NURS 4700 NURSING CONCEPTS AND INTERVENTIONS FOR THE CARE OF OLDERADULTS II (Module 5) CASE STUDIES MARQUETTE UNIVERSITY
CASE #1
Go through this Escape Room and answer the questions:
In this activity, you are assigned a new patient on the Med Tele floor. This is
an interactive scenario of shock in which you will review concepts to escape
(complete) the scenario.
• The Case of Mrs. Williams Links to an external site.
1. What are key differences between the initial, compensatory, and
progressive stage of shock?
Initial – first stage when the injury happens which leads to decreased cardiac
output and poor tissue perfusion.
Compensatory – in this stage the body’s homeostatic mechanisms attempt to
maintain Cardiac Output, blood pressure, and tissue perfusion.
Progressive – in this stage the compensatory mechanism begins to fail
meeting the metabolic needs of the shock cycle worsens.
2. What treatment would you suspect will be ordered for a cardiogenic
shock patient and why?
i. ABC comes first! For the airway, I will use mechanical ventilation to
reduce the workload of the body in general which helps to reduce
pulmonary edema
ii. Due to low perfusion, I will use vasopressors and vasoconstrictors like
dopamine, morphine, epinephrine, and adrenaline to increase preload
which increases venous return.
iii. I will also use diuretics to reduce pulmonary edema.
iv. I will watch for low hypotension.
v. No iv fluids at the beginning due to the increased workload of the
heart.
3. What is the final clue at the end?
CARDIOGENIC NO IV FLUIDS – to reduce workload of the heart