Trauma Nurse Core Course (TNCC) Practice Exam

Which of the following is NOT part of goal-directed therapy for cardiogenic shock?

1. Controlled fluid boluses

2. Antidysrhythmic administration

3. Pericardiocentesis

4. Cardiac cath

The correct answer is: Pericardiocentesis

In the context of goal-directed therapy for cardiogenic shock, the focus is on improving cardiac output, restoring adequate tissue perfusion, and addressing the underlying causes of heart dysfunction. Controlled fluid boluses, antidysrhythmic administration, and cardiac catheterization are all interventions aimed at optimizing hemodynamics and managing complications associated with cardiogenic shock. Controlled fluid boluses help to increase preload, which can improve cardiac output in a patient experiencing cardiogenic shock, while antidysrhythmics may be used to manage arrhythmias that could worsen cardiac performance. Cardiac catheterization allows for direct assessment of the heart's function and can guide therapeutic interventions such as stenting or angioplasty. On the other hand, pericardiocentesis is generally performed to relieve pressure from fluid accumulation in the pericardial sac, such as in cases of cardiac tamponade. While it can be a lifesaving procedure, it is not specifically part of the standard goals of therapy for cardiogenic shock unless the patient is presenting with evidence of tamponade physiology. Therefore, choosing pericardiocentesis as not being part of goal-directed therapy for cardiogenic shock aligns with the understanding that this procedure addresses a different pathology.