NUR 445 EXAM #4 QUESTIONS AND
ANSWERS
Pt in MODs-what would you expect to see - ANSWERS● Tachycardia
● Hypotension
● Oliguria
● Decreased LOC
● Tachypnea
MODS labs to expect: (know lab values) - ANSWERS● Increased lactic( >2.0 we worry
about it)
● Creatinine increased (normal range 0.6-1.2)
● Decreased Hct (Normal 38%)
● *BUN would increase (10-20)
Pt in MODS and they know they are going to die and the provider is persuading pt to
sign a DNR, but pt is confused what would you do? - ANSWERS● Ask pt if he
understood
● Call provider
MODS pt activity level? - ANSWERS● Decreased activity level-RESTING
MODS pt, How often should you take vitals? - ANSWERS● every 15 minutes
(hemodynamically monitored)
Beginning stages of shock- - ANSWERS● Decreased LOC
● Tachycardia(early sign)
● Tachypnea due to hypoxia
What leads to shock? Which one needs further explanation? - ANSWERS**Decreased
perfusion
Shock leads to MODS
What are the findings in cardiogenic shock? - ANSWERS(murmurs have nothing to do
with cardiogenic shock)
● **Crackles in lungs
● Decreased oxygen
● SOB
● CP
● N/V
● Hypotension
● Tachycardia
● Restless
, ● Dyspnea
● Decreased peripheral pulses
Hypovolemic shock-assessments? - ANSWERS● I and O's
● Daily WT
● VS
● Cap refill
● Neuro assessment-Decreased LOC
Best thing to do for infection control? - ANSWERS● Wash your hands
Pt in sepsis- what is the first thing that you are going to do? - ANSWERS● Put them on
oxygen
● Put them on heart monitor
● Obtain VS (get WT to determine how much fluids: 30ml/kg)
● Do assessment
● Labs (get **cultures)-IV access
● Administer isotonic fluids and broad spectrum abx
How do we know our interventions for sepsis worked? - ANSWERS● Decreased temp
● Normal HR
● Decreased WBC
● Normal LOC
Septic shock-increased RR, increased HR, decreased BP, decreased urinary output,
decreased cap refill-how do we know that the fluids worked? - ANSWERS● decreased
HR, increased urinary output, decreased RR
Hemodynamic shock- Traumatic injury and now they are in shock-what are beginning
stages of this type of shock? - ANSWERS● Skin- pale, cold, ashy
● Hypotension
● Pallor
● Bounding pulse at the beginning
Traumatic accident and had a head injury and they come into to ed, what do you do
first? - ANSWERSC-spine placement prior to CT
Neuro assessment- what is a factor that can interfere with it? - ANSWERS● Turn down
meds
● Prior to giving pain meds perform a neuro assessment
Suspected C-spine injury-how do you get an airway? - ANSWERS● Jaw thrust
maneuver
Why do we cut pts clothes in trauma? - ANSWERS● To perform a full body assessment
ANSWERS
Pt in MODs-what would you expect to see - ANSWERS● Tachycardia
● Hypotension
● Oliguria
● Decreased LOC
● Tachypnea
MODS labs to expect: (know lab values) - ANSWERS● Increased lactic( >2.0 we worry
about it)
● Creatinine increased (normal range 0.6-1.2)
● Decreased Hct (Normal 38%)
● *BUN would increase (10-20)
Pt in MODS and they know they are going to die and the provider is persuading pt to
sign a DNR, but pt is confused what would you do? - ANSWERS● Ask pt if he
understood
● Call provider
MODS pt activity level? - ANSWERS● Decreased activity level-RESTING
MODS pt, How often should you take vitals? - ANSWERS● every 15 minutes
(hemodynamically monitored)
Beginning stages of shock- - ANSWERS● Decreased LOC
● Tachycardia(early sign)
● Tachypnea due to hypoxia
What leads to shock? Which one needs further explanation? - ANSWERS**Decreased
perfusion
Shock leads to MODS
What are the findings in cardiogenic shock? - ANSWERS(murmurs have nothing to do
with cardiogenic shock)
● **Crackles in lungs
● Decreased oxygen
● SOB
● CP
● N/V
● Hypotension
● Tachycardia
● Restless
, ● Dyspnea
● Decreased peripheral pulses
Hypovolemic shock-assessments? - ANSWERS● I and O's
● Daily WT
● VS
● Cap refill
● Neuro assessment-Decreased LOC
Best thing to do for infection control? - ANSWERS● Wash your hands
Pt in sepsis- what is the first thing that you are going to do? - ANSWERS● Put them on
oxygen
● Put them on heart monitor
● Obtain VS (get WT to determine how much fluids: 30ml/kg)
● Do assessment
● Labs (get **cultures)-IV access
● Administer isotonic fluids and broad spectrum abx
How do we know our interventions for sepsis worked? - ANSWERS● Decreased temp
● Normal HR
● Decreased WBC
● Normal LOC
Septic shock-increased RR, increased HR, decreased BP, decreased urinary output,
decreased cap refill-how do we know that the fluids worked? - ANSWERS● decreased
HR, increased urinary output, decreased RR
Hemodynamic shock- Traumatic injury and now they are in shock-what are beginning
stages of this type of shock? - ANSWERS● Skin- pale, cold, ashy
● Hypotension
● Pallor
● Bounding pulse at the beginning
Traumatic accident and had a head injury and they come into to ed, what do you do
first? - ANSWERSC-spine placement prior to CT
Neuro assessment- what is a factor that can interfere with it? - ANSWERS● Turn down
meds
● Prior to giving pain meds perform a neuro assessment
Suspected C-spine injury-how do you get an airway? - ANSWERS● Jaw thrust
maneuver
Why do we cut pts clothes in trauma? - ANSWERS● To perform a full body assessment
