Question

A patient with a myocardial infarction (MI) and cardiogenic shock has the following vital signs: BP 86/50, pulse 126, respirations 30. Hemodynamic monitoring reveals an elevated PAWP and decreased cardiac output. The nurse will anticipate ______.

a. administration of furosemide (Lasix) IV.
b. titration of an epinephrine (Adrenalin) drip.
c. administration of a normal saline bolus.
d. assisting with endotracheal intubation.

[Pulmonary Capillary Wedge Pressure (PCWP or PAWP)]

Answer 1

The nurse should anticipate administering a normal saline bolus to a patient with myocardial infarction and cardiogenic shock.

Step-by-step explanation:

Cardiogenic shock occurs when the heart is unable to maintain cardiac output. It is often caused by a myocardial infarction (MI) but can also be caused by other heart conditions. In this case, the patient with MI and cardiogenic shock has low blood pressure, a fast heart rate, and rapid breathing, along with an elevated pulmonary artery wedge pressure (PAWP) and decreased cardiac output. To anticipate the appropriate treatment for this patient, the nurse should consider options that aim to improve cardiac output and blood pressure, such as administration of intravenous fluids or medications that restore tone to the vessels. From the given options, the most appropriate choice would be administering a normal saline bolus (c) to help increase blood volume and improve cardiac output.