02.16 Cardiogenic Shock for CCRN Review

Nursing Points

General

1. Cardiogenic Shock
   1. Cause
      1. MI
      2. CHF
      3. Arrhythmia
      4. Cardiac tamponade
      5. Papillary muscle rupture
   2. Assessment
      1. Confusion
      2. Increased respirations
      3. Increased HR
      4. Venous distention
      5. Low BP
      6. Decreased urine output
      7. Low PCWP
   3. Treatment -> Intra-aortic balloon pump (IABP)
      1. Deflate during systole
      2. Inflate during diastole
      3. Purpose
         1. Decrease afterload and heart’s demand for oxygen
         2. Increase perfusion of heart and cardiac output
      4. Do not use with…
         1. Aortic insufficiency (valve too weak for balloon)
         2. PVD
      5. Complications
         1. Loss of blood flow to limb
         2. Aortic dissection
         3. Infection
      6. Interventions
         1. Keep bed flat (<15 degrees)
         2. Monitor pulses
         3. Check for bleeding