Cook the fettuccine according to package instructions in a large pot of salted boiling water until al dente. Drain and set aside, reserving 1/2 cup of pasta water.

In a large skillet, heat the olive oil over medium-high heat. Add the shrimp, Cajun seasoning, garlic powder, onion powder, smoked paprika, salt, and pepper. Cook for about 2-3 minutes on each side until the shrimp are pink and cooked through. Remove the shrimp from the skillet and set aside.

In the same skillet, reduce the heat to medium and add the heavy cream. Bring to a simmer, then stir in the cherry tomatoes and cook for about 2-3 minutes until the tomatoes soften.

Add the cooked fettuccine and shrimp back into the skillet. Toss to combine, adding reserved pasta water as needed to reach desired sauce consistency.

Stir in the grated Parmesan cheese until melted and well combined. Remove from heat and garnish with fresh parsley before serving.