Cardiogenic Shock — NCLEX Cheat Sheet
Pump failure → ↓ COAlso known as: pump failure shock · heart shock · cardiogenic
Use this quick-reference guide to spot, treat, and prevent Cardiogenic Shock on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
🩺 Signs
- ↓ BP, ↑ HR, weak pulse
- Cool clammy skin, mottled
- Crackles, ↓ urine, ↓ LOC
🚩 Report
- High mortality, MODS
- Pulmonary edema
✅ Do
- Inotropes: dobutamine, dopamine
- O₂, diuretics, IABP/LVAD
- Treat MI cause (PCI)
⚠️ Causes
- MI #1, HF, dysrhythmias
📚 Cardiogenic Shock — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- It results from pump failure, most commonly after a massive MI, but also from severe heart failure, dysrhythmias, or valve failure.
- Signs include hypotension, tachycardia, cool clammy skin, weak pulses, and decreased urine output.
- Pulmonary congestion with crackles and dyspnea occurs as blood backs up into the lungs.
- Altered mental status and confusion reflect poor cerebral perfusion.
- Unlike hypovolemic shock, the problem is the pump itself, not low blood volume, so heart sounds and pressures reflect fluid overload.
Nursing priorities
What to do, in order- Ensure airway, breathing, and oxygenation, providing supplemental oxygen and preparing for possible intubation.
- Administer inotropes such as dobutamine to improve contractility and vasopressors to support blood pressure as ordered.
- Administer diuretics and vasodilators cautiously to reduce preload and afterload as ordered.
- Provide continuous hemodynamic and cardiac monitoring and monitor urine output hourly.
- Prepare for advanced support such as intra-aortic balloon pump or revascularization.
Red flags — report now
Escalate immediately- Worsening hypotension, falling urine output, and deteriorating mental status indicate progressing shock requiring immediate action.
- New or worsening pulmonary edema with severe dyspnea and hypoxia is an emergency.
- Life-threatening dysrhythmias require immediate intervention.
Labs & values
Numbers to know- Lactate: elevated above 1 mmol/L indicates poor tissue perfusion
- Troponin: elevated reflecting the underlying MI
- ABG showing metabolic acidosis and hypoxemia; BNP elevated
Patient teaching
What patients must know- Report chest pain, shortness of breath, or worsening symptoms immediately, as early treatment of MI prevents progression.
- After recovery, follow the prescribed cardiac medication, diet, and activity plan to protect heart function.
❓ Cardiogenic Shock: NCLEX FAQs
What are the priority nursing interventions for Cardiogenic Shock?
Ensure airway, breathing, and oxygenation, providing supplemental oxygen and preparing for possible intubation. Administer inotropes such as dobutamine to improve contractility and vasopressors to support blood pressure as ordered. Administer diuretics and vasodilators cautiously to reduce preload and afterload as ordered. Provide continuous hemodynamic and cardiac monitoring and monitor urine output hourly.
What are the warning signs of Cardiogenic Shock a nurse must report?
Worsening hypotension, falling urine output, and deteriorating mental status indicate progressing shock requiring immediate action. New or worsening pulmonary edema with severe dyspnea and hypoxia is an emergency. Life-threatening dysrhythmias require immediate intervention.
What do I need to know about Cardiogenic Shock for the NCLEX?
It results from pump failure, most commonly after a massive MI, but also from severe heart failure, dysrhythmias, or valve failure. Signs include hypotension, tachycardia, cool clammy skin, weak pulses, and decreased urine output. Pulmonary congestion with crackles and dyspnea occurs as blood backs up into the lungs. Altered mental status and confusion reflect poor cerebral perfusion.
What patient teaching is important for Cardiogenic Shock?
Report chest pain, shortness of breath, or worsening symptoms immediately, as early treatment of MI prevents progression. After recovery, follow the prescribed cardiac medication, diet, and activity plan to protect heart function.
Quick Tip
It results from pump failure, most commonly after a massive MI, but also from severe heart failure, dysrhythmias, or valve failure.
📖 Related Topics
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