Cardiogenic Shock

Critical Care / CV Disorders

extreme hypotension

Cardiogenic shock is characterized by ________.

The heart’s ability to pump/contract becomes impaired. Impaired contractility leads to decreased cardiac output (CO), leading to poor tissue perfusion. As a result the sympathetic nervous system activates.

How does cardiogenic shock occur?

• MI

• Decompensated HF

• Cardiomyopathy

• Valvular heart disease

• Arrhythmias

• Trauma to the heart

What are the causes of cardiogenic shock?

• Hypotension + tachycardia

• Weak pulses + delayed capillary refill time

• Pallor

• Decreased urine output

• Changes in LOC

• Anxiety + agitation

• JVD

• Peripheral edema

• Pulmonary congestion

What are the S/S of cardiogenic shock?

the left ventricle cannot effectively pump blood out to the body, resulting in a backup of blood in the lungs.

Pulmonary congestion occurs when ________.

• Dyspnea

• Orthopnea

• Tachypnea

• Hypoxia

• Crackles

What are the S/S of pulmonary congestion?

• EKG

• Echocardiogram

• CXR

• elevated BNP

• elevated CK-MB and Troponin

What are the diagnostics for cardiogenic shock?

1. initial stage

2. compensatory stage

3. progressive stage

4. irreversible stage

What are the stages of shock in order?

• Multi-organ failure

• Arrhythmias

• Cardiac arrest and death

What complications may result from cardiogenic shock?

• Elevate HOB

• Supplemental oxygen

• I&Os

• Cardiac monitoring

• Vasopressors to increase BP

• Prep for intubation and mechanical ventilation

• Prep for surgery (ex: PCI; valve surgery)

What are the nursing interventions for cardiogenic shock?