While conducting a physiological assessment on a client who experienced an anterior wall myocardial infarction the previous day, the nurse suspects the onset of hemodynamic compromise. Which clinical manifestations indicate the early development of cardiogenic shock? Select all that apply.
- Restlessness and new-onset confusionCevap
- Apical heart rate of 122 beats per minuteCevap
- Urine output of 15 mL over the past hourCevap
- DProgressively widening pulse pressure
- EWarm, flushed extremities
Cevap
The correct indicators of early cardiogenic shock are restlessness and new-onset confusion, an apical heart rate of 122 beats per minute, and a urine output of 15 mL over the past hour.
In early cardiogenic shock, decreased cardiac output triggers the sympathetic nervous system. This compensatory response causes tachycardia to increase cardiac output and shunts blood away from non-vital organs (causing oliguria, such as 15 mL/hr) and the skin. Furthermore, the brain is highly sensitive to slight drops in oxygenation, making restlessness and confusion very early indicators of compromised systemic perfusion.
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Early recognition of cardiogenic shock