NR 341 FINAL EXAM QUESTIONS AND
VERIFIED ANSWERS GRADED A+
Organ Donation Triggers - ANSWER- 1. talk about ventilator
withdrawal/terminal wean
2. comfort care measures
3. GCS < or = 5
4. Brain death testing
5. Positive apnea test
Apnea Test - ANSWER- -ran for 8-10 mins
-take patient off vent but keep O2
-positive: no respiratory movement = increased CO2
Support for Organ Donation - ANSWER- -thyroid: levoythyroxine
,-DI: DDAVP/vasopressin/desmopressin and monitor UO
-pancreas:(BG will run high) insulin, q 1 hour accu checks
-blood pressure: disconnect with SNS, neuro storm, put patient on
levophed and vasopressin
-respiratory: vent dependent, maintain Hgb around 10
Serum CO2 - ANSWER- HCO3
Nursing role for the donor patient - ANSWER- scripted and consistent
Brain death testing - ANSWER- A: Apnea test
B: EEG
C: Cerebral angiography
D: Radionuclide cerebral perfusion scan
-will have A and C or D
Circulatory Death - ANSWER- -after heart stops
-OD's
Organ Recipient Meds - ANSWER- 1. Prednisone
2. Tacrolimus/Cyclosporine (need lab draws for therapeutic levels and
nephrotoxic)
3. Mycophenolate Mofetil
, Organ Recipient Precautions - ANSWER- -need to wear a mask
-no raw fruit or veg unless properly washed
-no fresh flowers/plants
-no pet therapy
Complications to Immunusuppressants - ANSWER- 1. HTN - put on BP
meds
2. Nephrotoxicity - keep all lab appointments
3. Hyperlipidemia - put on meds to control levels
4. Hyperglycemia - taught BG control
5. Infection - BS ABX, antifungal, antiviral
Rejection - ANSWER- -need to biopsy first
Kidney Biopsy - ANSWER- -apply a pressure dressing
-keep patient on effected side
-bed rest for 24 hrs
-assess for bleeding, flank pain, hematocrit, labs
-avoid lifting objects for 5-7 days
Liver Biopsy - ANSWER- -need to coach the patient how to breathe
through the procedure since the liver is accessed through the ribs
-monitor for bleeding and pneumothorax
-keep patient lying on right side for minimum of 2 hours
VERIFIED ANSWERS GRADED A+
Organ Donation Triggers - ANSWER- 1. talk about ventilator
withdrawal/terminal wean
2. comfort care measures
3. GCS < or = 5
4. Brain death testing
5. Positive apnea test
Apnea Test - ANSWER- -ran for 8-10 mins
-take patient off vent but keep O2
-positive: no respiratory movement = increased CO2
Support for Organ Donation - ANSWER- -thyroid: levoythyroxine
,-DI: DDAVP/vasopressin/desmopressin and monitor UO
-pancreas:(BG will run high) insulin, q 1 hour accu checks
-blood pressure: disconnect with SNS, neuro storm, put patient on
levophed and vasopressin
-respiratory: vent dependent, maintain Hgb around 10
Serum CO2 - ANSWER- HCO3
Nursing role for the donor patient - ANSWER- scripted and consistent
Brain death testing - ANSWER- A: Apnea test
B: EEG
C: Cerebral angiography
D: Radionuclide cerebral perfusion scan
-will have A and C or D
Circulatory Death - ANSWER- -after heart stops
-OD's
Organ Recipient Meds - ANSWER- 1. Prednisone
2. Tacrolimus/Cyclosporine (need lab draws for therapeutic levels and
nephrotoxic)
3. Mycophenolate Mofetil
, Organ Recipient Precautions - ANSWER- -need to wear a mask
-no raw fruit or veg unless properly washed
-no fresh flowers/plants
-no pet therapy
Complications to Immunusuppressants - ANSWER- 1. HTN - put on BP
meds
2. Nephrotoxicity - keep all lab appointments
3. Hyperlipidemia - put on meds to control levels
4. Hyperglycemia - taught BG control
5. Infection - BS ABX, antifungal, antiviral
Rejection - ANSWER- -need to biopsy first
Kidney Biopsy - ANSWER- -apply a pressure dressing
-keep patient on effected side
-bed rest for 24 hrs
-assess for bleeding, flank pain, hematocrit, labs
-avoid lifting objects for 5-7 days
Liver Biopsy - ANSWER- -need to coach the patient how to breathe
through the procedure since the liver is accessed through the ribs
-monitor for bleeding and pneumothorax
-keep patient lying on right side for minimum of 2 hours
