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zSemester 4 > Test 2 N360 > Flashcards

Test 2 N360 Flashcards

1
Q

What is a good PaO2

A

> 60

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2
Q

fluid qty needed for sepsis

A

30ml/kg bolus

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3
Q

What is SpO2

A

Arterial oxygen saturation

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4
Q

hours to give the blood once you recv it? lab

A

4 hours

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5
Q

how many cc’s is a packed cell worth? lab

A

250-300ml

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6
Q

What part of the brain drives inspiration and expiration

A

pons and medulla oblongata

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7
Q

what causes desorientation, tremors, seizures, adn coma

A

respiratory acidosis

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8
Q

Reduced oxygenation of arterial blood is what

A

hypoxemia

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9
Q

What is the inhalation of oxygen and exhilation of carbon dioxide

A

ventilation

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10
Q

abnormally low number of RBCs

A

anemia

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11
Q

What the 3 classifications of anemia

A
  1. decreased production
  2. premature destruction
  3. increased loss
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12
Q

hemoglobin saturation is measured by what

A

SaO2 saturation of atrial oxygen

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13
Q

oxygen dissolved in plasma is measured by what

A

PaCO2

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14
Q

what can cause impaired ventilation

A

inadequate muscle or nerve function
narrowed airways
poor gas diffusion

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15
Q

what develops during hypoventilation

A

respiratory acidosis

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16
Q

normal PaO2 value and % of total o2

A

80 to 100 3%, this isnt SaO2, but >60 is good

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17
Q

normal SaO2 value and % of total o2

A

95-100 97% of total

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18
Q

what is the measurement of ventilation capability

A

PaCO2

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19
Q

what is the maximum amt of O2 a person with COPD should recv.

A

3L/min,> 3L may remove their desire to breath

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20
Q

the simple face mask delivers what % of O2

A

35-50

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21
Q

the simple face mask delivers what L of O2

A

6-12L/min

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22
Q

the nasal cannula delivers what % of O2

A

24-44%

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23
Q

the nasal cannula delivers what L of O2

A

1-4L

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24
Q

the partial rebreather or nonrebreather mask delivers what % of O2

A

60-90%

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25
Q

the partial rebreather or nonrebreather mask delivers what L of O2

A

10-15L

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26
Q

Venturi masks deliver what % of O2

A

24-50%, precise

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27
Q

A nurse is caring for a patient diagnosed with acute respiratory distress syndrome. The nurse is aware that these patients often will require which intervention?

A

Patients with acute respiratory distress syndrome likely will require mechanical ventilation to support their respiratory status. Frequent suctioning is not required often, but some suctioning may be required. Peritoneal dialysis and creatinine and BUN testing might be necessary with some level of kidney failure, not respiratory compromise.`

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28
Q

When caring for the patient with acute respiratory distress syndrome (ARDS), the critical care nurse knows that therapy is appropriate for the patient when which goal is being met?

  • pH is 7.32
  • PaO2 is greater than or equal to 60 mm Hg
  • (PEEP) increased to 20 cm H2O caused blood pressure (BP) to fall to 80/40
  • No change in PaO2 when patient is turned from supine to prone position
A

The overall goal in caring for the patient with ARDS is for the PaO2 to be greater than or equal to 60mm Hg with adequate lung ventilation to maintain a normal pH of 7.35 to 7.45. PEEP usually is increased for ARDS patients, but a dramatic reduction in BP indicates a complication of decreased cardiac output. A positive occurrence is a marked improvement in PaO2 from perfusion better matching ventilation when the anterior air-filled, nonatelectatic alveoli become dependent in the prone position.
Text Reference - p. 16

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29
Q

The nurse assesses a patient admitted 2 days ago with a diagnosis of chest trauma after a motor vehicle accident. Oxygen is being delivered at 60% by way of Venturi mask. Which assessment finding indicates the development of adult respiratory distress syndrome?

A

One of the main characteristics of adult respiratory distress syndrome (ARDS) is worsening hypoxemia despite increased delivery of higher concentrations of oxygen. An increase in urine specific gravity is not associated with ARDS. Wheezing and stridor and dyspnea may be present and progress to respiratory distress in the patient with ARDS.

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30
Q

Upon reviewing the reports of a patient, the nurse determines that the patient is at risk for hypoxia. Which finding supports the nurse’s conclusion

A

he partial pressure of oxygen of 45 mm Hg or less in arterial blood indicates that the patient has risk of hypoxia due low blood oxygen levels. A ventilation/perfusion ratio of 1:1 is a normal finding and does not indicate that the patient has risk of hypoxia. An inspiratory to expiratory ratio of 1:2 is a normal finding and does not indicate that the patient has respiratory distress or risk of cyanosis. If patient’s partial pressure of carbon dioxide in arterial blood is 30 mm Hg, it indicates that the patient has normal ventilator demand and supply and does not have risk of hypercapnia or hypoxemia.

Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.
Text Reference - p. 1658

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31
Q

azithromycin (Zithromax) help to prevent

A

infections.

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32
Q

Propofol (Diprivan) is a XX and XX drug mainly administered to mechanically ventilated patients in respiratory failure.

A

sedative and analgesic

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33
Q

Albuterol (Ventolin) is a XX that reduces bronchospasm. It helps to promote alveolar ventilation.

A

bronchodilator

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34
Q

XX is an opioid used to decrease anxiety caused by hypoxia.

A

Fentanyl (Sublimaze)

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35
Q

The nurse is providing care for an older adult patient who is experiencing low partial pressure of oxygen in arterial blood (PaO2) as a result of worsening left-sided pneumonia. Which intervention should the nurse use to help the patient mobilize secretions?

A

Augmented coughing and huff coughing techniques may aid the patient in the mobilization of secretions. If positioned side-lying, the patient should be positioned on the right side (good lung down) for improved perfusion and ventilation. Suctioning may be indicated, but always should be performed cautiously because of the risk of hypoxia. NIPPV is inappropriate in the treatment of patients with excessive secretions.
Text Reference - p. 1661

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36
Q

The nurse is monitoring a patient through pulse oximetry. What is monitored through pulse oximetry?

A

Pulse oximetry is a noninvasive method to determine oxygen saturation levels. It may be used intermittently or continuously to assess SpO2. Pulse oximetry cannot be used to assess inspired oxygen concentration, expired oxygen concentration, or venous oxygen saturation. These can be measured through arterial blood gases measurements or pulmonary artery pressure monitoring.
Text Reference - p. 1654

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37
Q

The nurse is caring for a patient with respiratory failure. What information should the nurse include when explaining the disease condition to the family members?

A

Respiratory failure is classified as hypoxemic or hypercapnic. Respiratory failure results when gas exchanging functions are inadequate, i.e., insufficient oxygen is transferred to the blood or inadequate carbon dioxide is removed from the lungs. Although respiratory failure may be secondary to cardiac failure, not all cases of respiratory failure are secondary to cardiac failure. Respiratory failure is not a disease but a symptom of an underlying pathologic condition affecting lung function, oxygen delivery, cardiac output, or the baseline metabolic state.

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38
Q

Respiratory failure is categorized as XX or XX

A

hypoxemic or hypercapnic.

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39
Q

The nurse is caring for a patient with a shunt due to acute respiratory distress syndrome (ARDS). Which nursing intervention is associated with better symptomatic relief for this patient?

A

Patients with ARDS having a shunt disorder are usually more hypoxemic than patients with ventilation-perfusion (V/Q) mismatch. They often require mechanical ventilation and a high FIO2 in combination to improve gas exchange. Bronchodilators and corticosteroids are not helpful for immediate relief because the patient does not have bronchospasm and inflammation.
Text Reference - p. 1656

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40
Q

A patient has benzodiazepines (lorazepam [Ativan]) and opioids (morphine) ordered to decrease anxiety, agitation, and pain. What are the nursing roles in managing this patient?

A

The nurse has to monitor patients closely for cardiopulmonary depression when giving benzodiazepines such as lorazepam (Ativan) and opioids (morphine). Patients receiving these agents are best managed by following an evidence-based protocol that includes a regular “sedation holiday” for ongoing assessment. Sedative and analgesic agents may have a prolonged effect in critically ill patients, delay weaning from mechanical ventilation, and contribute to increased length of stay. If respirations become depressed, then the dose of morphine has to be reduced.
Text Reference - p. 1663

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41
Q

The nurse understands that one way to assess the degree of impairment in gas exchange is to measure the arterial oxygen/fraction of inspired oxygen (PaO2/FIO2, or P/F) ratio. What is the P/F ratio in acute lung injury (ALI)?

  • Greater than 400
  • Greater than 300
  • Less than 200
  • Between 200 and 300
A

In ALI, the P/F ratio is between 200 and 300. This indicates compromised gas exchange through the alveoli. Under normal circumstances, when PaO2 is 85 to 100 mm Hg and FIO2 is 0.21, the P/F ratio would be greater than 400. The term acute respiratory distress syndrome (ARDS) is used when the P/F ratio is less than 200 (e.g., 80/0.8 = 100) and indicates refractory hypoxemia.
Text Reference - p. 1665

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42
Q

A patient with respiratory distress is agitated and confused. What is the best nursing action?

A

Call the provider, then give O2

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43
Q

A nurse is caring for a patient diagnosed with acute lung injury who has a PaO2 of 48 mm Hg. Which condition does the nurse expect?

A

Hypoxemia, an inadequate amount of oxygen in the blood, frequently is quantified as a PaO2 of less than 50 mm Hg. If allowed to progress, hypoxemia can result in hypoxia, which is defined as an inadequate amount of oxygen available at the cellular level such that cells experience anaerobic metabolism.
Text Reference - p. 1658

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44
Q

?? is a condition characterized by an inability of the cells to use oxygen properly despite adequate levels of oxygen delivery.

A

Dysoxia

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45
Q

The nurse is caring for an 83-year-old patient and is reviewing laboratory results. The PaO2 is 76 mm Hg. What nursing action is appropriate for this finding?

A

Age affects normal arterial blood gas (ABG) values. Elderly people have a lower PaO2 level, with a decrease in approximately 10 mm Hg per decade. Normal ABG values are ranges for normal, healthy adults. It is important to establish a baseline for the individual because abnormal values become “normal” for some individuals. Notifying either respiratory therapy or the primary health care provider is not necessary at this time. Administering oxygen is not necessary at this time.
Text Reference - p. 1665

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46
Q

Which medication helps to decrease heart rate and improve cardiac output in the patient with respiratory failure and atrial fibrillation?

A

Diltiazem (Cardizem) is a calcium channel blocker and potent vasodilator. It increases the blood flow through the arteries and decreases the heart rate. Calcium channel blockers reduce blood pressure and increase cardiac output. Administration of nitroglycerine (Tridil) decreases pulmonary congestion caused by heart failure. Metaproterenol (Alupent) is a bronchodilator. It improves breathing by relaxing the muscles in the airways. Methylprednisolone (Solu-Medrol) is administered in conjunction with bronchodilators to treat bronchospasm and asthma.

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47
Q

Diltiazem (Cardizem) is a

A

calcium channel blocker and potent vasodilator.

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48
Q

What reduce blood pressure and increase cardiac output.

A

Calcium channel blockers

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49
Q

Metaproterenol (Alupent) is a

A

bronchodilator.

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50
Q

pCO2

A

verify

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51
Q

ventilate for copd’rs lab

A

verify

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52
Q

What is the arterial oxygen/fraction of inspired oxygen (PaO2/FIO2, or P/F) ratio in acute respiratory distress syndrome (ARDS)?

A
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53
Q

The nurse in the cardiac care unit is caring for a patient who has developed acute respiratory failure. The nurse knows that which medication is being used to decrease this patient’s pulmonary congestion and agitation?

A

For a patient with acute respiratory failure related to the heart, morphine is used to decrease pulmonary congestion as well as anxiety, agitation, and pain. Albuterol is used to reduce bronchospasm. Azithromycin is used for pulmonary infections.

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54
Q

What is used to reduce airway inflammation and edema

A

Methylprednisolone

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55
Q

? is most effective in treating patients with respiratory failure resulting from chest wall and neuromuscular disease

A

NIPPV

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56
Q

If the P/F ratio is

A

ARDS

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57
Q

If the P/F ratio is 200-300 what do you have

A

ALI- acute lung injury

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58
Q

what is a good P/F ratio

A

> 400

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59
Q

what gas is not absorbed by the lungs and why is it important

A

Normally, nitrogen (which constitutes 79% of the air that is breathed) is not absorbed into the bloodstream. This prevents alveolar collapse. When high concentrations of O2 are given, nitrogen is washed out of the alveoli and replaced with O2 . If airway obstruction occurs, the O2 is absorbed into the bloodstream and the alveoli collapse. This process is called absorption atelectasis.

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60
Q

? is a sudden and progressive form of acute respiratory failure in which the alveolar-capillary interface becomes damaged and more permeable to intravascular fluid

A

Acute respiratory distress syndrome (ARDS)

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61
Q

The patient’s risk for O2 toxicity increases when the FIO2 exceeds ?%

A

60%

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62
Q

What causes ARDS?

A

sepsis, aspiration of gastric contents, gram negative especially, trauma, embolism, near drowning, head injury, shock states, anaphylaxis, acute pancreatitis

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63
Q

moving gas from high pressure to low pressure

A

diffusion

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64
Q

total volume of gas exchange between atmosphere and lungs

A

pulmonary ventilation

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65
Q

Elevate HOB to what with resp failure

A

at least 45*

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66
Q

What unusual thing can you do to patients with ARDS?

A

put them in a prone position (hogan p52)

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67
Q

O2 concentrations increase by how many % per liter of O2

A

4% for each Liter of O2

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68
Q

above what limit is bad for chest tube drainage per hour in mLs

A

> 100mLs

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69
Q

inadequate oxygenation causes the heart to do what

A

tachy

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70
Q

pursed lip breathing reduces what

A

co2

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71
Q

what is one of the most effective bronchodilators for COPD

A

ipratropium

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72
Q

what develops with relation to blood panel to patients with chronic bronchitis

A

polycythemia to compensate for hypoxemia

73
Q

blood in the pleural cavity

A

hemothorax

74
Q

NIPPV is for what type of pt

A

responsive, calm pt.

75
Q

what drug decreases pain, anxiety, and agitation

A

fentynal

76
Q

in caring for the pt with ARDS what is the most characteristic sign the nurse would expect the pt to exhibit?

A

refractive hypoxemia

77
Q

the nurse suspects the early stages of ARDS in any seriously ill pt who manifests what

A

dyspnea and restlessness

78
Q

the nurse suspects that a pt with PEEP is experiencing negative effects of this ventilatory maneuver

A

decreasing blood pressure

79
Q

Neutriphils high means

A

general inflammation and probable infection

80
Q

the waterseal chamber of the CDU is filled to where

A

2cm

81
Q

the suction control chamber is filled to where

A

20cm

82
Q

What is tideling

A

rising with inspiration and falling with expiration in a breathing pt, if not seen there is a block, the lungs are re-expanded, or the system is attached to suction

83
Q

if no bubbling is seen in the suction control chamber

A
  1. there is no suction
  2. suction is not high enough
  3. the pleural air leak is so large that suction is not high enough to evacuate it
84
Q

what test measures cross-linked fibrin fragments that are not found in healthy people

A

d-dimer

85
Q

bed position for PE

A

semi-Fowler with o2

86
Q

what drug lowers pulmonary artery pressure

A

Calcium Channel Blockers like nifedipine or diltiazem

87
Q

air in the pleural space

A

pnemothorax

88
Q

blood in the pleural space

A

hemothorax

89
Q

air in the pleural space that does not escape

A

tension pnemothorax

90
Q

fracture of 2 or more adjacent ribs in 2 or more places with lass of wall stability

A

flail chest

91
Q

presence of lymphatic fluid in the pleural space is

A

chylothorax

92
Q

in paradoxical breathing the chest moves out or in on inspiration?

A

in

93
Q

evaluate for what in flail chest

A

palpation of abnormal resp movements, crepitus, cxr, and ABGs

94
Q

SIRS

A

systemic inflammation response syndrome

95
Q

3 stages of ARDS

A
  • injury
  • engorgement
  • intrapulmonary shunting which causes a decrease in surfactant production
96
Q

Intense itching is

A

pruritus

97
Q

? shock is initially associated with warm and flushed skin with later changes that include cool and mottled skin.

A

Septic

98
Q

Warm or cool and dry skin is a sign of ? shock.

A

neurogenic

99
Q

Pale, cool, and clammy skin is a sign of ? shock.

A

obstructive

100
Q

at what % of blood loss do you use blood products

A

30%

101
Q

Bodies can compensate on their own for blood loss up to what %

A

15%

102
Q

MODS is

A

multi-system organ dysfunction syndrome is a lack of perfusion to organs, resulting in tissue and/or organ hypoxia. Interventions to improve perfusion with fluids or medications improve patient outcomes.

103
Q

What UOP is an early indication of hypo-perfusion

A
104
Q

acute septic shock, what should you prepare to do

A

Infusing large amounts of intravenous (IV) fluids

105
Q

Diphenhydramine may be used for ? shock,

A

anaphylactic

106
Q

What is diphenhydramine?

A

benadryl

107
Q

Bacterial toxins cause ?, which is characterized by high fever, hypotension, and malaise.

A

toxic shock syndrome

108
Q

The patient with ? is at a risk of bleeding due to increased bleeding time, thrombocytopenia, and dysfunctional clotting process. The nursing interventions should be aimed at preventing potential bleeding and replacing factors being lost. The patient should be observed for frank or occult bleeding from potential sites. The factors like platelets and clotting factors should be replaced if deficient. Traumatic interventions such as intramuscular injections or multiple venipunctures should be avoided. Decreasing the fluid intake and providing enteral feedings will not help in minimizing hematological complications.

A

multiple organ dysfunction syndrome

109
Q 
A patient is showing signs of anaphylactic shock from an insect sting. Which primary health care provider's prescription does the nurse implement first?
Epinephrine
Normal Saline IV
Diphenhydramine
Oxygen via nasal cannula
A

Epinephrine. The patient in anaphylaxis experiences bronchial spasm and constriction. The administration of epinephrine is necessary to reverse this process and facilitate an open airway. Although administering normal saline, diphenhydramine, and oxygen are appropriate, they must be done after an airway has been established.

110
Q

What drug causes arterial and venous dilation?

A

Sodium nitroprusside (Nipride). Sodium nitroprusside (Nipride) acts by dilating both the arteries and veins. It is used in the treatment of cardiogenic shock.

111
Q

What drug increases the force of a heartbeat?

A

Dopamine (Intropin) has inotropic activity. It increases the force of the heartbeat and is used in the treatment of cardiogenic shock.

112
Q

What drug is used in septic shock to cause vasoconstriction

A

Vasopressin (Pitressin) is a vasoconstrictor used mainly in the treatment of septic shock.

113
Q

what drug is used to constrict the peripheral nerves in neurogenic shock

A

Phenylephrine (Neo-Synephrine) acts by constricting the peripheral nerves and is used in the treatment of neurogenic shock.

114
Q

With shock, enteral feedings should be planned to achieve at least what % of calories per day

A

80%

115
Q

A patient involved in a motor vehicle accident was admitted to the intensive care unit with a closed-head injury. Which clinical manifestation warns the nurse that the patient’s condition is progressing to multiple organ dysfunction syndrome?

Hypotension and dysrhythmias

Urine output less than 400 mL/day

Alteration in level of consciousness

Decreased PaO2 with an increase in FiO2

A

Decreased PaO2 with an increase in FiO2 (refractory hypoxemia) is correct because the lungs are the first organ to show signs of dysfunction and is the main organ affected in multiple organ dysfunction syndrome. Hypotension and dysrhythmias can occur with hypovolemia and hypoxia without progressing to multiple organ dysfunction syndrome. Urine output less than 400 mL/day develops later in the course of multiple organ dysfunction syndrome, when the kidneys become involved. Alteration in level of consciousness is probably already present with the closed head injury, and also can occur with hypoperfusion, microvascular coagulopathy, or cerebral ischemia, and not necessarily progress to multiple organ dysfunction syndrome.

116
Q

What is the main organ affected in MODS

A

lungs

117
Q

The nurse would recognize which clinical manifestation as suggestive of sepsis?

Sudden diuresis unrelated to drug therapy

Hyperglycemia in the absence of diabetes

Respiratory rate of seven breaths per minute

Bradycardia with sudden increase in blood pressure

A

Hyperglycemia in patients with no history of diabetes is a diagnostic criterion for sepsis. Oliguria, not diuresis, typically accompanies sepsis, along with tachypnea and tachycardia, not bradypnea and bradycardia.

118
Q

what is the symbol for ammonia

A

NH3

119
Q

bilirubin greater that ? indicates liver failure

A

2mg/dL

120
Q

Volume excess is typical in what shock

A

cardiogenic

121
Q

what is urticaria

A

hives

122
Q

3 common signs in anaphylactic shock

A

pruritus,
flushing
urticaria

123
Q

What is the condition of below normal or absent reflexes

A

areflexia

124
Q

Which type of shock is associated with bradycardia?

A

neurogenic

125
Q

what is dobutrex used for in cardiogenic shock

A

Doubutamine is a sympathomimetic medication. When used in therapy with dobutamine, the patient’s heart rate and blood pressure should be continuously monitored, as it may worsen hypotension, requiring the addition of a vasopressor. The infusion should be stopped if tachydysrhythmias develop. The administration through a central line is recommended, as infiltration leads to tissue sloughing. The drug should not be administered with sodium bicarbonate, as it can get deactivated. As dobutamine is not adsorbed in plastic containers, it is not necessary to administer the drug in glass bottles.

126
Q

what is sucralfate

A

Treats ulcers and other stomach problems.

127
Q

how often do patients on a vent need to be turned

A

Q2H to prevent buildup of mucous

128
Q

Which type of shock causes an absence of bowel sounds?

A

hypovolemic

129
Q

When working in an acute medical setting, which patients should a nurse consider to be prone to a risk of developing septic shock?
An 80-year-old with a compromised immune system

A 55-year-old with diabetes

A 45-year-old with heart failure

A 70-year-old with malnourishment

A

all of them

130
Q

what is a normal cardiac index

A

2.5-4L/min/m2

131
Q

what is a normal CVP

A

8 to 12 mm Hg

132
Q

what is a normal MAP

A

70-100

133
Q

what is a normal PAP

A

Systolic 20-30 mmHg (PAS)
Diastolic 8-12 mmHg (PAD)
Mean 25 mmHg (PAM)

134
Q

What lab finding fits with a medical diagnosis of cardiogenic shock

A

increased BUN and serum creatinine levels

135
Q

what type of shock? The nurse reviews the medical record of a patient with pneumonia and notes that the patient has hypotension, hypothermia, leukocytosis, and hypoxemia.

A

septic shock, Septic shock is most commonly found in the patient having gram-negative bacterial infections, such as pneumonia. Since it is characterized by hypertension, hypothermia, leukocytosis, and hypoxemia in patients with infections, the nurse concludes that the patient has septic shock.

136
Q

shock is most commonly seen in the patient who has an injury.

A

Neurogenic

137
Q

4 types of shock

A

cardiogenic
hypovolemic
obstructive
distributive (includes septic, anaphylactic, and neurogenic)

138
Q

Causes of cardiogenic shock

A

acute myocardial infarction (MI), cardiomyopathy, blunt cardiac injury, severe systemic or pulmonary hypertension, and myocardial depression from metabolic problems.

139
Q

Clinical manifestations of cardiogenic shock

A

tachycardia, hypotension, a narrowed pulse pressure, tachypnea, pulmonary congestion, cyanosis, pallor, cool and clammy skin, diaphoresis, decreased capillary refill time, anxiety, confusion, and agitation.

140
Q

Absolute hypovolemia results when fluid is

A

lost through hemorrhage, gastrointestinal (GI) loss (e.g., vomiting, diarrhea), fistula drainage, diabetes insipidus, or diuresis.

141
Q

Relative hypovolemia results when

A

fluid volume moves out of the vascular space into extravascular space, such as with sepsis and burns.

142
Q

what is PAWP

A

It measures pressures generated by the left ventricle. It is used to assess left ventricular function. Normal PAWP is 8-12 mmHg.

143
Q

which thorasic vertebra for neurogenic shock

A

5th

144
Q

Neurogenic shock can last how many weeks

A

6

145
Q

S/s neurogenic shock

A

hypotension, bradycardia, temperature dysregulation (resulting in heat loss), dry skin, and poikilothermia.

146
Q

Septic shock is the presence of sepsis with

A

hypotension despite adequate fluid resuscitation along with the presence of inadequate tissue perfusion.

147
Q

What are the stages of shock

A
  1. initial stage - not clinically present, but at cellular level
  2. compensatory stage
  3. progressive stage
  4. irreversible stage
148
Q

drug of choice for anaphylactic shock

A

epinephrine

149
Q

4 prioritized goals for pt in shock

A
  1. adequate tissue perfusion
  2. restoration of normal BP
  3. recovery of organ function
  4. avoidance of complications from prolonged states of hypoperfusion
150
Q

? is characterized by generalized inflammation in organs remote from the initial insult and can be triggered by mechanical tissue trauma (e.g., burns, crush injuries), abscess formation, ischemic or necrotic tissue (e.g., pancreatitis, myocardial infarction), microbial invasion, and global and regional perfusion deficits.

A

Systemic inflammatory response syndrome (SIRS)

151
Q

What results fm SIRS

A

MODS

152
Q

A patient’s localized infection has progressed to the point where septic shock is now suspected. What medication is an appropriate treatment modality for this patient?

A

Patients in septic shock require large amounts of crystalloid fluid replacement.

153
Q

The amount of blood pumped by the heart, per minute, per meter square of body surface area.

A

Cardiac Index

154
Q

What reflects the arterial pressure in the vessels perfusing the organs.

A

MAP= (2 x DBP) + SBP / 3

155
Q

In cardiogenic shock what happens to PAWP

A

it is increased.

156
Q

in the compensatory stage of shock what manifestations do you see (3 of them)

A

tachypnea and tachycardia
pale and cool
lower BP than baseline

157
Q

Thrombocytopenia is ….

A

deficiency of platelets in the blood. This causes bleeding into the tissues, bruising, and slow blood clotting after injury.

158
Q

What Is Refractory Hypoxemia?

A

Refractory hypoxemia is rare and refers to hypoxemia that cannot be corrected by giving the patient extra oxygen to breathe. It usually develops as the end result of a condition known as acute respiratory distress syndrome, in which breathing becomes extremely difficult.

159
Q

a pt is experiencing hypovolemia what do you give first

A

100% o2, then IV

160
Q

What abnormal findings should the nurse expect to find in early compensatory shock

A

metabolic acidosis and increased serum sodium.

161
Q

A patient with a suspected traumatic brain injury has bloody nasal drainage. What observation should cause the nurse to suspect that this patient has a cerebrospinal fluid (CSF) leak?

A

When drainage containing both CSF and blood is allowed to drip onto a white pad, within a few minutes the blood will coalesce into the center, and a yellowish ring of CSF will encircle the blood, giving a halo effect. The presence of glucose would be unreliable for determining the presence of CSF because blood also contains glucose. Decreased blood pressure and urinary output would not be indicative of a CSF leak.

162
Q

Normal ICP ranges from

A

5 to 15 mm Hg

163
Q

you have runs of VTAC with what

A

excessive K (peaked T wave) hyperkalemia

164
Q

rebreather O2 limit

A

15L (has bag)

165
Q

Digoxin level

A

0.8-2

166
Q

.25mg/ml for

A

digoxin

167
Q

what is the antedote for digoxin

A

digibind 38mg

168
Q

K max per hour

A

10ml

169
Q

VTac without pulse

A

cpr

170
Q

Hang mg or k first

A

mg. cause mg helps the K follow. cant pick it up fast up enough.

171
Q

autonomic dysreflexia occurs at what level

A

T6

172
Q

LASIX AND KAYEXALATE

A

removes K through BM

173
Q

calcium chloride

A

calms cardiac cells

174
Q

Insulin escorts what besides BS into cells

A

insulin, but chase with D50

175
Q

KBCIDAL remove acidosis

A

Kayexalate, Bicard, CaCl, insulin, D50/dialysis, albuterol, lasix

176
Q

albuterol can treat

A

hyperkalemia

177
Q

What sign is associated when knee is extended

A

kernig’s sign

178
Q

What sign is associated with bending head forward

A

brudzinski’s sign

179
Q

wbc protein high, glucose low

A

bacterial meningitis

zSemester 4 (6 decks)

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