MODS

Question 0

What occurs in MODS with organ and metabolic dysfunction?

Answer 0

Hypotension, decreases perfusion, micro emboli, shunting of blood

Question 1

What is the definition of MODS?

Answer 1

Multi system organ dysfunction syndrome: failure of 2 or more organ systems, the body cannot maintain homeostasis, and severe hypotension and hypoperfusion

Question 2

What are some respiratory signs and symptoms related to MODS?

Answer 2

Alveolar edema, decreased surfactant, increased shunt, VQ mismatch, atelectasis

Question 3

What are some signs of cardiovascular dysfunction in MODS?

Answer 3

Myocardial depression, angina, massive vasodilation, tachycardia

Question 4

What are some signs of neurological dysfunction in MODS?

Answer 4

Hypoxemia, decreased perfusion, mental status changes, confusion, restlessness, agitation

Question 5

What are some signs of renal dysfunction in MODS?

Answer 5

Decreased urine output, acute renal failure, hypoperfusion, RAAS activation, nephrotoxic drugs

Question 6

What are some signs of GI dysfunction in MODS?

Answer 6

Decreased motility, distention, paralytic illeus, decreased perfusion, bleeding from mucous production, flora from GI may leak from vascular changes

Question 7

What are some signs of integumentary failure with MODS?

Answer 7

Cool, clammy skin, cyanotic, ashen, gray skin, poor capillary refill

Question 8

What are some signs of a hyper metabolic state in MODS?

Answer 8

Increased then decreased blood sugar, insulin resistance, catabolic state, liver dysfunction, lactic acidosis

Question 9

What are some hematological signs of MODS?

Answer 9

Electrolyte imbalance- high Na and H2O, low K, catecholamines make K move into cells, metabolic acidosis, and DIC

Question 10

What is disseminated intravascular coagulation?

Answer 10

A thrombo-hemmorrhagic vascular disorder

Question 11

What happens during DIC?

Answer 11

FDP is released as clots break down, since body can’t maintain the clots, FDP interrupts the fibrinogens ability to convert fibrin so the patient is at high risk for bleeding

Question 12

What is the diagnosis and treatment of DIC?

Answer 12

D-Dimer which shows clots, and FDP levels

Treat with heparin, blood products, treat the cause

Question 13

How can sepsis be diagnosed?

Answer 13

Blood culture, urine culture, CSF and wound cultures, culture respiratory secretions, chest x-Ray, h&h, bmp, potassium levels, bun/cr levels, coagulation studies, abg’s, lactate levels

Question 14

Once sepsis is diagnoses, when should antibiotics be given?

Answer 14

Within 45 minutes

Question 15

What are some treatments and nursing care for sepsis/sirs/mods?

Answer 15

ABCs come first, O2, fluid resuscitation then pressers, neuromuscular blocking agents to decrease WOB, manage pain, manage hgb, tight glycemic control, inotropic therapy, corticosteroids if no shock, prevent dvt, prevent stress ulcers, dialysis if needed

Question 16

How can you tell treatment is effective for sepsis?

Answer 16

Urine output will be greater than 30ml an hour, warm dry skin, normal mental status, BP and O2 status will improve, and lactate levels will go down