Nur 430 Final Exam 3 Assignment
2025-2026 All Questions Solved
Correct.
OPO - Answer Organ Procurement Organization
- Early notification of OPO necessary
- NEVER mention donation to the families as a nurse
- IDN should be involved at the earliest possible moment
- Exactly when donation is discussed varies, but IDN should be the one approaching the families,
not nursing staff
When do I refer OPO? - Answer - Any cardiac death (tissue donation, call with cardiac arrest of
any type)
For vented patients, call with any of the following:
- GCS of </= 5, regardless of sedation, call within 1 hour
- At first mention of ANY end-of-life discussions
- Before any withdrawal of support and/or terminal extubating
- If family mentions donations
- Within 1 hour of time of death
Donor Mangement Goals - Answer - Increase the number of organs transplanted per donor
- Have certain parameters to treat the patient with once donation is established
- Once brain death is declared, our goal switches from meaningful recovery of the patient to
organ management and not letting this gift they are giving to others go to waste
Clinical Parameters for Donor Management Goals - Answer - MAP= 60-100 mmHg
- CVP= 4-10 mmHg
- Ejection fraction: >50%
- Vasopressors= <1 and low dose
- Arterial blood gas pH= 7.3-7.45
- PaO2/FiO2 ratio= >300
,RN Role for donor management - Answer - Refer patient to OPO in a timely manner
Vital Signs:
- At least every hour
- Hemodynamic readings from a-line
- Give these numbers to the donor people (OPO)
I & O:
- Very strict
- Everything going into the NG, IV
Oxygenation status
Obtain specimens
- Drawing like 20 different labs to test for several things
Assist with any procedures required (x-ray, CI, bronchoscopy)
Provide any care within scope as directed by OPO
Brain Death - Answer Irreversible cessation of all brain function
- Including the brain stem
Brain Death Testing: Requirements - Answer Patient MUST be:
- Normothermic (temp greater than 36 C/98.5 F)
- Cannot be hypotensive (SBP > 90)
- No positive drug screen
- Cannot have had recent dose of paralytics (NMBAs)
- Cannot be acidotic
Confirmatory Testing for Brain Death - Answer - Cerebral motor response
- Brainstem Reflexes; pupillary reflexes, oculocephalic reflex, oculovestibular reflex, corneal and
,*Neurologist does all of these reflexes and tests on the patient; nurse assists*
Confirmatory Testing: Cerebral Motor Response - Answer - Movement of painful stimuli
(nailbed pressure on fingers, toes, sternal rubbing, pinching)
- Negative= no movement and suggests brain death
Confirmatory Testing: Pupillary Reflexes (Brainstem Reflex) - Answer Absence of pupil
movement in response to light suggests brain death
Confirmatory Testing: Oculocephalic Reflex (Brainstem Reflex) - Answer AKA Doll's Eyes
- Fast turning of the head to both sides
- When the MD turns the head to the right, your eyes should go to the left
- *In brain death, their eyes will not move*
Confirmatory testing: Oculovestibular reflex (Brainstem Reflex) - Answer AKA Cold Caloric Test
- Put HOB at 30 degrees
- Take ice cold water or NS and inject into the ear
- Observe for 1-5 minutes before putting water into the other ear
- *Brain death= no movement of eyes towards the stimulant* (cold water)
Confirmatory Testing: Corneal and Jaw reflexes (Brainstem Reflex) - Answer Corneal= soft
cotton is whisked on the corneal
- Normal: pt. should blink or grimace
- Brain death= no response
Jaw= put pain on jaw using nail beds
- Brain death= no response
Confirmatory Testing: Gag and Cough Reflexes (Brainstem Reflex) - Answer Gag= take tongue
blade and tick the back of the throat and move around
- Testing for gag reflex
, Confirmatory Testing: Apnea Testing - Answer - The loss of brain stem function results in the
loss of centrally controlled breathing
- Hook patient to pulse ox, preoxygenate for 10 minutes with 100% oxygen, begin reducing
settings if the patient keeps their sats greater than 90 then we draw an ABG for baseline... then
we decrease ventilator to settings that allows the patient to initiate breaths on their own and
monitor
- STOP apnea testing if BP < 90 consistently despite going up on vasopressors OR if O2 sat <80
for 2 minutes
- *Results are positive for apnea test if respirations are absent and PCO2 >60 or 20 above the
baseline for the patient* (meaning brain death)
Blunt Trauma - Answer When you have rapid deceleration; so as body stops suddenly the
internal organs continue to move forward
- Motor vehicle crashes (MVC)
- Falls
- Contact sports
- Blunt force injuries
Penetrating Trauma - Answer Those that puncture the body and result in damage to internal
structures
- Stabbings
- Firearms
- Impalements
Resuscitation Phases of Trauma - Answer - Prehospital Resuscitation
- Hospital Resuscitation
- Definitive Care and Operative Phase/ Damage Control Resuscitation
- Critical Care
- Intermediate Care
- Rehabilitation
First Peak vs Second Peak of Trauma - Answer The first peak of trauma deaths occur within 48
hours after initial injury, and the second peak occurs days to weeks after the injury
2025-2026 All Questions Solved
Correct.
OPO - Answer Organ Procurement Organization
- Early notification of OPO necessary
- NEVER mention donation to the families as a nurse
- IDN should be involved at the earliest possible moment
- Exactly when donation is discussed varies, but IDN should be the one approaching the families,
not nursing staff
When do I refer OPO? - Answer - Any cardiac death (tissue donation, call with cardiac arrest of
any type)
For vented patients, call with any of the following:
- GCS of </= 5, regardless of sedation, call within 1 hour
- At first mention of ANY end-of-life discussions
- Before any withdrawal of support and/or terminal extubating
- If family mentions donations
- Within 1 hour of time of death
Donor Mangement Goals - Answer - Increase the number of organs transplanted per donor
- Have certain parameters to treat the patient with once donation is established
- Once brain death is declared, our goal switches from meaningful recovery of the patient to
organ management and not letting this gift they are giving to others go to waste
Clinical Parameters for Donor Management Goals - Answer - MAP= 60-100 mmHg
- CVP= 4-10 mmHg
- Ejection fraction: >50%
- Vasopressors= <1 and low dose
- Arterial blood gas pH= 7.3-7.45
- PaO2/FiO2 ratio= >300
,RN Role for donor management - Answer - Refer patient to OPO in a timely manner
Vital Signs:
- At least every hour
- Hemodynamic readings from a-line
- Give these numbers to the donor people (OPO)
I & O:
- Very strict
- Everything going into the NG, IV
Oxygenation status
Obtain specimens
- Drawing like 20 different labs to test for several things
Assist with any procedures required (x-ray, CI, bronchoscopy)
Provide any care within scope as directed by OPO
Brain Death - Answer Irreversible cessation of all brain function
- Including the brain stem
Brain Death Testing: Requirements - Answer Patient MUST be:
- Normothermic (temp greater than 36 C/98.5 F)
- Cannot be hypotensive (SBP > 90)
- No positive drug screen
- Cannot have had recent dose of paralytics (NMBAs)
- Cannot be acidotic
Confirmatory Testing for Brain Death - Answer - Cerebral motor response
- Brainstem Reflexes; pupillary reflexes, oculocephalic reflex, oculovestibular reflex, corneal and
,*Neurologist does all of these reflexes and tests on the patient; nurse assists*
Confirmatory Testing: Cerebral Motor Response - Answer - Movement of painful stimuli
(nailbed pressure on fingers, toes, sternal rubbing, pinching)
- Negative= no movement and suggests brain death
Confirmatory Testing: Pupillary Reflexes (Brainstem Reflex) - Answer Absence of pupil
movement in response to light suggests brain death
Confirmatory Testing: Oculocephalic Reflex (Brainstem Reflex) - Answer AKA Doll's Eyes
- Fast turning of the head to both sides
- When the MD turns the head to the right, your eyes should go to the left
- *In brain death, their eyes will not move*
Confirmatory testing: Oculovestibular reflex (Brainstem Reflex) - Answer AKA Cold Caloric Test
- Put HOB at 30 degrees
- Take ice cold water or NS and inject into the ear
- Observe for 1-5 minutes before putting water into the other ear
- *Brain death= no movement of eyes towards the stimulant* (cold water)
Confirmatory Testing: Corneal and Jaw reflexes (Brainstem Reflex) - Answer Corneal= soft
cotton is whisked on the corneal
- Normal: pt. should blink or grimace
- Brain death= no response
Jaw= put pain on jaw using nail beds
- Brain death= no response
Confirmatory Testing: Gag and Cough Reflexes (Brainstem Reflex) - Answer Gag= take tongue
blade and tick the back of the throat and move around
- Testing for gag reflex
, Confirmatory Testing: Apnea Testing - Answer - The loss of brain stem function results in the
loss of centrally controlled breathing
- Hook patient to pulse ox, preoxygenate for 10 minutes with 100% oxygen, begin reducing
settings if the patient keeps their sats greater than 90 then we draw an ABG for baseline... then
we decrease ventilator to settings that allows the patient to initiate breaths on their own and
monitor
- STOP apnea testing if BP < 90 consistently despite going up on vasopressors OR if O2 sat <80
for 2 minutes
- *Results are positive for apnea test if respirations are absent and PCO2 >60 or 20 above the
baseline for the patient* (meaning brain death)
Blunt Trauma - Answer When you have rapid deceleration; so as body stops suddenly the
internal organs continue to move forward
- Motor vehicle crashes (MVC)
- Falls
- Contact sports
- Blunt force injuries
Penetrating Trauma - Answer Those that puncture the body and result in damage to internal
structures
- Stabbings
- Firearms
- Impalements
Resuscitation Phases of Trauma - Answer - Prehospital Resuscitation
- Hospital Resuscitation
- Definitive Care and Operative Phase/ Damage Control Resuscitation
- Critical Care
- Intermediate Care
- Rehabilitation
First Peak vs Second Peak of Trauma - Answer The first peak of trauma deaths occur within 48
hours after initial injury, and the second peak occurs days to weeks after the injury
