What is the goal of treatment for the client diagnosed with cardiogenic shock?
Control dysrhythmias and decrease the heart rate
Decrease cardiac workload and increase systemic perfusion
Improve oxygen exchange and decrease urinary output
Decrease the blood pressure and respiratory rate
The Correct Answer is B
A. Control dysrhythmias and decrease the heart rate
Controlling dysrhythmias is important, but decreasing heart rate is not always the goal, as a compensatory tachycardia may be necessary for perfusion.
B. Decrease cardiac workload and increase systemic perfusion
Cardiogenic shock results from impaired cardiac output. The goal is to reduce the heart’s workload (e.g., by reducing afterload) while improving systemic perfusion.
C. Improve oxygen exchange and decrease urinary output
Oxygenation is important, but decreased urinary output indicates poor renal perfusion and worsening shock, which is not a goal of treatment.
D. Decrease the blood pressure and respiratory rate
In cardiogenic shock, blood pressure is already low. The goal is to maintain adequate perfusion, not to further reduce BP.
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Related Questions
Correct Answer is D
Explanation
A. Continue to monitor the client as a paralytic ileus is possible
Paralytic ileus can occur postoperatively, but sudden severe pain and distension indicate a more serious issue, such as bowel infarction.
B. Administer the PRN stool softener to the client
A stool softener is inappropriate if the client has a possible bowel obstruction or ischemia.
C. Obtain an order to insert a nasogastric tube set to low suction
An NG tube may help relieve distension, but it does not treat the underlying cause. The priority is to notify the surgeon.
D. Report the assessment findings to the surgeon
Absent bowel sounds, severe pain, and distension suggest bowel ischemia, a life-threatening complication requiring immediate surgical intervention.
Correct Answer is A
Explanation
A. Fluid resuscitation
Burns covering a large TBSA result in massive fluid loss due to increased capillary permeability, leading to hypovolemic shock. Fluid resuscitation with lactated Ringer’s solution using the Parkland formula is the priority to restore intravascular volume and prevent organ failure.
B. Transfer to a burn center
While this patient requires specialized burn care, the immediate priority is fluid resuscitation. After initial stabilization, transfer to a burn center can be arranged.
C. Application of sterile dressings
Wound care is important, but it is not the priority in the emergent phase. Restoring circulation and preventing shock take precedence.
D. Administer morphine 8 mg IV
Pain management is crucial, but it is secondary to restoring intravascular volume and preventing hypovolemic shock.
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