The nurse is asked to help treat a patient brought in by ambulance in cardiogenic shock secondary to an acute ST-elevation myocardial infarction. The patient is cyanotic with significant jugular venous distention, peripheral edema, and dyspnea from pulmonary edema. Which of the following treatments would be most appropriate for this patient?

Question

The nurse is asked to help treat a patient brought in by ambulance in cardiogenic shock secondary to an acute ST-elevation myocardial infarction.  The patient is cyanotic with significant jugular venous distention, peripheral edema, and dyspnea from pulmonary edema.  Which of the following treatments would be most appropriate for this patient?

Accepted Answer

Dopamine. This patient is presenting with signs of cardiogenic shock, namely cyanosis, jugular venous distention, and peripheral edema.  Cardiogenic shock is inadequate tissue perfusion due to insufficient cardiac output.  The main goal of hemodynamic support is to restore and maintain adequate perfusion and oxygenation.  First-line treatments include vasopressors and positive inotropes such as dopamine and dobutamine.  Aggressive fluid resuscitation is not advisable in cardiogenic shock complicated by pulmonary edema.  Whole blood transfusion is an appropriate treatment for hemorrhagic shock.  High-dose corticosteroids, such as methylprednisolone, are indicated in the acute treatment of neurogenic shock.

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