Exam 2 Nur2115 latest 2023/ 119 Questions and
Answers/ verified.
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.
-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
-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) - -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 - -blood shunted to most vital organs.
increased heart rate to maintain adequate BP & CO
RR increases to compensate for met. acidosis
-compensatory stage s/s - -increased HR, adequate BP (>65), narrowing PP, increased
RR, cool pale skin, hypoactive bowel sounds, decreased urine output.
-compensatory stage effects on kidney - -releases renin. releases aldosterone.
-compensatory stage effects on pituitary - -secretes ADH. clinical s/s- dec urine output.
adequate BP (>65)
-compensatory stage SEPSIS s/s - -warm flushed skin, increased temp, bounding pulse
-progressive stage - -compensatory mechanisms fail causing anasarca (major swelling)
-progressive stage effects on pulmonary system - -pulmonary hypertension, ARDS
-progressive stage effects on cardiovascular system - -myocardial dysfunction
-progressive stage effects on neurological system - -decreased LOC
-progressive stage effects on integumentary system - -cold, clammy, mottled skin,
profuse diaphoresis, sub normal temp.
-progressive stage effects on renal system - -metabolic acidosis, dec. urine output, incr.
BUN/CREAT
Answers/ verified.
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.
-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
-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) - -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 - -blood shunted to most vital organs.
increased heart rate to maintain adequate BP & CO
RR increases to compensate for met. acidosis
-compensatory stage s/s - -increased HR, adequate BP (>65), narrowing PP, increased
RR, cool pale skin, hypoactive bowel sounds, decreased urine output.
-compensatory stage effects on kidney - -releases renin. releases aldosterone.
-compensatory stage effects on pituitary - -secretes ADH. clinical s/s- dec urine output.
adequate BP (>65)
-compensatory stage SEPSIS s/s - -warm flushed skin, increased temp, bounding pulse
-progressive stage - -compensatory mechanisms fail causing anasarca (major swelling)
-progressive stage effects on pulmonary system - -pulmonary hypertension, ARDS
-progressive stage effects on cardiovascular system - -myocardial dysfunction
-progressive stage effects on neurological system - -decreased LOC
-progressive stage effects on integumentary system - -cold, clammy, mottled skin,
profuse diaphoresis, sub normal temp.
-progressive stage effects on renal system - -metabolic acidosis, dec. urine output, incr.
BUN/CREAT
