For a patient to be diagnosed with multiple organ Two
dysfunction syndrome (MODS), how many organ systems
must be simultaneously failing? MODS is the failure of two or more organ systems in an acutely ill patient such that
homeostasis cannot be maintained without intervention. Three, four, or five organ
Two systems failing are more than necessary for a MODS diagnosis.
Three
Four
Five
A patient is diagnosed with multiple organ dysfunction Obtain a prescription for broad-spectrum antibiotic therapy.
syndrome. While aggressive treatment is continued, the
nurse suspects infection. What is the most appropriate If an infection is suspected, broad-spectrum antibiotics should be started
action that the nurse should perform? immediately to limit the infection. Aggressive treatment for infection control should
be carried out in parallel. These patients are usually hypoxemic. Therefore oxygen
Discontinue the aggressive treatment. should be administered strictly as prescribed. Cultures can be sent, and based on the
Reduce oxygen delivery to the patient. reports, specific antibiotics can be added.
Wait for laboratory reports to confirm the suspicion.
Obtain a prescription for broad-spectrum antibiotic
therapy.
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Which system shows initial signs of dysfunction in systemic Respiratory system
inflammatory response syndrome (SIRS) and multiple organ
dysfunction syndrome (MODS)? The pulmonary vasculature is directly affected by inflammatory mediators. Hence the
initial signs of dysfunction in systemic inflammatory response syndrome (SIRS) and
Respiratory system multiple organ dysfunction syndrome (MODS) are seen in the respiratory system.
Cardiovascular system Cardiovascular changes are detected later when there is myocardial depression.
Gastrointestinal system Effects on the gastrointestinal system are seen when the motility gets decreased.
Central nervous system Neurologic dysfunctions are seen when the patient's mental status begins to show
signs of change.
Which laboratory finding in a patient with multiple organ Urine specific gravity is increased.
dysfunction syndrome (MODS) suggests prerenal
manifestations of renal dysfunction? An increase in urine specific gravity suggests prerenal manifestations in patients with
MODS. This occurs due to renal hypoperfusion. A urine Na + level above 20 mEq/L is
Urine Na + is 22 mEq/L. a sign of intrarenal manifestations in MODS. It occurs due to acute tubular necrosis.
Urine specific gravity is 1.010. Other intrarenal manifestations of MODS are urine specific gravity of around 1.010
Urine osmolality is decreased. and a decrease of the urine osmolality.
Urine specific gravity is increased.
Which sign of neurologic dysfunction is commonly seen in Confusion, agitation, and lethargy
both systemic inflammatory response syndrome (SIRS) and
multiple organ dysfunction syndrome (MODS)? The sign of neurologic dysfunction commonly seen in systemic inflammatory
response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) is
Difficulty breathing change in mental status, which may cause the patient to become confused, agitated,
Increased heart rate and lethargic. The patient's heart rate increases due to changes in the cardiovascular
Increased liver enzymes system. The patient's liver enzymes increase due to dysfunction in the hepatic system
Confusion, agitation, and lethargy and finally the dysfunction results in hepatic encephalopathy. The patient's dyspnea is
caused by changes in the respiratory system by inflammatory mediators.
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What causes dysrhythmias in patients with systemic Hypokalemia due to activities of aldosterone and catecholamines
inflammatory response syndrome (SIRS) and multiple organ
dysfunction syndrome (MODS)? In systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction
syndrome (MODS), there are hormonal and metabolic changes and fluid shifts,
Metabolic acidosis resulting in increase in lactate levels including the release of aldosterone and catecholamines. Aldosterone increases
urinary potassium loss and catecholamines cause potassium to move into the cell,
Increased capillary permeability in the cardiovascular resulting in hypokalemia, which causes dysrhythmias. Dysrhythmias are not
system associated with an increased lactate level caused by metabolic acidosis. Increased
capillary permeability causes tachycardia rather than dysrhythmias. The increase in
Hypokalemia due to activities of aldosterone and sodium reabsorption raises the serum osmolality and stimulates the release of the
catecholamines antidiuretic hormone (ADH). Increased sodium is not related to the development of
dysrhythmias.
Aldosterone-mediated sodium and water reabsorption in
kidneys
What actions should the nurse take to optimize tissue Advise the patient to rest.
oxygenation in a patient with systemic inflammatory Administer sedatives to the patient.
response syndrome (SIRS) and multiple organ dysfunction
syndrome (MODS)? Select all that apply. The patient with systemic inflammatory response syndrome (SIRS) and multiple organ
dysfunction syndrome (MODS) should be restricted to very limited activity to
Avoid giving analgesics. maintain tissue oxygenation. Resting reduces the body's oxygen demand. Hence the
Advise the patient to rest. patient should rest. Sedation is used to help the patient rest. Analgesics should be
Administer sedatives to the patient. given to reduce pain and thereby reduce the demand for oxygen. The nurse should
Perform all activities at a particular time of the day. provide care at intervals to reduce the patient's oxygen demand, not at a particular
Frequently reposition the patient for ulcer prophylaxis. time of the day. The patient should not be repositioned frequently because this may
increase oxygen demand on the body.
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