Final Exam: NR571/ NR 571 (2023/ 2024 New Update) Complex Diagnosis & Management in Acute Care Practicum Exam Review |Weeks 5-8 | Questions and 100% Correct Verified Answers - Chamberlain

Final Exam: NR571/ NR 571 (2023/ 2024 New Update) Complex Diagnosis & Management in Acute Care Practicum Exam Review |Weeks 5-8 | Questions and 100% Correct Verified Answers - Chamberlain QUESTION A DNR order is signed and a patient has an implantable device. What should be the next step? Answer: implantable cardiac devices: -continuous pacing by a PPM or AICD -uses an LVAD these devices should be deactivated If a DNR order is signed or if a withdrawal of LST is desired by the patient and/or surrogate decision-maker. QUESTION DNRCC-Arrest Answer: DNR Comfort Care-Arrest orders (DNRCC-Arrest) permit the use of life-saving measures (such as powerful heart or blood pressure medications) before a person's heart or breathing stops. However, only comfort care may be provided after a person's heart or breathing stops. -activates the DNR order when a cardiac or respiratory arrest occurs -All resuscitative therapies will be given before an arrest but not during an arrest. -Cardiac arrest occurs when there is no palpable pulse can be identified. -A respiratory arrest occurs when agonal breathing or no spontaneous breathing occurs. QUESTION DNRCC Answer: Do not resuscitate comfort care, no CPR -no resuscitative therapies will be undertaken from the time that the dnr order is signed -no chest compressions -no cardiac defibrillation or cardioversion -no insertion of an artificial airway -no resuscitative drugs (vasopressors, antiarrhythmics, etc.) QUESTION Do Not Intubate (DNI) Answer: a medical order that tells medical professionals not to place a breathing tube in a person. QUESTION DNR Reversal During Surgery Answer: -Any arrest during a surgery or endoscopy is considered to be potentially reversible. -DNR status should be addressed prior to any procedure that requires anesthesia including surgery or endoscopy. -If the patient or their surrogate decision maker rescinds the DNR order periopera- tively, a decision about when to reinstitute it upon arrival in the recovery room or at a specified time interval after surgery should be made prior to the procedure. -In some circumstances, a patient or their decision maker may decide that they do not wish to rescind the DNR perioperatively. -This decision must be documented in the surgical consent. If the patient expires in the OR, this would be characterized as an "expected death" meaning that a patient's demise is anticipated in a DNR situation. QUESTION Zeze is a 52-year-old female with metastatic lung cancer to the brain who is admitted to the hospital with shortness of breath. A chest x-ray demonstrates a large pleural effusion. Initially, she is alert and conversant and is agreeable to the recommended procedure of a thoracentesis that is scheduled for the next day. Overnight, she becomes agitated and requires multiple doses of benzodiazepines. The following morning, she refuses thoracentesis and wants to be discharged from the hospital immediately. What is an important principle for the provider to consider in response to the patient's requests? A. Competence B. Advanced Directives C. Medical decision-making capacity D. Hospice consultation Answer: Medical decision-making capacity Rationale: Medical decision-making capacity may not be present in this patient who has had an abrupt change in mental status as well as an underlying neurological condition (brain metastasis). If there is a concern that the patient lacks the c