Cardiogenic Shock: Stages and Assessment (Nursing)

00:00 Now, you're thinking about the NCSBN Clinical Judgment Measurement Model.

00:04 We always like to slide that in.

00:06 So you think through this, because this is how you're preparing to sit for your licensure exam and for clinical practice.

00:13 You see the different layers appearing there on the screen.

00:15 But Layer 3 is really the one I want you to focus on.

00:19 Remember that one recognize cues.

00:22 So, think through. Hey, what would it look like if someone's in cardiogenic shock? How would that look different than hypovolemic shock or neurogenic shock? You'll have those answers as you work through this whole series with us.

00:34 But first for cardiogenic shock, recognize cues, analyze them, make your hypothesis prioritize which one you think is most likely, then you figure out what are you going to do to try to fix it, generate solutions.

00:48 Then you take actions and you evaluate the outcomes.

00:52 Exam questions can come from any one of those steps.

00:55 They may try and see if you recognize a cue.

00:57 If you can put them together to come up with a hypothesis. On and on.

01:01 That's why Level 3 is what we really focus on in this series.

01:05 This is a framework we use for four stages of shock.

01:09 There's the initial stage, then the compensatory stage, then the progressive stage, and then the refractory stage.

01:17 As you can tell, this is a patient declining when they move from initial, to compensatory to progressive, to refractory.

01:25 That's the concept we want you to take away from this.

01:28 The cues in shock will vary depending on which stage you're in.

01:32 Now, the stages are essentially the same for the different types of shock.

01:37 A bottom line problem is that not enough oxygen is being delivered to the tissues to meet their metabolic needs.

01:46 Then when they don't have enough oxygen, they can no longer do aerobic metabolism.

01:51 They have to switch to anaerobic, which ends up with a buildup and lactic acid.

01:56 Now, some of the symptoms you might be would see would be retrosternal chest pain.

02:01 Moving into the next stage, the compensatory stage, we walk through that in more detail in our hypovolemic video.

02:09 So let's jump ahead through the progressive and the refractory stages, and go into what we'll expect to see differently in cardiogenic shock.