CHAPTER 1 Cardiovascular System^23
- Pericardiocentesis: A needle is inserted into the pericardium and fluid is aspi-
rated or drained. - Administer adrenergic agent—increases heart rate and blood pressure.
NURSING DIAGNOSES
- Anxiety
- Ineffective tissue perfusion
- Decreased cardiac output
NURSING INTERVENTION
- Monitor vital signs.
- Assure adequate oxygenation.
Cardiogenic Shock
WHAT WENT WRONG?
A drop in blood pressure and blood flow caused by the heart’s inability to pump
blood as a result of a cardiac emergency, such as cardiac tamponade, myocardial
ischemia, myocarditis, or cardiomyopathy (a disease of the heart that deteriorates
the heart muscle). Blood pools in the left ventricle, which causes a back up of blood
into the lungs, resulting in pulmonary edema. Contractions increase to compensate
for the decreased cardiac output, causing an increase in demand for oxygen by
the heart. However, the lungs are not oxygenating the blood sufficiently due to
decreased blood flow; and therefore heart muscles are starved for oxygen.
PROGNOSIS
Treatment needs to find a balance between improving cardiac output and reducing
oxygen needs and cardiac workload of the myocardium. This balance must be
achieved while maintaining perfusion of the heart muscle. Prognosis depends on
finding and treating the underlying cause. Cardiogenic shock requires immediate
treatment, often before the cause is known.
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