Exam 3

Question 1

What are signs and symptoms of liver failure?

Answer 1

• Loss of normal liver function
• Asterixis: Liver flap
• Jaundice:
• Ascites
• Edema
• Abd. pain
• Chronic dyspepsia: GI upset
• Itchy skin
• Increased bilirubin and ammonia:
• Decreased platelets and WBC’s: Bleeding and infection risk

Question 2

What is the priority action for symptomatic ascites?

Answer 2

paracentesis, watch for sudden shift in fluid volume (hypovolemic shock)
- ABC’s
- Low sodium diet: reduces fluid retention and decreases the accumulation
- Diuretics: Helps increases sodium and water excretion, promoting diuresis and reducing ascitic fluid accumulation
- Fluid and electrolyte monitoring

Question 3

Signs and symptoms of ascites?

Answer 3

-swelling in abdominal cavity
-SOB
-fatigue
-fever
-blood in stool or vomit
-swollen legs or ankles

Question 4

Labs for pancreatitis?

Answer 4

Increased:
-amylase
-lipase
-wbc
-bilirubin
-glucose
Decreased:
-platelets
-calcium & mag

Question 5

What is the treatment for pancreatitis?

Answer 5

rest

Question 6

What is the patho of sepsis?

Answer 6

1. Infection occurs (pneumonia, covid, uti)
2. immune response triggered but out of control
3. inflammatory mediators and cytokines released into blood causing; vasodilation (low volume), capillary leak (and low volume), and blood clotting.
4. organ damage occurs due to O2 starvation
5. met acidosis occurs due to organ dysfunction ( pH low, CO2, lactic acid, bicarb high)
6. Septic shock: when sepsis is resistant to fluid resuscitation
7. organ failure: 2 or more organs fail q

Question 7

S/Sx of sepsis?

Answer 7

-increased HR
-increased RR
-decreased BP
-fever
-clammy skin
-change in mental status
-decreased urinary output

Question 8

What is the goal map for sepsis?

Answer 8

> or equal to 65

Question 9

What is the order of events in shock?

Answer 9

hypotension-> decreased CO-> organ failure-> death

Question 10

Management for neuorgenic shock?

Answer 10

-airway support
-fluid PRN
-atropine for bradycardia
-vasopressors

Question 11

Causes of hypovolemic shock?

Answer 11

vomiting diarrhea, bleeding, burns

Question 12

What is the formula for fluid resus for burns?

Answer 12

4 mL x Patient weight in kg x % of TBSA burned = 24hour volume of IV
fluid
 First 8 hours give half of the 24 total volume of fluid
 Second 8 hours give one-fourth of the total volume
 Third 8 hours give one-fourth of the total volume

Question 13

GI bleed priority?

Answer 13

• Loss of volume leads to decreased cardiac output
• ABC’s

Question 14

NG tube/suction risks?

Answer 14

One of the biggest risks especially with continuous suction is electrolyte imbalance, specifically potassium.

Question 15

Tx for burns?

Answer 15

• Wound care
• Fluid replacement
• Skin grafts

Question 16

What can cause obstructive shock?

Answer 16

• Tamponade, Pneumothorax, Pulmonary embolus, Congenital heart disease.

Question 17

What are some causes of dissociative shock?

Answer 17

• Carbon monoxide, Cyanide, Other Toxins

Question 18

Transplant rejection signs and symptoms?

Answer 18

Flu like symptoms, fatigue, fever, and organ specific symptoms