Multisystem CCRN Flashcards
MODS begins with _____ ,______ and ________ usually within the first ______of hospitalization. Chest film will show________
low grade fever, Dyspnea, Tachycardia; week; infiltrates
SOFA stands for _____ _____ _____ ______ and is a scale for predicting_____ ___ ______
Sequential Organ Failure Assessment; outcome of MODS
Antibody-antigen primarily associated with anaphylactic shock is _____
IgE
Antibody-antigen primarily associated with hemolytic blood transfusion reaction or activation of complement C5_____
IgM
Antibody-antigen primarily associated with bacterial infections____
IgG
Antibody-antigen primarily associated with inflammation associated with mucous and breast milk?
IgA
MODS affect _____organs has 100% mortality rate
4
Mortality chance ______has number of affected organs increases
increases
What percentage of admitted ICU patients have MODS
15%
What percentage of trauma patients have MODS
20-47%
MODS responsible for _____% of deaths in ICU
80%
After patient swallowed a lye-based substance, what should given
water or milk 150ml to dilute the substance.
Dexamethasone not given for emergency why?
It can take about 6 hours to work
Immediate treatment of anaphylaxis?
Adrenalin: reverse bronchospasm and hypotension
Benadryl: blunts histamine reaction
IV Fluids: restore BP and CO by restoring circulating volume
Up to _____ % of patients who die with MODS have no infection
30
A site of infection is ______needed to develop MODS
NOT
MODS involves multiple _______ from multiple members of the _____system
Cytokines; immune
In regards to ARDS, too much IV fluids does what? reduces ______________ and causes _______edema
reduces pulmonary surfactant and causes alveolar edema
Overzealous IV fluids resuscitation in the trauma patient can lead to complication and patient may develop______
ARDS
What is the first emergency to treat in trauma?
Emergency involving airway or breathing.
Emergency tx of tension pneumothorax
Needle Thoracotomy
What are the 3 main causes of PEA in a trauma patient? (PTH)
Pericardial tamponade
Tension pneumothorax
Hypovolemia.
Manifestation of SIRS in response ton an infectious process is
Sepsis
Sepsis is
Systemic response to infection
Name criteria for sepsis diagnosis
Temp 38. 0 or 100.4 F
HR 90 beats/min
WBC >12 or >10 % immature band forms
Risk factors in the development of sepsis
Immunosuppresion
Malnutrition
Prolonged ABT use
invasive devices
In Anaphylaxis shock, __________ is produced and secreted in response.
Histamine
Histamine produces profound ___________ , SVR is __________ and capillary permeability is _________
Vasodilation; Decreased; lncreased.
During anaphylaxis shock, fluid shifts from _________ compartment into the ________space causing (hyper or hypotension)___________ and ________cardiac output and ______preload meaning _______and _____ _____ ____ ____
vascular; extravascular; hypotension; decreased; decreased; CVP; PCWP
_______infusion is contraindicated in _______shock
Dopamine; hypovolemic
Cite the Parkland Formula:
%TBSA burned x weight (kg) x 4ml
Signs and symptoms of overdose TCA:
Seizures, Coma, dysrhythmias, HF, and shock
Signs and symptoms/ monitor for/ for PCP overdose
HYPERTENSIVE CRISIS
hallucinations
Seizures
Rhabdomyolosis
What is rhabdomyolysis
Breakdown of muscle tissue that released a damaging protein in the blood.
_______ lavage is indicated for patients with life-threatening ingestion as long as it within ______minutes or ______hours
Gastric; 120; 2 hours
Lund and Bowder formula list trunk as what %
13
List a TRIAD in complications of trauma
Acidosis, hypoxia, coagulopathies
Salicyclates is toxic to what part of the kidney
Renal tubules.
Why does a sodium bicarb gtt needed in salicyclates toxicity?
It promotes urinary alkalization and facilitates removal of salicyclate from the body.
The most common cause of Cardiac contusion
Blunt trauma to the chest.
Burn patient signs of airway obstruction
singed nasal hairs Hoarseness black sputum Expiratory wheezing frequent swallowing. .
Toxic ingestion that produce markedly elevated methomoglobin levels should be treated with ______ ________
Exchange Transfusion
What is exchange transfusion
Removal of circulating blood while infusion banked RBCs and FFP
Burns greater than ______% of the BSA trigger a ______ _____response which results in ______ capillary permeability and _______ systemic vascular resistance
205; systemic inflammatory; increased; decreased
In burns fluid shifts from _________space into the ________ and _______spaces
intravascular; interstitium; intracellular space.
________plays a role in vasodilation and ________SVR
HIstamine; decreased
