NUR 430 EXAM 3 QUESTIONS AND ANSWERS 100% CORRECT!!
What is OPO
Answers Organ Procurement Organization
When to contact OPO
Answers vented pts:
-GCS less than or = to 5
-poor prognosis
call updates or refer back:
-hemodynamically unstable
-brain death testing
always call:
-first mention of any end of life decisions
-before terminal extubation/withdrawl of support
-family mentions it
-call within 1 hr of time of death
donor management goals**/interventions
Answers - support the organ --> increase the number of organs transplanted per
donor
MAP 60 - 100
- use fluids to keep MAP up
,CVP 4 - 10
- fluids if low, diuretic if high
EF > 50%
Vasopressors < 1 and low dose
pH 8.3 - 7.45
P/F ratio > 300
Sodium 135 - 155
Glucose < 150
Urine output 0.5-3.0/kg/hr over 4 hrs
confirmatory testing
Answers - motor response
- pupillary response
- oculocephalic
- oculovestibular
- corneal and jaw reflex
- gag and cough
- apnea teat
,- EEG
- cerebral angiography
motor response (brain death)
Answers apply nail bed pressure --> pt has no response
what should the nurse inform pt families about motor response in brain death?
Answers inform families that there can be movement, but they are twitches and do
not mean brain function
pupillary response (brain death)
Answers no reactiveness to light
oculocephalic reflex (Doll's eye)
Answers turn the pts head to the side --> if eyes go with the head (like a doll) this
indicates brain injury
who would you not perform the doll's eye test on?
Answers a pt with an unstable C spine (neck injury)
oculovestibular reflex (cold caloric)
Answers sit the patient up and put ice cold water in the ear
normal: eyes look towards the ear
asymmetrical: one eye goes towards
, negative: eyes don't move
- indicates brain stem injury
corneal and jaw reflex
Answers suction/gag them
apnea test
Answers looking at CO2, unhook ventilator but keep oxygen on them, wait 8
minutes (CO2 rise 3 points per min/or 20 in 8 mins from baseline after 8 mins,
considered brain dead) if you're brain dead you're not taking a breath, if SBP falls
less than 90 during test -> put vent back on
EEG (brain death)
Answers can support diagnosis, but not confirmative
cerebral angiography
Answers gold standard for conclusive brain death
donation after circulatory death (DCD)
Answers Terminal extubation occurs in the OR → cardiac asystole must occur
within 60 - 90 mins
Viable organs are procured after confirmation of cardiac and respiratory cessation
+ a 3-5 min wait period
golden hour (trauma)
What is OPO
Answers Organ Procurement Organization
When to contact OPO
Answers vented pts:
-GCS less than or = to 5
-poor prognosis
call updates or refer back:
-hemodynamically unstable
-brain death testing
always call:
-first mention of any end of life decisions
-before terminal extubation/withdrawl of support
-family mentions it
-call within 1 hr of time of death
donor management goals**/interventions
Answers - support the organ --> increase the number of organs transplanted per
donor
MAP 60 - 100
- use fluids to keep MAP up
,CVP 4 - 10
- fluids if low, diuretic if high
EF > 50%
Vasopressors < 1 and low dose
pH 8.3 - 7.45
P/F ratio > 300
Sodium 135 - 155
Glucose < 150
Urine output 0.5-3.0/kg/hr over 4 hrs
confirmatory testing
Answers - motor response
- pupillary response
- oculocephalic
- oculovestibular
- corneal and jaw reflex
- gag and cough
- apnea teat
,- EEG
- cerebral angiography
motor response (brain death)
Answers apply nail bed pressure --> pt has no response
what should the nurse inform pt families about motor response in brain death?
Answers inform families that there can be movement, but they are twitches and do
not mean brain function
pupillary response (brain death)
Answers no reactiveness to light
oculocephalic reflex (Doll's eye)
Answers turn the pts head to the side --> if eyes go with the head (like a doll) this
indicates brain injury
who would you not perform the doll's eye test on?
Answers a pt with an unstable C spine (neck injury)
oculovestibular reflex (cold caloric)
Answers sit the patient up and put ice cold water in the ear
normal: eyes look towards the ear
asymmetrical: one eye goes towards
, negative: eyes don't move
- indicates brain stem injury
corneal and jaw reflex
Answers suction/gag them
apnea test
Answers looking at CO2, unhook ventilator but keep oxygen on them, wait 8
minutes (CO2 rise 3 points per min/or 20 in 8 mins from baseline after 8 mins,
considered brain dead) if you're brain dead you're not taking a breath, if SBP falls
less than 90 during test -> put vent back on
EEG (brain death)
Answers can support diagnosis, but not confirmative
cerebral angiography
Answers gold standard for conclusive brain death
donation after circulatory death (DCD)
Answers Terminal extubation occurs in the OR → cardiac asystole must occur
within 60 - 90 mins
Viable organs are procured after confirmation of cardiac and respiratory cessation
+ a 3-5 min wait period
golden hour (trauma)
