“Mr. C is a 65-year-old male with a history of CAD, ACS, and MI x 2 who presents to the emergency department complaining of chest pain. EKG illustrates a STEMI. The client is brought to the catherization lab where it is found that he has an elevated LVEDP with significant dysfunction of the LV. Client is placed on an IABP and referred to surgery due to significant diffuse disease. During the case, the client became unresponsive, a rapid response was called, and he required intubation. Mr. C was admitted to the ICU for close monitoring due to cardiogenic shock and an EF of 10% on IABP support.”
Given the scenario you created, consider the hemodynamic variables that should be closely monitored, the technology utilized for monitoring (i.e. arterial line) and the information gathered from that monitoring. Are there any special considerations for this client and particular information that may give an indication that the shock state is worsening? What would you look for (objective/subjective data) related to the different stages of shock?
Identify specific nursing and medical interventions that may be necessary to support the client in the different stages of shock. How do these interventions positively and negatively impact the client? Are there risks involved for the client? Are there specific safety considerations relative to the interventions?
