Exam 2 Nur2115 Practice Questions and Answers (100% Pass)

Exam 2 Nur2115 Practice Questions and Answers (100% Pass) how to calculate cardiac output - Answer️️ -CO = SV x HR Mean Arterial Pressure (MAP) - Answer️️ -MAP= SBP + 2(DBP) / 3 Normal= 70-105mmHg Needs to be 65mmHg to perfuse ONLY the vital organs. THIS IS NOT NORMAL Use A line to measure Pulmonary Artery Catheter Pressures - Answer️️ -PA pressures- (distal port) PAS= 15-30mmHg PAD 8-15mmHg SIRS - Answer️️ -systemic inflammatory response syndrome. does not have to be associated with an infection. SIRS criteria - Answer️️ -need 2 or more s/s ©SOPHIABENNETT@ Sunday, August 18, 2024 6:00 PM Page 2 of 29 -temp 100.4, temp 96.8 -HR 90bpm -RR 20 and /or PCO2 32 (rapid breathing) -WBC 12,000 or 4,000 WOTF is not criteria s/s for dx SIRS 1. RR 20 2. HR 60 3. Temp 100.4 4. PaCO2 32 - Answer️️ -2. HR 60 ANSWER DIC - Answer️️ -disseminated intravascular coagulation DEATH IS COMING NO PERFUSION They will have an increased D Dimer DIC clinical presentation - Answer️️ -Acute bleeding from multiple sites. Bleeding from everywhere. Organ dysfunction, Thrombosis. DIC nursing management - Answer️️ -1. Occult blood testing of all fluids ©SOPHIABENNETT@ Sunday, August 18, 2024 6:00 PM Page 3 of 29 2. avoid puncturing the pt. 3. Apply pressure 10-15 MIN for arterial puncture. 5MIN for venous puncture. 4. paper tape 5. No BP cuff. NEED AN A LINE 6. No rectal temp 7. gentle personal care 8. dec. pressure points 9. monitor pupils for changes- Could be cerebral bleed. WOTF lab value is indicative of DIC 1. dec PTT 2. inc Platelet 3. dec INR 4. inc FDP (fibrin degradation product) - Answer️️ -4. inc FDP (fibrin degradation product) ANSWER hypovolemic shock - Answer️️ -TANK PROBLEM inadequate fluid volume in the space ©SOPHIABENNETT@ Sunday, August 18, 2024 6:00 PM Page 4 of 29 cardiogenic shock - Answer️️ -PUMP PROBLEM Coronary- problem with heart itself, cant move blood. Non-Coronary- physical obstruction into or out of heart circulatory (distributive) shock - Answer️️ -PIPE PROBLEM --- EXTREME VASODILATION septic shock- inflammatory response due to invasion of organism anaphylactic- antigen-antibody response shock initially - Answer️️ -Dont see anything at first. will just have a lactic acid buildup. Compensatory stage - Answer️️ -blood shunted to most vital organs. increased heart rate to maintain adequate BP & CO RR increases to compensate for met. acidosis compensatory stage s/s - Answer️️ -increased HR, adequate BP (65), narrowing PP, increased RR, cool pale skin, hypoactive bowel sounds, decreased urine output. compensatory stage effects on kidney - Answer️️ -releases renin. releases aldosterone. ©SOPHIABENNETT@ Sunday, August 18, 2024 6:00 PM Page 5 of 29 compensatory stage effects on pituitary - Answer️️ -secretes ADH. clinical s/s- dec urine output. adequate BP (65) compensatory stage SEPSIS s/s - Answer️️ -warm flushed skin, increased temp, bounding pulse progressive stage - Answer️️ -compensatory mechanisms fail causing anasarca (major swelling) progressive stage effects on pulmonary system - Answer️️ -pulmonary hypertension, ARDS progressive stage effects on cardiovascular system - Answer️️ -myocardial dysfunction progressive stage effects on neurological system - Answer️️ -decreased LOC progressive stage effects on integumentary system - Answer️️ -cold, clammy, mottled skin, profuse diaphoresis, sub normal temp. progressive stage effects on renal system - Answer️️ -metabolic acidosis, dec. urine output, incr. BUN/CREAT progressive stage effects on GI system - Answer️️ -bacterial translocation. increased NH3 (ammonia). increased lactate. ©SOPHIABENNETT@ Sunday, August 18, 2024 6:00 PM Page 6 of 29 progressive stage effects on hematological system - Answer️️ -DIC. bleeding. bruising. ecchymosis. petechiae (red/purple dots on the skin) NO TISSUE PERFUSION. NEED AGGRESSIVE TREATMENT Irreversible stage - Answer️️ -recovery is not expected. ORGAN FAILURE. irreversible stage s/s - Answer️️ -unresponsive, refractory hypoxemia, ischemic gut, anuric, hypothermic, mottled cyanotic skin, no peripheral pulses, no cap refill, DIC Which ABG is late shock? 1. ph- 7.35 CO2- 40 CO3- 24 2. 7.46, 32, 22 3. 7.31, 40, 18 4. 7.30, 50, 28 - Answer️️ -3. ANSWER. (Profound metabolic acidosis) medical management for ALL TYPES OF SHOCK - Answer️️ -