Nur2115 Exam 2 Questions and
Correct Answers | Latest Update
how to calculate cardiac output
✓ ~:- CO = SV x HR
Mean Arterial Pressure (MAP)
✓ ~:- 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
✓ ~:- PA pressures- (distal port)
PAS= 15-30mmHg
PAD 8-15mmHg
SIRS
✓ ~:- systemic inflammatory response syndrome.
does not have to be associated with an infection.
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SIRS criteria
✓ ~:- need 2 or more s/s
-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
✓ ~:- 2. HR <60 ANSWER
DIC
✓ ~:- disseminated intravascular coagulation
DEATH IS COMING
NO PERFUSION
They will have an increased D Dimer
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DIC clinical presentation
✓ ~:- Acute bleeding from multiple sites. Bleeding from everywhere.
Organ dysfunction, Thrombosis.
DIC nursing management
✓ ~:- 1. Occult blood testing of all fluids
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)
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✓ ~:- 4. inc FDP (fibrin degradation product) ANSWER
hypovolemic shock
✓ ~:- TANK PROBLEM
inadequate fluid volume in the space
cardiogenic shock
✓ ~:- PUMP PROBLEM
Coronary- problem with heart itself, cant move blood.
Non-Coronary- physical obstruction into or out of heart
circulatory (distributive) shock
✓ ~:- PIPE PROBLEM ---> EXTREME VASODILATION
septic shock- inflammatory response due to invasion of organism
anaphylactic- antigen-antibody response
shock initially
✓ ~:- Dont see anything at first. will just have a lactic acid buildup.
Compensatory stage
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