Progressive Care Nursing Certification (PCCN) Practice Exam

What assessment finding is critical in determining the severity of cardiogenic shock?

1. Blood glucose levels

2. Heart rate variability

3. Urine output

4. Serum electrolytes

The correct answer is: Urine output

Urine output is a critical assessment finding in determining the severity of cardiogenic shock because it provides direct insight into the patient's renal perfusion and overall hemodynamic status. In cardiogenic shock, the heart's ability to pump effectively is compromised, leading to decreased cardiac output and, subsequently, poor tissue perfusion. As a result, the kidneys may receive insufficient blood flow, which can significantly reduce urine output. Monitoring urine output can help assess the severity of shock; a decrease in urine output indicates worsening renal perfusion and correlates with the extent of systemic hypotension and circulatory failure. It is an essential indicator of the patient's response to fluid resuscitation and other therapeutic interventions. In clinical practice, a urine output of less than 30 mL per hour is often considered an early sign of decreased renal perfusion, warranting further evaluation and management of the patient's condition. Factors such as blood glucose levels, heart rate variability, and serum electrolytes are important in assessing various aspects of a patient's health status but do not provide as direct an indication of cardiac output and perfusion status as urine output does in the context of cardiogenic shock.