AACN PCCN Exam Review: Multisystem
Questions and Answers.
Normal inflammatory response -
\vasodilatation, increased microvascular permeability, cellular activation and release of
mediators, and coagulation
Define sepsis -
\systemic response to infection, manifested by two or more conditions resulting from
infection (temp >38C, HR >90 bpm, RR >20 bpm, PaCO2 <32 mmHg, WBC >12, <4)
Define septic shock -
\sepsis with hypotension, despite adequate fluid resuscitation, along with presence of
perfusion abnormalities including lactic acidosis, oliguria, acute AMS
Risk factors for sepsis -
\malnutrition, immunosuppression, prolonged antibiotic use, invasive devices
Define MODS -
\multiple organ dysfunction, worsening progression of systemic inflammatory response
(SIRS) involving signs of organ dysfunction
Management of sepsis -
\treat cause (antibiotics), maximize oxygen, maximize CO (difficult bc pathological
problem of SIRS is increased permeability of capillary bed - liberal fluid admin),
decrease oxygen demand (reduce tachycardia, tachypnea, hyperthermia, pain, prevent
shivering, comfort measures)
What is NOT an accurate measurement of adequate perfusion -
\BLOOD PRESSURE, adequate pressure does not always equal adequate perfusion
Symptoms of alcohol withdrawal -
\insomnia, tremors, anxiety, GI upset, HA, sweating, palpitations, hallucinations,
seizures, fever, agitation
How is isopropyl alcohol intoxication distinguished from other types of alcohol
intoxication -
\presence of ketoacids in urine and serum
Which imbalance is seen in methanol intoxication and relieved by hyperventilation -
\metabolic acidosis (decreased bicarbonate level)
Which alcohol intoxication affects renal tubular degeneration -
\ethylene glycol intoxication
Questions and Answers.
Normal inflammatory response -
\vasodilatation, increased microvascular permeability, cellular activation and release of
mediators, and coagulation
Define sepsis -
\systemic response to infection, manifested by two or more conditions resulting from
infection (temp >38C, HR >90 bpm, RR >20 bpm, PaCO2 <32 mmHg, WBC >12, <4)
Define septic shock -
\sepsis with hypotension, despite adequate fluid resuscitation, along with presence of
perfusion abnormalities including lactic acidosis, oliguria, acute AMS
Risk factors for sepsis -
\malnutrition, immunosuppression, prolonged antibiotic use, invasive devices
Define MODS -
\multiple organ dysfunction, worsening progression of systemic inflammatory response
(SIRS) involving signs of organ dysfunction
Management of sepsis -
\treat cause (antibiotics), maximize oxygen, maximize CO (difficult bc pathological
problem of SIRS is increased permeability of capillary bed - liberal fluid admin),
decrease oxygen demand (reduce tachycardia, tachypnea, hyperthermia, pain, prevent
shivering, comfort measures)
What is NOT an accurate measurement of adequate perfusion -
\BLOOD PRESSURE, adequate pressure does not always equal adequate perfusion
Symptoms of alcohol withdrawal -
\insomnia, tremors, anxiety, GI upset, HA, sweating, palpitations, hallucinations,
seizures, fever, agitation
How is isopropyl alcohol intoxication distinguished from other types of alcohol
intoxication -
\presence of ketoacids in urine and serum
Which imbalance is seen in methanol intoxication and relieved by hyperventilation -
\metabolic acidosis (decreased bicarbonate level)
Which alcohol intoxication affects renal tubular degeneration -
\ethylene glycol intoxication
