NURS 434 FINAL EXAM WITH ANSWERS

NURS 434 FINAL EXAM WITH ANSWERS |\ |\ |\ |\ |\




What is the appropriate administration of nutrition in the
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sepsis patient? - CORRECT ANSWERS ✔✔-Enteral nutrition
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within 24 hours
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-Slow continuous drip of small amounts of enteral
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feedings |\




-Weigh patients ont he same scale at the same time each
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day |\




-Large weight gains are common bc of 3rd spacing of
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fluids


Urinary tract infection - CORRECT ANSWERS ✔✔-
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inflammation of the urinary tract |\ |\ |\ |\




-Symptoms: fever, chills, flank pain |\ |\ |\ |\




-infection caused from ecoli from perineum |\ |\ |\ |\ |\ |\




-Puts a patient at risk for sepsis
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What are the risk factors of a UTI? - CORRECT ANSWERS
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✔✔-Anything that increases urinary stasis (stone, tumor, |\ |\ |\ |\ |\ |\ |\



obstruction, retention, neurogenic bladder) |\ |\ |\




-Foreign bodies (calculi, catheters)
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,-Anatomical factors (congenital defects, fistula, urine or
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feces in the vagina), female have a shorter urethra,
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obesity
-Immune response dysfunction (aging, HIV, diabetes)
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-Functional disorders: constipation, voiding dysfunction
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-Other: pregnancy, multiple sex partners, poor personal
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hygiene


What populations are at greater risk for UTI's? - CORRECT
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ANSWERS ✔✔-Women going through menopause
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What are individual risk factors for UTI's? - CORRECT
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ANSWERS ✔✔-Pyelonephritis: inflammation of the renal
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parenchyma (upper urinary system) |\ |\ |\




-Cystitis: inflammation of the bladder
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-Urethritis: inflammation of the urethra
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-Urosepsis: infection spread systematically
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-Sexual activity, birth control, pregnancy
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What populations are at greatest risk for sepsis? -
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CORRECT ANSWERS ✔✔-People with invasive
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devices/procedures (JP, IV's, Central lines, chest tubes),
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pneumonia

,What are individual risk factors for sepsis? - CORRECT
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ANSWERS ✔✔-Old age, diabetes, foley catheters, |\ |\ |\ |\ |\ |\



immunocompromised and malnourished patients |\ |\ |\




What is cardiogenic shock? - CORRECT ANSWERS
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✔✔Shock that causes systolic dysfunction (heart cannot
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pump forward), diastolic dysfunction (heart cannot fill,
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casues cardiac tamponade), dysrhythmias, MI,
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cardiomyopathy, systemic/pulmonary HTN |\ |\




-The patient may get a narrowed pulse pressure,
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tachycardia, hypotension, tachypnea, respiratory crackles |\ |\ |\ |\




-hypoperfusion: sodium and water retention, decreased |\ |\ |\ |\ |\ |\



UO, anxiety, confusion, decreased cerebral perfusion
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What is absolute hypovolemia? - CORRECT ANSWERS ✔✔-
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External loss of whole blood: hemorrhage from trauma,
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surgery, GI bleeding |\ |\




-Loss of other body fluids: vomiting, diarrhea
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What is relative hypovolemia? - CORRECT ANSWERS
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✔✔Pooling or blood or fluids from a bowel obstruction (3rd
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spacing), fluid shifts (burn injuries, ascites), internal
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bleeding, ruptured spleen, pancreatitis |\ |\ |\




-Massive vasodilation: sepsis |\ |\

, -Decreased blood volume to heart, decreased preload, SV |\ |\ |\ |\ |\ |\ |\



& CO, impaired perfusion, cell metabolism, correct w/
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crystalloid solution |\




What are the 4 different types of distrubutive shock? -
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CORRECT ANSWERS ✔✔-Neurogenic shock |\ |\ |\




-Anaphylactic shock |\




-Septic Shock |\




-Obstructive shock |\




What is neurogenic shock? - CORRECT ANSWERS ✔✔-
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shock that occurs from a spinal cord injury or diseases
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above T5 |\




-Can occur within 30 min of SCI and last up to 6 weeks
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-Spinal anesthesia |\




-Vasomotor center depression |\ |\




-Massive vasodilation, loss of SNS vasomotor tone
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-Hypotension!!! and bradycardia |\ |\




What is anaphylactic shock? - CORRECT ANSWERS ✔✔-A
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hypersensitivity reaction to a sensitizing substance |\ |\ |\ |\ |\




-Can occur form contrast media, blood or blood products,
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drugs, insect bites, anesthetic agents, food or food
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additives, vaccines, latex |\ |\