Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
44 Cards in this Set
- Front
- Back
Which of the following patient profiles can indicate that a patient with pancreatitis also has an active systemic inflammatory response
|
T35.4, P 90, R 26, WBC 8000
|
|
S I RS parameters include two of the following four
|
T<96.4F or >100.4; <36C or >38C;
RR >20; P > 90; WBC <4000 or >12000 |
|
Sepsis defn
|
SIRS +signs of infection
|
|
Severe sepsis
|
Sepsis +1 organ dysfunction
|
|
Septic shock
|
Severe sepsis + volume resistant hypotension. Volume resistance hypo tension in the presence of severe sepsis/SIRS. Vasopressors are required to sustain adequate BP
|
|
MODS
|
Dysfunction of two or more organ systems requiring medical intervention to maintain homeostasis
|
|
Vasodilation, vascular permeability, cellular activation and adhesion, and coagulation occur as part of the immune response due to
|
Activation of mediators
|
|
Laboratory values associated with hepatobiliary dysfunction in MODS include increased
|
Liver enzymes and bilirubin
|
|
An increase in patients are O2 demand can be caused by
|
Bathing and weighing the patient. Routine nursing activities will cause an increase in the metabolic oxygen demands of the pt.
|
|
Most common cause of DIC
|
Endotoxin's from sepsis
|
|
DIC etiology
|
Endotoxin from sepsis. Metabolic acidosis. Hypoperfusion with shock. Massive trauma. Burns. Abruptio placenta, retained placenta, or retain fetus.
|
|
Lab values for DIC
|
Platelet count <50, or 50% drop from norm. PT >12.5. PTT/aPTTT >40 seconds. Fibrinogen <100. FSP/FTP >40. Ddimer >250
|
|
That illegal street drug most commonly encountered in the emergency department
|
Cocaine
|
|
Death from acetaminophen overdose is usually as a result of
|
Hepatic failure
|
|
Patients with an overdose of tricyclic antidepressant may show signs of
|
Seizures, heart failure, shock
|
|
Primary MODS
|
Occurs as a direct result of injury to an organ or organs system and any resuscitation measures
|
|
In the patient with MODS, adequate pain control
|
Improves tissue perfusion and oxygenation
|
|
Use of the Gut for nutrition is important for the critically ill patient to
|
Prevent bacterial translocation to the pulmonary system
|
|
Mediator activation in SIRSresults in
|
Vasodilation, increased vascular permeability, cell activation with adhesions to vessel walls, increased coagulation.
|
|
Cascade of organ dysfunction in secondary MODS starts with and goes to
|
Lungs-ARDS, G.I., CV, liver, renal failure, CNS, hematological dysfunction
|
|
The release of biochemical and cellular mediators damages the endothelium of the pulmonary vasculature resulting in increased vascular permeability which contributes to the development of surfactant deficiency, pulmonary hypertension and non-cardiogenic pulmonary edema
|
True
|
|
Primary cardiovascular response to MODS during hyper dynamic phase
|
Decreased SVR with increased CO. Relative hypovolemia. Tachycardia with hypotension. Decrease our RAP and PAOP
|
|
Neurogenic shock may result from
|
Spinal cord injury above T6. High levels of spinal anesthesia. Pain
|
|
Interventions for treating hypovolemic shock may include all of the following except
|
Chest x-ray
|
|
In MODS, cytokines act on the vascular endothelial lining to produce a prothrombotic state
|
True
|
|
Which of the following patient profiles suggests that patient has adequate hemodynamics to support tissue perfusion
|
Map 70, cVP 12, PAWP 14, CI 2.8 L
|
|
Nursing interventions to control sources of infection and the patient with MODS include
|
Frequent oral care and position changes
|
|
The hyper dynamic phase of the cardiovascular response to MODS includes
|
mAP 60, CVP 5, PAOP 8, CI 2.8 L
|
|
Patients with MO DS with renal involvement may present with the following signs
|
Pulmonary edema, urinary output less than 0.5 ML/KG/HR, fluid overload, All the above.
|
|
The cascade of organ dysfunction and secondary MODS usually starts with the lungs, and exhibits as acute respiratory distress syndrome or ARDS
|
True
|
|
Which patient profile suggests that the patient has adequate hemodynamics to support tissue perfusion
|
Decreased SVR with increased cardiac output
|
|
Circulation and perfusion of the – is selectively decreased during low flow states to preserve perfusion of the major organ systems
|
Splanchnic bed
|
|
Patients with MODSmay have blood glass analysis that reflects
|
Early respiratory alkalosis, hypoxemia, progressing to metabolic acidosis
|
|
Gastrointestinal dysfunction in MODS can be evidenced by
|
And ileus and increase stool bacteria count
|
|
The cardiovascular system initially responds to MODS by
|
Decreasing SVR
|
|
The evidence based vasoppressors used within the first six hours of sepsis therapy are
|
Dopamine and norepinephrine
|
|
Mediator activation in SIRS results in which four mechanisms of inflammatory response
|
Vasodilation, increased vascular permeability, cell activation with adhesions to vessel walls, increased coagulation
|
|
The typical sequela in organ dysfunction in MODS is
|
Pulmonary, G.I., cardiac, hepatic, and/or renal
|
|
The distinguishing feature of systemic inflammatory response syndrome is severe and infection
|
False
|
|
Which of the following best describes the purpose of inflammation in the body
|
It brings immune cells and nutrients to the injured area
|
|
Central nervous system symptoms of alcohol overdose me.
|
Seizure
|
|
All the following are true about the initial stage of shock except which statement. Tissue perfusion is inadequate. Cardiac output is increased. Lactic acid levels begin to increase. A decreased cardiac output can lead to cell damage
|
Cardiac output is increased
|
|
During the compensatory phase of shock, the compensatory mechanisms are activated and attempt to return the cells to a pre-shock state. Which of the following organ systems control the compensatory mechanism
|
Endocrine system and neurologic System
|
|
To compensate for cellular acidosis caused by shock, chemo receptors in the brainstem stimulate an increase in the rate and depth of respirations. This leads to a
|
Decrease in PaCO2 and respiratory alkalosis
|