lOMoARcPSD|62982272
dprehensive-exam-blueprint-ch-11-29
(2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!))))))))))))(((((((((((((((((((((())))))))))))))))))))))))))!!!!!!!!!!!!!!!
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
- converted (2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!advanced-adult-health-nursin
- converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
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advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29 - converted (2).pdfhttps://www.stuvia.com/user/amelyn
https://www.stuvia.com/user/amelyn
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
Advanced Adult Health Nursing
Comprehensive Medical Surgical Exam Blueprint
Chapter 11: Health care of the older adult:
KNOW signs and symptoms of, treatment for, nursing management, medications used, and complications of
specific disorders: Alzheimer’s
Alzheimer’s Disease Cx: Increasing age, genes, environment, diet,
inflammation, neurotransmitter, vacular, stress,
neurotic plaques and acetylcholine alteration
S/S: Slow onset, wandering, pacing, restlessness,
depression, lost feeling
Dx: Rule out other conditions
Tx: Donepezil, Rivastigmine, memantine: cognition
enhancers
NurseMx: Asses, promote function/independence,
nutrition, cognitive stimulation
Chapter 13: Fluid and electrolyte, acid base disorders
KNOW LAB VALUES: CBC, chemistries, coagulation, and inflammatory indicators. Signs and symptoms of
electrolyte disorders, Treatment of electrolyte disorders, Physiology of acid base balance and imbalance,
Regulation of acid/base, ABG interpretation, Treatment of abnormal ABG’s
( CHECK SHEET ATTACHED, labs, electrolytes, acid/base)
Anticoagulants
Monitor Reversal agent
LMWH Platelets Protamine Sulfate
Heparin PTT (25-35 Protamine Sulfate
sec)
Warfarin PT (11-14 Vitamin K/FFP
sec)/INR
(0.8-1.2)
1
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, lOMoARcPSD|62982272
dprehensive-exam-blueprint-ch-11-29
(2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!))))))))))))(((((((((((((((((((((())))))))))))))))))))))))))!!!!!!!!!!!!!!!
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
- converted (2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!advanced-adult-health-nursin
- converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
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advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29 - converted (2).pdfhttps://www.stuvia.com/user/amelyn
https://www.stuvia.com/user/amelyn
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
Chapter 14: Shock & multiple organ dysfunction
Types, etiology, stages, complications, clinical manifestations, treatments, and nursing interventions
Stages of Shock Compensatory
1. Compensatory -SNS causes vasoconstriction, increased HR, increased heart contractility to
2. Progressive maintain BP and CO
3. Irreversible -Body shunts blood from skin, kidneys, GI tract. Results in cool, clammy skin,
hypoactive BS, decreased UO
-Perfusion of tissues is inadequate
-Acidosis occurs from anaerobic metabolism
-RR inc due to acidosis, may cause compensatory resp alkalosis. Confusion can
also occur
Progressive
-BP regulation can no longer compensate so BP/MAP decrease
-Hypoperfusion to all organ with further vasoconstriction
-Metal status further deteriorates from dec cerebral perfusion and hypoxia
-Lungs start to fail because decreased pulmonary blood flow causes further
hypoxemia, inc CO2 levels, alveoli collapse and pulmonary edema
-MAP <70, GFR cannot be maintained causes acute renal failure
-Liver, GI and hematological function affected
-DIC may occur
Irreversible
-Cannot survive
-Organ damage so severe that pt does not respond to tx
-BP low
-Renal, liver fail
-Anaerobic metabolism worsens acidosis
-Multi organ damage
General Mx of shock -Fluid replacement: Crystalloid, colloid sln. First line!
-Vasoactive meds
• Norepi, dopamine, phenylephrine, vasopressin: they need fluid on board to work!
(volume) SE: tachycardia and dec peripheral perfusion
-Nutritional support
-Modified Trendelenburg can help keep BP up. Report MAP <65
-VS q15min
-Can monitor O2 Sat via central line (70%+)
-Meds can be given thru central line if possible and titrated to effect: risk for
extravasation
Classifications of shock Hypovolemic: Decreased intravascular volume due to fluid loss
Cardiogenic: Impairment or failure of myocardium
Septic: Overwhelming infections causing relative hypovolemia
Neurogenic: Loss of sympathetic tone causing relative hypovolemia
2
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- converted (2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!advanced-adult-health-nursin
Downloaded - converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
by elizabeth moses ()
, lOMoARcPSD|62982272
dprehensive-exam-blueprint-ch-11-29
(2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!))))))))))))(((((((((((((((((((((())))))))))))))))))))))))))!!!!!!!!!!!!!!!
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
- converted (2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!advanced-adult-health-nursin
- converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
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advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29 - converted (2).pdfhttps://www.stuvia.com/user/amelyn
https://www.stuvia.com/user/amelyn
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
Anaphylactic: Severe allergic reaction producing overwhelming systemic
vasodilation, relative hypolvolemia
Hypovolemic shock Cx
External fluid loss: traumatic bleed
Internal fluid shift: Intravascular to interstitial compartment (severe edema, ascites
and dehydration)
Mx
-Fluids with 2 large bore IVs
-Intraosseous cannulation if hard to get IV catheter in.
NurseMx:
-Administer blood, fluids safely
-Need for blood transfusion based on amount of blood lost, response to crystalloid
fluid, ABGs, need for oxygenation with use of Hbg.
Cardiogenic shock Coronary: Myocardinal damage due to decrease in perfusion; MI, HF.
**A-line: for continuous Noncoronary: Conditions that stress the myocardium; hypoxia, acidosis,
BP and arterial blood hypoglycemia, hypocalcemia, tension pneumo, PE, valve damage, tamponade,
draw. dysrhythmias,
-In both, CO is compromised, BP drops, tissue perfusion is reduced
Mx:
-Correct cause: Coronary=PCI, CABG. NonCoronary=valve replacement, correct
electrolyte replacement, correct dysrhythmia.
-Limit further myocardium damage; increase cardiac contractility and dec
ventricular afterload.
-Initiate first line tx: O2, serial EKG, hemodynamic monitoring (a-line and
pulmonary artery cath), labs (BNP, CK-MB), fluids, mechanical assistive devices
(intra-aortic balloon, R/L ventricular assist devices
Pharm therapy:
- Dobutamine: Inotrope.
- Nitroglycerin: Reduces preload
- Dopamine: Sympathomimetic improved contractility
- Other vasoactive meds
- Antiarrhythmic meds:
NurseMx:
- Preventing cardiogenic shock by ID risk pt
- Monitor hemodynamics
- Meds, fluids; avoid overload
- Monitoring UO
Circulatory Shock ; Definition: Intravascular volume pools in peripheral vessels so not enough blood
septic, neurogenic and returns to the heart. Inability to vasoconstrict
3
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dprehensive-exam-blueprint-ch-11-29
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- converted (2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!advanced-adult-health-nursin
Downloaded - converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
by elizabeth moses ()
, lOMoARcPSD|62982272
dprehensive-exam-blueprint-ch-11-29
(2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!))))))))))))(((((((((((((((((((((())))))))))))))))))))))))))!!!!!!!!!!!!!!!
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
- converted (2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!advanced-adult-health-nursin
- converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
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advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29 - converted (2).pdfhttps://www.stuvia.com/user/amelyn
https://www.stuvia.com/user/amelyn
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
anaphylactic shock.
Cx: Loss of sympathetic tone or relsease of biochemical mediators
Manifestations: Dec venous return, decreased CO, decreased tissue perfusion
Mx:
-Fluid replacement to restore intravascular volume
-Vasoactive meds to restore vasomotor tone
-improve cardiac function
-Nutrition
Septic shock Definition: Inflammatory response leads to decrease tissue perfusion, increased
capillary permeability and activation of coagulation system
Cx: gram neg rods, gram positive cocci bacteremia
S/S: Low BP, tachy, hyperthermia
Tx:
- ID and tx cx
- Abx, fluids, vasopressors (epi, dopamine)
- Nutrition within 1st 24hrs to address hypermetabolic state; enteral or parenteral
feedings
- No not tx hyperthermia unless 104+
Systemic inflammatory Definition: overwhelming inflammatory response in the absence of infection that
response syndrome causes hypovolemia and dec tissue perfusion. May progress into sepsis
(SIRS)
Tx: ABx can be given for possible unrecognized infection
Neurogenic shock Definition: Vasodilation occurs due to loss of balance between sympathetic and
parasympathetic stimulation. Pt experiences an enhances parasympathetic
**Sympath cause response during vasodilation.
constriction and
parasympathetic causes Cx: spinal cord injury, spinal anesthesia, other NS damage, hypoglycemia
smooth muscle relax
S/S: dry, warm skin, low BP, bradycardia, no perspiration in paralysed portion of
body
Tx:
- ABC
- Stabilize spinal cord
- Atropine 0.5mg IV
- Keep map 70+
- IV steroids
- HOB 30 with spinal and epidural anesthesia
- DVT prevention
Anaphylactic shock Definition: Antibody-antigen reaction, allergic rxn (IgE)
S/S: hypoTN, neurologic changes, resp distress, cardiac arrest
4
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by elizabeth moses ()
dprehensive-exam-blueprint-ch-11-29
(2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!))))))))))))(((((((((((((((((((((())))))))))))))))))))))))))!!!!!!!!!!!!!!!
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
- converted (2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!advanced-adult-health-nursin
- converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
https://www.stuvia.com/user/amelyn
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29 - converted (2).pdfhttps://www.stuvia.com/user/amelyn
https://www.stuvia.com/user/amelyn
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
Advanced Adult Health Nursing
Comprehensive Medical Surgical Exam Blueprint
Chapter 11: Health care of the older adult:
KNOW signs and symptoms of, treatment for, nursing management, medications used, and complications of
specific disorders: Alzheimer’s
Alzheimer’s Disease Cx: Increasing age, genes, environment, diet,
inflammation, neurotransmitter, vacular, stress,
neurotic plaques and acetylcholine alteration
S/S: Slow onset, wandering, pacing, restlessness,
depression, lost feeling
Dx: Rule out other conditions
Tx: Donepezil, Rivastigmine, memantine: cognition
enhancers
NurseMx: Asses, promote function/independence,
nutrition, cognitive stimulation
Chapter 13: Fluid and electrolyte, acid base disorders
KNOW LAB VALUES: CBC, chemistries, coagulation, and inflammatory indicators. Signs and symptoms of
electrolyte disorders, Treatment of electrolyte disorders, Physiology of acid base balance and imbalance,
Regulation of acid/base, ABG interpretation, Treatment of abnormal ABG’s
( CHECK SHEET ATTACHED, labs, electrolytes, acid/base)
Anticoagulants
Monitor Reversal agent
LMWH Platelets Protamine Sulfate
Heparin PTT (25-35 Protamine Sulfate
sec)
Warfarin PT (11-14 Vitamin K/FFP
sec)/INR
(0.8-1.2)
1
Page 1 2026
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Downloaded - converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
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, lOMoARcPSD|62982272
dprehensive-exam-blueprint-ch-11-29
(2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!))))))))))))(((((((((((((((((((((())))))))))))))))))))))))))!!!!!!!!!!!!!!!
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
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- converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
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advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29 - converted (2).pdfhttps://www.stuvia.com/user/amelyn
https://www.stuvia.com/user/amelyn
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
Chapter 14: Shock & multiple organ dysfunction
Types, etiology, stages, complications, clinical manifestations, treatments, and nursing interventions
Stages of Shock Compensatory
1. Compensatory -SNS causes vasoconstriction, increased HR, increased heart contractility to
2. Progressive maintain BP and CO
3. Irreversible -Body shunts blood from skin, kidneys, GI tract. Results in cool, clammy skin,
hypoactive BS, decreased UO
-Perfusion of tissues is inadequate
-Acidosis occurs from anaerobic metabolism
-RR inc due to acidosis, may cause compensatory resp alkalosis. Confusion can
also occur
Progressive
-BP regulation can no longer compensate so BP/MAP decrease
-Hypoperfusion to all organ with further vasoconstriction
-Metal status further deteriorates from dec cerebral perfusion and hypoxia
-Lungs start to fail because decreased pulmonary blood flow causes further
hypoxemia, inc CO2 levels, alveoli collapse and pulmonary edema
-MAP <70, GFR cannot be maintained causes acute renal failure
-Liver, GI and hematological function affected
-DIC may occur
Irreversible
-Cannot survive
-Organ damage so severe that pt does not respond to tx
-BP low
-Renal, liver fail
-Anaerobic metabolism worsens acidosis
-Multi organ damage
General Mx of shock -Fluid replacement: Crystalloid, colloid sln. First line!
-Vasoactive meds
• Norepi, dopamine, phenylephrine, vasopressin: they need fluid on board to work!
(volume) SE: tachycardia and dec peripheral perfusion
-Nutritional support
-Modified Trendelenburg can help keep BP up. Report MAP <65
-VS q15min
-Can monitor O2 Sat via central line (70%+)
-Meds can be given thru central line if possible and titrated to effect: risk for
extravasation
Classifications of shock Hypovolemic: Decreased intravascular volume due to fluid loss
Cardiogenic: Impairment or failure of myocardium
Septic: Overwhelming infections causing relative hypovolemia
Neurogenic: Loss of sympathetic tone causing relative hypovolemia
2
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, lOMoARcPSD|62982272
dprehensive-exam-blueprint-ch-11-29
(2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!))))))))))))(((((((((((((((((((((())))))))))))))))))))))))))!!!!!!!!!!!!!!!
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- converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
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advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29 - converted (2).pdfhttps://www.stuvia.com/user/amelyn
https://www.stuvia.com/user/amelyn
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
Anaphylactic: Severe allergic reaction producing overwhelming systemic
vasodilation, relative hypolvolemia
Hypovolemic shock Cx
External fluid loss: traumatic bleed
Internal fluid shift: Intravascular to interstitial compartment (severe edema, ascites
and dehydration)
Mx
-Fluids with 2 large bore IVs
-Intraosseous cannulation if hard to get IV catheter in.
NurseMx:
-Administer blood, fluids safely
-Need for blood transfusion based on amount of blood lost, response to crystalloid
fluid, ABGs, need for oxygenation with use of Hbg.
Cardiogenic shock Coronary: Myocardinal damage due to decrease in perfusion; MI, HF.
**A-line: for continuous Noncoronary: Conditions that stress the myocardium; hypoxia, acidosis,
BP and arterial blood hypoglycemia, hypocalcemia, tension pneumo, PE, valve damage, tamponade,
draw. dysrhythmias,
-In both, CO is compromised, BP drops, tissue perfusion is reduced
Mx:
-Correct cause: Coronary=PCI, CABG. NonCoronary=valve replacement, correct
electrolyte replacement, correct dysrhythmia.
-Limit further myocardium damage; increase cardiac contractility and dec
ventricular afterload.
-Initiate first line tx: O2, serial EKG, hemodynamic monitoring (a-line and
pulmonary artery cath), labs (BNP, CK-MB), fluids, mechanical assistive devices
(intra-aortic balloon, R/L ventricular assist devices
Pharm therapy:
- Dobutamine: Inotrope.
- Nitroglycerin: Reduces preload
- Dopamine: Sympathomimetic improved contractility
- Other vasoactive meds
- Antiarrhythmic meds:
NurseMx:
- Preventing cardiogenic shock by ID risk pt
- Monitor hemodynamics
- Meds, fluids; avoid overload
- Monitoring UO
Circulatory Shock ; Definition: Intravascular volume pools in peripheral vessels so not enough blood
septic, neurogenic and returns to the heart. Inability to vasoconstrict
3
Page 3 2026
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Downloaded - converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
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, lOMoARcPSD|62982272
dprehensive-exam-blueprint-ch-11-29
(2) - converted.pdf@@@@@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!))))))))))))(((((((((((((((((((((())))))))))))))))))))))))))!!!!!!!!!!!!!!!
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- converted (2) - converted~~~~~~~~~~~~~~~~~~~~~~!!!!!
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advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29 - converted (2).pdfhttps://www.stuvia.com/user/amelyn
https://www.stuvia.com/user/amelyn
advanced-adult-health-nursing-comprehensive-exam-blueprint-ch-11-29
anaphylactic shock.
Cx: Loss of sympathetic tone or relsease of biochemical mediators
Manifestations: Dec venous return, decreased CO, decreased tissue perfusion
Mx:
-Fluid replacement to restore intravascular volume
-Vasoactive meds to restore vasomotor tone
-improve cardiac function
-Nutrition
Septic shock Definition: Inflammatory response leads to decrease tissue perfusion, increased
capillary permeability and activation of coagulation system
Cx: gram neg rods, gram positive cocci bacteremia
S/S: Low BP, tachy, hyperthermia
Tx:
- ID and tx cx
- Abx, fluids, vasopressors (epi, dopamine)
- Nutrition within 1st 24hrs to address hypermetabolic state; enteral or parenteral
feedings
- No not tx hyperthermia unless 104+
Systemic inflammatory Definition: overwhelming inflammatory response in the absence of infection that
response syndrome causes hypovolemia and dec tissue perfusion. May progress into sepsis
(SIRS)
Tx: ABx can be given for possible unrecognized infection
Neurogenic shock Definition: Vasodilation occurs due to loss of balance between sympathetic and
parasympathetic stimulation. Pt experiences an enhances parasympathetic
**Sympath cause response during vasodilation.
constriction and
parasympathetic causes Cx: spinal cord injury, spinal anesthesia, other NS damage, hypoglycemia
smooth muscle relax
S/S: dry, warm skin, low BP, bradycardia, no perspiration in paralysed portion of
body
Tx:
- ABC
- Stabilize spinal cord
- Atropine 0.5mg IV
- Keep map 70+
- IV steroids
- HOB 30 with spinal and epidural anesthesia
- DVT prevention
Anaphylactic shock Definition: Antibody-antigen reaction, allergic rxn (IgE)
S/S: hypoTN, neurologic changes, resp distress, cardiac arrest
4
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