What are the pathophysiologic changes that place a client who has suffered a myocardial infarction at risk for cardiogenic shock?
Decreased cardiac output and increased MAP
Decreased cardiac output and decreased MAP
Increased cardiac output and increased afterload
Increased cardiac output and increased MAP
The Correct Answer is B
A. Decreased cardiac output with increased mean arterial pressure (MAP) does not typically occur in cardiogenic shock. In shock states, MAP tends to decrease.
B. Decreased cardiac output and decreased MAP are the hallmark pathophysiologic changes in cardiogenic shock following a myocardial infarction. The damaged myocardium cannot pump effectively, leading to poor perfusion and hypotension.
C. Increased cardiac output and increased afterload are not features of cardiogenic shock; in fact, cardiac output is decreased.
D. Increased cardiac output and increased MAP suggest improved perfusion, not the compromised state seen in cardiogenic shock.
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Related Questions
Correct Answer is D
Explanation
A. Taking a diuretic before sleep can lead to nocturia (frequent urination at night), disrupting sleep. Also, fluid intake may need to be restricted, not encouraged.
B. Clients with heart failure are usually advised to limit sodium to 2 grams or less per day, not 4 grams, to help reduce fluid retention.
C. Naproxen (a NSAID) is not recommended for clients with heart failure as it can cause fluid retention and worsen the condition.
D. Slowing down when tired after exercise shows an understanding of energy conservation and pacing—appropriate for managing heart failure symptoms. This indicates that teaching was effective.
Correct Answer is B
Explanation
A. A heart rate of 160/min is more indicative of the progressive stage of shock, where compensation begins to fail.
B. Blood pressure 115/68 mmHg is within normal limits and reflects the compensatory stage, where the body maintains perfusion through mechanisms like increased heart rate and vasoconstriction.
C. Hypokalemia is not a typical finding in the compensatory stage; electrolyte shifts are more pronounced in later stages.
D. Mottled skin is a sign of poor perfusion, typically seen in the progressive or irreversible stages of shock.
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