Which one of the following conditions is a common cause of cardiogenic shock?

SCTIMST Staff Nurse - 2015 (Set-A)

Medical & Surgical Nursing

Easy

Appeared in: SCTIMST Staff Nurse - 2015 (Set-A)

Explanation

Cardiogenic shock is defined as a state of inadequate tissue perfusion due to cardiac dysfunction, or 'pump failure'.
The most common cause of cardiogenic shock is acute myocardial infarction (MI), which leads to the death of heart muscle tissue and subsequent left ventricular failure.
When the left ventricle fails, it cannot effectively pump oxygenated blood into the systemic circulation, causing a significant drop in cardiac output and blood pressure.
This failure of the heart as a pump, despite adequate or even elevated blood volume, is the hallmark of cardiogenic shock.

Option A: While severe electrolyte imbalances can trigger cardiac arrhythmias that may degrade into shock, it is not considered the most common primary cause of cardiogenic shock. It is more of a contributing or precipitating factor.
Option B: Fluid overload is a consequence of pump failure (the heart can't handle the volume), not the cause of it. In cardiogenic shock, the primary problem is the failing pump, which leads to fluid backing up in the lungs and body.
Option D: Hypovolaemia, or low blood volume, is the defining cause of hypovolemic shock, a completely different category of shock. Cardiogenic shock is characterized by pump failure with normal or high intravascular volume.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Cardiogenic Shock as background academic context rather than a clinical decision trigger.
Recognizing the cause of shock is critical because treatments are vastly different. For example, giving large fluid boluses is the primary treatment for hypovolemic shock but can be fatal in cardiogenic shock by worsening pulmonary edema.
Key nursing assessments for cardiogenic shock include monitoring for hypotension (SBP below 90 mmHg), cool and clammy skin, weak peripheral pulses, crackles in the lungs, and decreased urine output.
Priority nursing interventions involve administering oxygen to improve tissue oxygenation, establishing IV access for medication, and preparing to administer inotropes (like dobutamine) or vasopressors (like norepinephrine) to improve cardiac contractility and blood pressure.

How to Approach the Question

First, identify the core concept in the question: 'cardiogenic shock'.
Break down the term: 'Cardio' refers to the heart, and 'genic' means 'originating from'. Therefore, cardiogenic shock originates from a heart problem.
Define the condition: Cardiogenic shock is fundamentally a 'pump failure' where the heart cannot supply enough blood to the body's organs.
Evaluate each option against this definition: 'Left ventricular failure' is a direct and severe form of pump failure.
Eliminate the other options by categorizing them: 'Hypovolaemia' is a 'volume' problem (hypovolemic shock). 'Electrolyte imbalance' is an 'electrical' problem that can cause arrhythmias. 'Fluid overload' is a 'volume' problem, often a result of pump failure, not the cause.

Concept Tested & Keywords

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