NUR 4420 Final Exam (Week 10) with Complete Solutions
NUR 4420 Final Exam (Week 10) with
Complete Solutions
Multi-system Organ Dysfunction (MODS) - ✔-Also called systemic inflammatory response syndrome
(SIRS)
Critical illness that progressively involves 2 or more systems
When caring for a patient w/ MODS, the nurse knows to look for what respiratory symptoms? - ✔-
Endothelial lung damage
Bronchoconstriction & pulmonary vasoconstriction
---> *Biggest thing w/ resp, will cause wheezing*
Massive capillary leak causes *pulmonary edema*
Altered hydrostatic & oncotic pressure
Interstitial edema
Potential ventilation-perfusion mismatch
---> May cause ARDS & hypoxia
What does MODS do to the renal system? - ✔-Causes endothelial damage d/t decreased perfusion
---> *Will cause prerenal & intrarenal failure*
Renal vasoconstriction
Microemboli results in renal ischemia & an inc risk of MI
NUR 4420 Final Exam (Week 10) with Complete Solutions
,NUR 4420 Final Exam (Week 10) with Complete Solutions
Renal interstitial edema
Effects of MODS on the CV system - ✔-Myocardial ischemia
Dec contractility causes dec CO, hypotension, & a change in heart rhythm
A patient presents in the ICU w/ MODS. The nurse knows what symptoms signify dysfunction of the GI
system? - ✔-Bowels start to die because dec blood flow to the intestines
---> GI system is one of the first systems to lose blood supply
Pt has gastric ulceration (*Largely seen w/ MODS*)
---> Give PPI, gastric reducing agents
Splanchnic blood flow impairment
Inc bacterial load resulting in systemic bacterial translocation
---> *More bacterial d/t ischemia*
---> H. pylori is most common
What neuro changes are seen w/ MODS? - ✔-*CHANGE IN LOC*
---> First thing we see
Cerebral ischemia causes a stroke risk because of the micro emboli in the system
Cerebral hemorrhage
Cerebral vasodilation causes IICP, possible aneurysm
*Dec CPP*
NUR 4420 Final Exam (Week 10) with Complete Solutions
,NUR 4420 Final Exam (Week 10) with Complete Solutions
Hematological effects w/ MODS - ✔-*Consumption of hematologic & clotting factors which will
CAUSE DIC*
---> Pt will bleed from everywhere
Dec WBCs, RBCs, Plts
S&S of respiratory failure w/ MODS - ✔-Tachypnea
---> Pt becomes alkalotic & then acidotic later
Dyspnea
Crackles d/t capillary leak & pulmonary edema
Pulmonary HTN
S&S of renal failure w/ MODS - ✔-Dec GFR
---> Puts us in ARF (Pt oliguric then diuretic)
Oliguria, anuria, or polyuria
Electrolyte imbalance
Lab changes w/ MODS - ✔-Serum Cr >2.0 mg/dl
BUN >20 mg/dl
K+ >5 mEq/L
NUR 4420 Final Exam (Week 10) with Complete Solutions
, NUR 4420 Final Exam (Week 10) with Complete Solutions
*Calcium <8.5 mg/dl*
Mg <1.5 mEq/L
S&S of CV failure w/ MODS - ✔-Tachycardia
Bounding or diminished pulses
MAP <70 mmHg
Intractable dysrhythmias
CVP <8 mmHg
CO initially >8L/min & then later <4 L/min
CI initially >4 L/min & then late <2.5 L/min
Skin initially warm & then later cool & clammy
Pale skin
Peripheral edema
S3 heart sound
Assessment findings for neuro w/ MODS - ✔-Altered LOC
H/A
Hepatic encephalopathy
Hypothermia or hyperthermia
---> We put them in hypothermic conditions for MI & CVA to dec metabolic demand & then slowly
warm them back up after *24 hr*
GCS < 6
NUR 4420 Final Exam (Week 10) with Complete Solutions
NUR 4420 Final Exam (Week 10) with
Complete Solutions
Multi-system Organ Dysfunction (MODS) - ✔-Also called systemic inflammatory response syndrome
(SIRS)
Critical illness that progressively involves 2 or more systems
When caring for a patient w/ MODS, the nurse knows to look for what respiratory symptoms? - ✔-
Endothelial lung damage
Bronchoconstriction & pulmonary vasoconstriction
---> *Biggest thing w/ resp, will cause wheezing*
Massive capillary leak causes *pulmonary edema*
Altered hydrostatic & oncotic pressure
Interstitial edema
Potential ventilation-perfusion mismatch
---> May cause ARDS & hypoxia
What does MODS do to the renal system? - ✔-Causes endothelial damage d/t decreased perfusion
---> *Will cause prerenal & intrarenal failure*
Renal vasoconstriction
Microemboli results in renal ischemia & an inc risk of MI
NUR 4420 Final Exam (Week 10) with Complete Solutions
,NUR 4420 Final Exam (Week 10) with Complete Solutions
Renal interstitial edema
Effects of MODS on the CV system - ✔-Myocardial ischemia
Dec contractility causes dec CO, hypotension, & a change in heart rhythm
A patient presents in the ICU w/ MODS. The nurse knows what symptoms signify dysfunction of the GI
system? - ✔-Bowels start to die because dec blood flow to the intestines
---> GI system is one of the first systems to lose blood supply
Pt has gastric ulceration (*Largely seen w/ MODS*)
---> Give PPI, gastric reducing agents
Splanchnic blood flow impairment
Inc bacterial load resulting in systemic bacterial translocation
---> *More bacterial d/t ischemia*
---> H. pylori is most common
What neuro changes are seen w/ MODS? - ✔-*CHANGE IN LOC*
---> First thing we see
Cerebral ischemia causes a stroke risk because of the micro emboli in the system
Cerebral hemorrhage
Cerebral vasodilation causes IICP, possible aneurysm
*Dec CPP*
NUR 4420 Final Exam (Week 10) with Complete Solutions
,NUR 4420 Final Exam (Week 10) with Complete Solutions
Hematological effects w/ MODS - ✔-*Consumption of hematologic & clotting factors which will
CAUSE DIC*
---> Pt will bleed from everywhere
Dec WBCs, RBCs, Plts
S&S of respiratory failure w/ MODS - ✔-Tachypnea
---> Pt becomes alkalotic & then acidotic later
Dyspnea
Crackles d/t capillary leak & pulmonary edema
Pulmonary HTN
S&S of renal failure w/ MODS - ✔-Dec GFR
---> Puts us in ARF (Pt oliguric then diuretic)
Oliguria, anuria, or polyuria
Electrolyte imbalance
Lab changes w/ MODS - ✔-Serum Cr >2.0 mg/dl
BUN >20 mg/dl
K+ >5 mEq/L
NUR 4420 Final Exam (Week 10) with Complete Solutions
, NUR 4420 Final Exam (Week 10) with Complete Solutions
*Calcium <8.5 mg/dl*
Mg <1.5 mEq/L
S&S of CV failure w/ MODS - ✔-Tachycardia
Bounding or diminished pulses
MAP <70 mmHg
Intractable dysrhythmias
CVP <8 mmHg
CO initially >8L/min & then later <4 L/min
CI initially >4 L/min & then late <2.5 L/min
Skin initially warm & then later cool & clammy
Pale skin
Peripheral edema
S3 heart sound
Assessment findings for neuro w/ MODS - ✔-Altered LOC
H/A
Hepatic encephalopathy
Hypothermia or hyperthermia
---> We put them in hypothermic conditions for MI & CVA to dec metabolic demand & then slowly
warm them back up after *24 hr*
GCS < 6
NUR 4420 Final Exam (Week 10) with Complete Solutions
