Discussion Question

This should be a discussion reply to other student post below is one of the student post.

Discussion Board Questions-Week 7

Danyer Gonzalez,

Florida National University

NUR 3805

Prof. Karell Curbelo

Feb 18th, 2020

Chapter 34

A patient who is 48 hours post–mitral valve replacement surgery has become progressively more hypotensive, tachycardic, tachypneic, and restless over the past several hours. You suspect that the patient is going into shock.

a. Since this patient is at high risk for both cardiogenic and septic shock, how would you go about determining what type of shock (if any) is present? Support your approach.

a. This specific patient is going into cardiogenic shock. The following factors mentioned above are all significant to a patient going into shock. Unspecified sepsis or cardiogenic shock may oftentimes not be very specific but this patient is showing signs of tachycardia, tachypnea, and restlessness. With these criteria a sepsis diagnosis can be made, thus enough to call a code sepsis. The key to a good outcome in patients with cardiogenic shock is an organized approach. (Xiushui 2019). Cardiogenic shock features may include but are not limited to, hypotension, decreased mean arterial BP, decreased urine output and cool skin and cyanosis. Cardiogenic shock is an emergency involving acute hemodynamic instability that necessitates immediate resuscitative therapy before shock irreversibly damages vital organs. (Xiushui 2019).

b. What special challenges are associated with trying to treat septic shock in a patient with cardiovascular disease?

b. In terms of treating the septic shock, first thing would be labs and fluid replacement. Treat the underlying causing agent while stabilizing the patient. Maintain circulation and intravenous access in the case of emergency life-saving medications. (i.e.) vasopressors. The special challenges associated with trying to treat septic shock in a patient with cardiovascular disease are as follows; this patient has an increased oxygen demand due to the unstable state. In addition, this patient cannot meet the body’s metabolic needs due to the cardiovascular shock. In closing, there are several go-to drugs or medications that will treat early sepsis or septic shock, (i.e.) vasopressors and positive inotropic agents. The most common cause of cardiogenic shock is acute myocardial infarction (AMI). Timely recognition of cardiogenic shock is essential to provide appropriate interventions. (Gorman 2008).Thus decreasing cardiac workload and greatly reduce the oxygen (O2) demand.

References

Xiushui (Mike) Ren. (2019). Cardiogenic Shock Treatment & Management. Retrieved from: https://emedicine.medscape.com/article/152191-treatment

Gorman, Diane. (2008). Take a rapid treatment approach to cardiogenic shock. Retrieved from:
Grossman, S., & Porth, C. (2014). Porth’s Pathophysiology : Concepts of Altered Health States 9th. Lippincott Williams & Wilkins.