Health and Technology Journal (HTECHJ)
Vol. 4 No. 3 (2026): June 2026

Navigating the Hemodynamic Paradox: Integrated Nursing Management of Cardiogenic Shock Complicated by Acute Gastrointestinal Fluid Loss

Fuad Alfian Nurfahmi (Undergraduate Nursing Program, Faculty of Nursing, Universitas Jember, Indonesia)
Dwi Yoga Setyarini (Faculty of Nursing, Universitas Jember, Indonesia)
Nurul Arifah (Faculty of Nursing, Universitas Jember, Indonesia)
Ikha Nurjihan (Faculty of Nursing, Universitas Jember, Indonesia)
Yopi Darmawan (Faculty of Nursing, Universitas Jember, Indonesia)



Article Info

Publish Date
13 Jun 2026

Abstract

Cardiogenic shock is a life-threatening cardiovascular emergency characterized by profound systemic hypoperfusion and multi-organ dysfunction. This case study delineates the clinical trajectory of a 75-year-old female presenting with progressive dyspnoea, generalized weakness, and acute gastrointestinal distress manifesting as severe diarrhea. Clinical investigations revealed severe tachypnoea (50 breaths per minute), hypotension, cardiomegaly, and bilateral suprahilar pulmonary edema, establishing a diagnosis of cardiogenic shock secondary to rapid atrial fibrillation. Primary nursing diagnoses included an ineffective breathing pattern, activity intolerance, and diarrhea, prompting immediate collaborative therapeutic interventions. The deployed regimen encompassed intensive respiratory monitoring, strategic semi-Fowler positioning, high-flow oxygen therapy (8 L/min), structured energy management, and meticulously titrated intravenous fluid resuscitation. Following 72 hours of targeted nursing care, the patient demonstrated optimal clinical outcomes, evidenced by a normalized respiratory rate (20 breaths per minute), stabilized oxygen saturation (98%), complete resolution of diarrhea, and restored physical tolerance. The unique clinical challenge in this case involved the intricate intersection of cardiogenic respiratory failure and profound gastrointestinal fluid loss, which severely complicated conventional fluid titration protocols. This report validates an integrated nursing protocol that successfully coordinates non-invasive oxygenation strategies with precise metabolic and fluid stabilization. Rapid execution of structured positioning and tailored oxygenation bundles significantly mitigates myocardial workload and improves clinical outcomes in acute cardiac crises.

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Journal Info

Abbrev

htechj

Publisher

Subject

Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

Description

Health and Technology Journal (HTECHJ) is peer-reviewed and open access international journal which published by KHD Production, to accommodate researchers and health practitioners publishing their scientific articles. NHSJ accepts original papers, review articles, short communications, case reports ...