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Assignment Task

The following questions are based on the provided scenario. Utilize the course resources to assist you in providing your answers.

Section 1

Interpret the patient’s 12-lead ECG from admission to ER: /4

Each measurement is worth 0.25 points and the final interpretation is worth 1.25 points for a total of 4 points.

Looking at the 12 lead from question 1, what surface of the heart and coronary artery are affected? What implications does this have on the cardiac output components?

Describe the impact of frequent runs of ventricular tachycardia on cardiac output and coronary perfusion.

Which medications do you expect this patient will be prescribed upon discharge? Provide the rationale for each using the action of the drug and relate its effect on the cardiac output if applicable.

Describe how, in this case, a STEMI led to the onset of cardiogenic shock. Imagine you are educating your classmate about how the STEMI leads to cardiogenic shock and describe the progression in terms of the cardiac output components were applicable.

Considering the assessment findings and cardiac output measurements, which cardiac output components require optimization? Which medication (pick only one) would you choose to add to this patient’s care plan based to better optimize the cardiac output? Consider the pathophysiology of the cardiac output, cardiogenic shock, and the action of critical care medications to provide rationale for your selection.

Section 2

A priority of care for this patient is focused on the cardiac output as the patient is hemodynamically unstable. In this section, you will demonstrate your knowledge of the cardiac output components by connecting them with the pathophysiology of the cardiac alteration, assessment and diagnostics, management, and evaluation.

Priority of care:

Decreased cardiac output related to alterations in heart rate, preload, contractility, and afterload secondary to cardiogenic shock.

Pathophysiology:  

Use this section to describe how cardiogenic shock affects the cardiac output components. Be sure to indicate which are high, low, or normal within the description.

1. Heart Rate
2. Contractility
3. Preload
4. Afterload

Supporting Assessments and Diagnostics:

In this section, categorize the assessment findings and diagnostic results provided in the case overview into the most relevant cardiac component. Save medications and interventions for the next section.

1. Overall Cardiac Output
2. Contractility
3. Preload
4. Afterload

Interventions:

In this section, categorize the interventions provided into the cardiac output component they correlate with the most. i.e. Which treatments are specifically meant to optimize the preload?  Include any nursing interventions the nurse could incorporate or advocate for to aid in optimizing the cardiac output components.

1. Heart Rate
2. Contractility
3. Preload
4. Afterload

Evaluations:

In this section consider the following question: How will I know the cardiac output is improving? List the specific assessment, diagnostics, or events that will provide evidence that the cardiac output is improving over time.

• Overall Cardiac Output