respiratory Acidosis
Which of the following best describes the underlying cause of cardiogenic shock?
Which of the following best describes the underlying cause of cardiogenic shock?
- Obstruction of blood flow in the pulmonary circulation.
- Inadequate circulating blood volume due to hemorrhage or dehydration.
- Massive vasodilation leading to decreased systemic vascular resistance.
- Impaired cardiac function resulting in reduced cardiac output. (correct)
What is the primary goal of Intra-Aortic Balloon Pump (IABP) therapy in patients with cardiogenic shock?
What is the primary goal of Intra-Aortic Balloon Pump (IABP) therapy in patients with cardiogenic shock?
A patient in cardiogenic shock has a pulmonary artery catheter in place. Which of the following readings would the nurse expect to see?
A patient in cardiogenic shock has a pulmonary artery catheter in place. Which of the following readings would the nurse expect to see?
In the context of the 'perfusion triangle', which component is most directly compromised in cardiogenic shock?
In the context of the 'perfusion triangle', which component is most directly compromised in cardiogenic shock?
Which condition can lead to obstructive shock?
Which condition can lead to obstructive shock?
What is the initial treatment strategy for cardiogenic shock related to acute myocardial infarction (MI)?
What is the initial treatment strategy for cardiogenic shock related to acute myocardial infarction (MI)?
Why might oliguria develop in a patient experiencing cardiogenic shock?
Why might oliguria develop in a patient experiencing cardiogenic shock?
In the context of shock, what is the significance of the formula BP = CO x SVR?
In the context of shock, what is the significance of the formula BP = CO x SVR?
Flashcards
Shock Definition
Shock Definition
Life-threatening condition caused by imbalance between cellular oxygen supply and demand, leading to organ dysfunction.
Perfusion Triangle
Perfusion Triangle
Heart (Pump function), Blood vessels (Container function), Blood (Content function).
Cardiogenic Shock
Cardiogenic Shock
Occurs when the heart is weakened or damaged and can no longer pump blood effectively.
Obstructive Shock
Obstructive Shock
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Distributive Shock
Distributive Shock
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Hypovolemic Shock
Hypovolemic Shock
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Cardiogenic Shock Cause
Cardiogenic Shock Cause
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Hemodynamic Profile
Hemodynamic Profile
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Signs of Shock
Signs of Shock
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Intra-Aortic Balloon Pump (IABP)
Intra-Aortic Balloon Pump (IABP)
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Study Notes
- Cardiogenic shock involves an imbalance between cellular oxygen supply and demand leading to organ dysfunction.
- Circulatory failure causing hypotension. Systolic blood pressure <90 mmHg or mean arterial blood pressure <65 mmHg
Perfusion Triangle
- Three key components make up the perfusion triangle.
- The heart to pump function.
- Blood vessels to container function.
- Blood to content function
- Damage or injury to the heart impairs its ability to move blood effectively.
- Blood in the container isn't in adequate quantity to support bodily perfusion needs.
- If there is blood or plasma loss, the volume is not enough to support the perfusion needs of the body.
- Vessels can dilate at once, resulting in normal blood volume being insufficient.
Types of Shock
- Obstructive shock, blood cannot get to where it needs to go, as in a pulmonary embolism or collapsed lung.
- Cardiogenic shock, the weakened heart can no longer pump blood effectively.
- Distributive shock, vessels become floppy, reducing the amount of blood reaching organs.
- Hypovolemic shock, there isn't enough fluid circulating through the body.
Hemodynamics Characteristics of the Major Types of Shock
- PCWP, CVP, Cardiac Output, and Systemic Vascular Resistance varies amongst the various types of shock, allowing for greater clinical understanding of the condition
Cardiogenic Shock
- A consequence of cardiac pump failure.
- Cardiac output decreases.
- Systemic Vascular Resistance increases, to compensate for diminished CO.
- PCWP increases an indirect measurement of Left Atrial pressure due to cardiac output
Hemodynamics of Cardiogenic Shock
- Cardiac Output DECREASES
- Pulmonary Capillary Wedge Pressure INCREASES
- Systemic Vascular Resistance Increases
Hemodynamic Profile in Cardiogenic Shock
- PCWP, Pulmonary Capillary Wedge Pressure increased
- Cardiac Output decreased
- Systemic Vascular Resistance increased
Signs of Shock
- Hypotension arises from a profound decrease in cardiac output.
- Oliguria occurs due to renal blood flow moving elsewhere.
- Change in mental status
- Cool, clammy skin happens due to vasoconstrictive mechanisms redirecting blood.
- Metabolic acidosis reflects decreased lactate by the liver, kidneys, and skeletal muscle
Cardiogenic Shock Signs/Symptoms
- Dyspnea, chest pain, or palpitations are causes
Intraaortic Balloon Pump (IABP)
- The balloon inflates during diastole
- It helps to measure the pressures to make sure its okay
Treatment options for cardiogenic shock
- Ventilation support
- Optimize intravascular volume
- Sodium bicarbonate only for severe metabolic acidosis
- Aspirin
- Intravenous heparin
- Pulmonary artery catheter
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