Multisystem CCRN

Question 1

MODS begins with _____ ,______ and ________ usually within the first ______of hospitalization. Chest film will show________

Answer 1

low grade fever, Dyspnea, Tachycardia; week; infiltrates

Question 2

SOFA stands for _____ _____ _____ ______ and is a scale for predicting_____ ___ ______

Answer 2

Sequential Organ Failure Assessment; outcome of MODS

Question 3

Antibody-antigen primarily associated with anaphylactic shock is _____

Answer 3

IgE

Question 4

Antibody-antigen primarily associated with hemolytic blood transfusion reaction or activation of complement C5_____

Answer 4

IgM

Question 5

Antibody-antigen primarily associated with bacterial infections____

Answer 5

IgG

Question 6

Antibody-antigen primarily associated with inflammation associated with mucous and breast milk?

Answer 6

IgA

Question 7

MODS affect _____organs has 100% mortality rate

Answer 7

4

Question 8

Mortality chance ______has number of affected organs increases

Answer 8

increases

Question 9

What percentage of admitted ICU patients have MODS

Answer 9

15%

Question 10

What percentage of trauma patients have MODS

Answer 10

20-47%

Question 11

MODS responsible for _____% of deaths in ICU

Answer 11

80%

Question 12

After patient swallowed a lye-based substance, what should given

Answer 12

water or milk 150ml to dilute the substance.

Question 13

Dexamethasone not given for emergency why?

Answer 13

It can take about 6 hours to work

Question 14

Immediate treatment of anaphylaxis?

Answer 14

Adrenalin: reverse bronchospasm and hypotension
Benadryl: blunts histamine reaction
IV Fluids: restore BP and CO by restoring circulating volume

Question 15

Up to _____ % of patients who die with MODS have no infection

Answer 15

30

Question 16

A site of infection is ______needed to develop MODS

Answer 16

NOT

Question 17

MODS involves multiple _______ from multiple members of the _____system

Answer 17

Cytokines; immune

Question 18

In regards to ARDS, too much IV fluids does what? reduces ______________ and causes _______edema

Answer 18

reduces pulmonary surfactant and causes alveolar edema

Question 19

Overzealous IV fluids resuscitation in the trauma patient can lead to complication and patient may develop______

Answer 19

ARDS

Question 20

What is the first emergency to treat in trauma?

Answer 20

Emergency involving airway or breathing.

Question 21

Emergency tx of tension pneumothorax

Answer 21

Needle Thoracotomy

Question 22

What are the 3 main causes of PEA in a trauma patient? (PTH)

Answer 22

Pericardial tamponade
Tension pneumothorax
Hypovolemia.

Question 23

Manifestation of SIRS in response ton an infectious process is

Answer 23

Sepsis

Question 24

Sepsis is

Answer 24

Systemic response to infection

Question 25

Name criteria for sepsis diagnosis

Answer 25

Temp 38. 0 or 100.4 F HR 90 beats/min WBC >12 or >10 % immature band forms

Question 26

Risk factors in the development of sepsis

Answer 26

Immunosuppresion Malnutrition Prolonged ABT use invasive devices

Question 27

In Anaphylaxis shock, __________ is produced and secreted in response.

Answer 27

Histamine

Question 28

Histamine produces profound ___________ , SVR is __________ and capillary permeability is _________

Answer 28

Vasodilation; Decreased; lncreased.

Question 29

During anaphylaxis shock, fluid shifts from _________ compartment into the ________space causing (hyper or hypotension)___________ and ________cardiac output and ______preload meaning _______and _____ _____ ____ ____

Answer 29

vascular; extravascular; hypotension; decreased; decreased; CVP; PCWP

Question 30

_______infusion is contraindicated in _______shock

Answer 30

Dopamine; hypovolemic

Question 31

Cite the Parkland Formula:

Answer 31

%TBSA burned x weight (kg) x 4ml

Question 32

Signs and symptoms of overdose TCA:

Answer 32

Seizures, Coma, dysrhythmias, HF, and shock

Question 33

Signs and symptoms/ monitor for/ for PCP overdose

Answer 33

HYPERTENSIVE CRISIS hallucinations Seizures Rhabdomyolosis

Question 34

What is rhabdomyolysis

Answer 34

Breakdown of muscle tissue that released a damaging protein in the blood.

Question 35

_______ lavage is indicated for patients with life-threatening ingestion as long as it within ______minutes or ______hours

Answer 35

Gastric; 120; 2 hours

Question 36

Lund and Bowder formula list trunk as what %

Answer 36

13

Question 37

List a TRIAD in complications of trauma

Answer 37

Acidosis, hypoxia, coagulopathies

Question 38

Salicyclates is toxic to what part of the kidney

Answer 38

Renal tubules.

Question 39

Why does a sodium bicarb gtt needed in salicyclates toxicity?

Answer 39

It promotes urinary alkalization and facilitates removal of salicyclate from the body.

Question 40

The most common cause of Cardiac contusion

Answer 40

Blunt trauma to the chest.

Question 41

Burn patient signs of airway obstruction

Answer 41

``` singed nasal hairs Hoarseness black sputum Expiratory wheezing frequent swallowing. . ```

Question 42

Toxic ingestion that produce markedly elevated methomoglobin levels should be treated with ______ ________

Answer 42

Exchange Transfusion

Question 43

What is exchange transfusion

Answer 43

Removal of circulating blood while infusion banked RBCs and FFP

Question 44

Burns greater than ______% of the BSA trigger a ______ _____response which results in ______ capillary permeability and _______ systemic vascular resistance

Answer 44

205; systemic inflammatory; increased; decreased

Question 45

In burns fluid shifts from _________space into the ________ and _______spaces

Answer 45

intravascular; interstitium; intracellular space.

Question 46

________plays a role in vasodilation and ________SVR

Answer 46

HIstamine; decreased