Question

When the nurse is caring for a patient in cardiogenic shock who is receiving dobutamine (Dobutrex) and nitroglycerin (Tridil) infusions, the best evidence that the medications are effective is that the

a. systolic BP increases to greater than 100 mm Hg.
b. cardiac monitor shows sinus rhythm at 96 beats/min.
c. PAWP drops to normal range.
d. troponin and creatine kinase levels decrease.

Answer 1

The best evidence that the medications are effective in treating a patient in cardiogenic shock is that the pulmonary artery wedge pressure (PAWP) drops to a normal range.

Step-by-step explanation:

The best evidence that the medications, dobutamine (Dobutrex) and nitroglycerin (Tridil), are effective in treating a patient in cardiogenic shock is that the pulmonary artery wedge pressure (PAWP) drops to a normal range. PAWP is a measure of the filling pressure in the left side of the heart and reflects the heart's ability to pump effectively. A decrease in PAWP indicates that the medications are improving the heart's function and reducing fluid buildup in the lungs.

Some additional evidence that the medications are effective may include an increase in systolic blood pressure to greater than 100 mm Hg, restoration of sinus rhythm on the cardiac monitor at a normal heart rate, and a decrease in troponin and creatine kinase levels, which are markers of heart muscle damage. However, the drop in PAWP would be the most direct evidence of the medications' effectiveness in treating cardiogenic shock.