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Cardiogenic Shock (Diagnosis/Tests (5; 6) (Blood tests (Urinalysis…

- - - - Beta Blockers
      - Calcium Channel Blockers
  - - - Arrhythmias
      - Injure heart valves
- - - - Tai Chi
      - Yoga
      - Meditation
      - Cardio
        
        Running
        
        Cycling
        
        Swimming
    - - Low cholesterol
      - Low saturated fats
      - Limit sugar
      - Limit alcohol
      - Low sodium
- - - - Elevated total cholesterol, low-density liproprotein (LDL), triglycerides, and low serum value for high-density liproprotein (HDL)
    - - Elevated Creatinine
      - Elevated BUN
    - - AST
        
        ALT
- - - - Coronary Artery Bypass Grafting (CABG)
      - Surgery to repair heart injury
      - Precutaneous Circulatory Assist Devices (PCAD)
      - Heart Transplant
      - Intra-Aortic Balloon Pump (IABP)
        
        Increase myocardial perfusion & decrease left ventricular workload
    - - Precutaneous Cardiac Intervention (PCI)
      - Fibrinolytic Therapy when associated with STEMI
  - - - Norepinephrine
      - Dopamine
    - - alteplase (Activase)
      - reteplase (Retavase)
    - - Clopidogrel (Plavix) PO
      - Platelet Glycoprotein IIb/IIIa Receptor Blockers
        
        abciximab (Reopro)
        
        tirofiban (Aggrastat)
        
        eptifibatide (Integrilin)
    - - PO/IV heparin, LMWH, Acetylsalicylic Acid (Aspirin)
    - - furosemide (Lasix)
    - - Nitrolycerine (Nitro-Bid)
- - - - Skin cool
      - Clammy skin
    - - Oliguria
    - - Tachycardia
      - Thready pulse
        
        Peripheral pulses diminish
      - HoTN
      - Peripheral Edema
      - Mean Arterial Pressure (MAP)
        
        MAP <65 mmHg
    - - Agitation
      - Neuro status deteriorates
      - Confusion
      - Dizziness
    - - Adventitious lung sounds
        
        Crackles
      - Dyspnea
      - Tachypnea
        
        Hyperventilation
        
        Respiratory alkalosis
    - - Nausea
      - Constipation
    - - Assess q15min
  - - - MAP > 65 mm Hg
    - - optimal management of underlying heart disease
        
        coronary artery disease
        
        control of arrhythmias
      - optimal management of co-morbidities
        
        COPD
        
        sleep apnea
        
        anemia
        
        depression
        
        memory disorders
      - education on water and salt restrictions
      - nutritional support
      - adhere to post-discharge program
        
        scheduled follow-ups
        
        starts 7 days after discharge
  - - - Thrombolytic therapy
      - Percutaneous coronary intervention
      - Surgical revascularization
    - - Anxiety
        
        Rest
        
        Provide a calm and quiet environment
        
        Sedatives
      - Pain management
        
        Analgesics
      - Intubated patient
        
        Paralytic agents
      - Modify nursing care to prevent an increased demand in O2
      - Semi-Fowler's position
    - - Nasal prongs
        
        3 to 5 L/min
      - Mechanical ventilation
        
        respiratory distress
        
        oxygen desaturation
        
        severe pulmonary edema
    - - Monitor/record input & output
        
        Adequate fluid volume = pulmonary capillary wedge pressure of 14 to 18 mmHg
  - - - Perfusion restored to heart
      - Reduced workload of heart
      - Client is stable
    - - Client monitors daily weight
    - - Comfort measures
      - Palliative care
      - End-of-life discussion
- - - - HTN
        
        Hx of heart failure
      - Hx of MI