NU 545 Unit 7 Exam Questions and
Answers All Correct
What is the primary direction of current therapy for MODS? - Answer- *PREVENTION*
1. Prevent infections
2. Maintain nutrition
3. Maintain oxygenation-perfuse organs
Medical management BEFORE MODS
**Potential source of sepsis or inflammation must
excised or removed**
1. When source cannot be removed, antimicrobial agents are used
2. If agent is known—antibiotic to which organism is sensitive
3. If agent is not known—broad-spectrum antibiotics are given
4. Antibiotics sometimes directed at the probable organism—empirical treatment
*increase infection risk w/ increased number of lines*
Medical management if pt does progress to MODS (pulmonary)
*Lungs are often the first organs to fail and require special attention*
• Aggressive pulmonary care is needed-O2, CDB, elevate HOB, possibly a ventilator
• Oxygen saturation must be monitored continuously
Medical management if pt does progress to MODS - Answer- (GI)
1. Malnutrition develops (HYPERMETABOLISM) and the GI tract often seeds
other areas with bacteria, some clinicians require patient to be fed ENTERALLY
• Enhances perfusion
• Decreases the bacterial load and the effects of endotoxins
• May limit bacterial translocation
*Assess residuals on tube feeding*
Control the mediators of inflammation by performing...
GENERAL LEVELS OF CARE:
1. Maintenance of a positive nitrogen balance via nutrition
2. Promotion of sleep and rest
3. Management of pain
4. Specific treatments targeted at problem cells
5. Monoclonal antibodies to control mediators such as interleukin-1, endotoxins, and
tumor necrosis factors
Protect the organs with MODS by...
1. Care directed toward maintaining the function of organs that fail with MODS-attention
to the organ that is failing
2. Patient is mechanically ventilated to maintain adequate oxygenation
3. Nurses must recognize certain clinical problems further increase the need for oxygen:
-Fever
,-pain
-increased CNS stimulation
-increased respirations, shivering
Protect the organs w. MODS cont...
1. Fluids and meds are used to support cardiovascular status
2. Continuous monitoring needed-O2, CVP line, foley, etc
3. Nutritional support is critical to reduce the catabolism that accompanies
hypermetabolism-specific amounts of fluids, etc.
4. Continuous renal replacement therapy (CRRT) or hemodialysis is used to manage
renal failure
What is transcription? What is nondisjunction? What is aneuploidy?, Whats is
polyploidy? What is translocation? - Answer- Transcription: is the process by which
RNA is synthesized from a DNA template.
Nondisjunction: Aneuploidy is usually a result of nondisjunction, an error in which
homologous chromosomes or sister chromatids fail to operate normally during meiosis
or mitosis.
Aneuploidy: are defined as those that do not contain a multiple of 23 chromosomes.
Polyploidy: When a euploid cell has more than the diploid number of chromosomes, it is
said to be a polyploid cell
Translocation: The interchanging of genetic material between non homologous
chromosomes is called translocation, and the most clinically significant type of
translocation is termed a Robertsonian translocation.
Inheritance of blood types. - Answer- Blood groups are inherited from our parents in the
same way as other genetic traits (eg, eye colour). ABO and Rh are the most well-known
among the blood group systems.
ABO inheritance patterns
The ABO blood group system is determined by the ABO gene, which is found on
chromosome 9. The four ABO blood groups, A, B, AB and O, arise from inheriting one
or more of the alternative forms of this gene (or alleles) namely A, B or O.
Genetic Combinations of ABO Blood Groups
Blood group Possible genes
A
AA or AO
B
BB or BO
AB
AB
O
, OO
The A and B alleles are codominant so both A and B antigens will be expressed on the
red cells whenever either allele is present. O alleles do not produce either A or B
antigens, thus, are sometimes called 'silent' alleles.
ABO Inheritance Patterns
Parental blood groups Child's blood group
O and O
O
O and A
O or A
O and B
O or B
O and AB
A or B
A and A
A or O
A and B
O or A or B or AB
A and AB
A or B or AB
B and B
O or B
B and AB
B or A or AB
AB and AB
A or B or AB
Note: These are various possible blood groups that children may inherit according to the
combination of parental blood groups.
Rh inheritance patterns
The Rh blood group system is attributable to two genes, RHD and RHCE, which are
located on chromosome 1.
The inheritance of the Rh antigens are: - Answer- Rh positivity or Rh negativity is
distinguished by testing for the RhD antigen, the expression of which depends upon
whether an RHD gene has been inherited from one or both parents.
The RHD gene is dominant so a person is considered to be RhD positive whenever this
gene is present, even though the gene may have only been inherited from one parent.
Conversely, a person will be RhD negative if no RHD gene is inherited.
Parental Rh type Child's Rh type
Positive and Positive
Positive or Negative
Positive and Negative
Positive or Negative
Negative and Negative
Negative
Answers All Correct
What is the primary direction of current therapy for MODS? - Answer- *PREVENTION*
1. Prevent infections
2. Maintain nutrition
3. Maintain oxygenation-perfuse organs
Medical management BEFORE MODS
**Potential source of sepsis or inflammation must
excised or removed**
1. When source cannot be removed, antimicrobial agents are used
2. If agent is known—antibiotic to which organism is sensitive
3. If agent is not known—broad-spectrum antibiotics are given
4. Antibiotics sometimes directed at the probable organism—empirical treatment
*increase infection risk w/ increased number of lines*
Medical management if pt does progress to MODS (pulmonary)
*Lungs are often the first organs to fail and require special attention*
• Aggressive pulmonary care is needed-O2, CDB, elevate HOB, possibly a ventilator
• Oxygen saturation must be monitored continuously
Medical management if pt does progress to MODS - Answer- (GI)
1. Malnutrition develops (HYPERMETABOLISM) and the GI tract often seeds
other areas with bacteria, some clinicians require patient to be fed ENTERALLY
• Enhances perfusion
• Decreases the bacterial load and the effects of endotoxins
• May limit bacterial translocation
*Assess residuals on tube feeding*
Control the mediators of inflammation by performing...
GENERAL LEVELS OF CARE:
1. Maintenance of a positive nitrogen balance via nutrition
2. Promotion of sleep and rest
3. Management of pain
4. Specific treatments targeted at problem cells
5. Monoclonal antibodies to control mediators such as interleukin-1, endotoxins, and
tumor necrosis factors
Protect the organs with MODS by...
1. Care directed toward maintaining the function of organs that fail with MODS-attention
to the organ that is failing
2. Patient is mechanically ventilated to maintain adequate oxygenation
3. Nurses must recognize certain clinical problems further increase the need for oxygen:
-Fever
,-pain
-increased CNS stimulation
-increased respirations, shivering
Protect the organs w. MODS cont...
1. Fluids and meds are used to support cardiovascular status
2. Continuous monitoring needed-O2, CVP line, foley, etc
3. Nutritional support is critical to reduce the catabolism that accompanies
hypermetabolism-specific amounts of fluids, etc.
4. Continuous renal replacement therapy (CRRT) or hemodialysis is used to manage
renal failure
What is transcription? What is nondisjunction? What is aneuploidy?, Whats is
polyploidy? What is translocation? - Answer- Transcription: is the process by which
RNA is synthesized from a DNA template.
Nondisjunction: Aneuploidy is usually a result of nondisjunction, an error in which
homologous chromosomes or sister chromatids fail to operate normally during meiosis
or mitosis.
Aneuploidy: are defined as those that do not contain a multiple of 23 chromosomes.
Polyploidy: When a euploid cell has more than the diploid number of chromosomes, it is
said to be a polyploid cell
Translocation: The interchanging of genetic material between non homologous
chromosomes is called translocation, and the most clinically significant type of
translocation is termed a Robertsonian translocation.
Inheritance of blood types. - Answer- Blood groups are inherited from our parents in the
same way as other genetic traits (eg, eye colour). ABO and Rh are the most well-known
among the blood group systems.
ABO inheritance patterns
The ABO blood group system is determined by the ABO gene, which is found on
chromosome 9. The four ABO blood groups, A, B, AB and O, arise from inheriting one
or more of the alternative forms of this gene (or alleles) namely A, B or O.
Genetic Combinations of ABO Blood Groups
Blood group Possible genes
A
AA or AO
B
BB or BO
AB
AB
O
, OO
The A and B alleles are codominant so both A and B antigens will be expressed on the
red cells whenever either allele is present. O alleles do not produce either A or B
antigens, thus, are sometimes called 'silent' alleles.
ABO Inheritance Patterns
Parental blood groups Child's blood group
O and O
O
O and A
O or A
O and B
O or B
O and AB
A or B
A and A
A or O
A and B
O or A or B or AB
A and AB
A or B or AB
B and B
O or B
B and AB
B or A or AB
AB and AB
A or B or AB
Note: These are various possible blood groups that children may inherit according to the
combination of parental blood groups.
Rh inheritance patterns
The Rh blood group system is attributable to two genes, RHD and RHCE, which are
located on chromosome 1.
The inheritance of the Rh antigens are: - Answer- Rh positivity or Rh negativity is
distinguished by testing for the RhD antigen, the expression of which depends upon
whether an RHD gene has been inherited from one or both parents.
The RHD gene is dominant so a person is considered to be RhD positive whenever this
gene is present, even though the gene may have only been inherited from one parent.
Conversely, a person will be RhD negative if no RHD gene is inherited.
Parental Rh type Child's Rh type
Positive and Positive
Positive or Negative
Positive and Negative
Positive or Negative
Negative and Negative
Negative
