Bccc Ormc Multi System Disorders

Front 1

Which of the following patient profiles can indicate that a patient with pancreatitis also has an active systemic inflammatory response

Back 1

T35.4, P 90, R 26, WBC 8000

Front 2

S I RS parameters include two of the following four

Back 2

T<96.4F or >100.4; <36C or >38C;
RR >20;
P > 90;
WBC <4000 or >12000

Front 3

Sepsis defn

Back 3

SIRS +signs of infection

Front 4

Severe sepsis

Back 4

Sepsis +1 organ dysfunction

Front 5

Septic shock

Back 5

Severe sepsis + volume resistant hypotension. Volume resistance hypo tension in the presence of severe sepsis/SIRS. Vasopressors are required to sustain adequate BP

Front 6

MODS

Back 6

Dysfunction of two or more organ systems requiring medical intervention to maintain homeostasis

Front 7

Vasodilation, vascular permeability, cellular activation and adhesion, and coagulation occur as part of the immune response due to

Back 7

Activation of mediators

Front 8

Laboratory values associated with hepatobiliary dysfunction in MODS include increased

Back 8

Liver enzymes and bilirubin

Front 9

An increase in patients are O2 demand can be caused by

Back 9

Bathing and weighing the patient. Routine nursing activities will cause an increase in the metabolic oxygen demands of the pt.

Front 10

Most common cause of DIC

Back 10

Endotoxin's from sepsis

Front 11

DIC etiology

Back 11

Endotoxin from sepsis. Metabolic acidosis. Hypoperfusion with shock. Massive trauma. Burns. Abruptio placenta, retained placenta, or retain fetus.

Front 12

Lab values for DIC

Back 12

Platelet count <50, or 50% drop from norm. PT >12.5. PTT/aPTTT >40 seconds. Fibrinogen <100. FSP/FTP >40. Ddimer >250

Front 13

That illegal street drug most commonly encountered in the emergency department

Back 13

Cocaine

Front 14

Death from acetaminophen overdose is usually as a result of

Back 14

Hepatic failure

Front 15

Patients with an overdose of tricyclic antidepressant may show signs of

Back 15

Seizures, heart failure, shock

Front 16

Primary MODS

Back 16

Occurs as a direct result of injury to an organ or organs system and any resuscitation measures

Front 17

In the patient with MODS, adequate pain control

Back 17

Improves tissue perfusion and oxygenation

Front 18

Use of the Gut for nutrition is important for the critically ill patient to

Back 18

Prevent bacterial translocation to the pulmonary system

Front 19

Mediator activation in SIRSresults in

Back 19

Vasodilation, increased vascular permeability, cell activation with adhesions to vessel walls, increased coagulation.

Front 20

Cascade of organ dysfunction in secondary MODS starts with and goes to

Back 20

Lungs-ARDS, G.I., CV, liver, renal failure, CNS, hematological dysfunction

Front 21

The release of biochemical and cellular mediators damages the endothelium of the pulmonary vasculature resulting in increased vascular permeability which contributes to the development of surfactant deficiency, pulmonary hypertension and non-cardiogenic pulmonary edema

Back 21

True

Front 22

Primary cardiovascular response to MODS during hyper dynamic phase

Back 22

Decreased SVR with increased CO. Relative hypovolemia. Tachycardia with hypotension. Decrease our RAP and PAOP

Front 23

Neurogenic shock may result from

Back 23

Spinal cord injury above T6. High levels of spinal anesthesia. Pain

Front 24

Interventions for treating hypovolemic shock may include all of the following except

Back 24

Chest x-ray

Front 25

In MODS, cytokines act on the vascular endothelial lining to produce a prothrombotic state

Back 25

True

Front 26

Which of the following patient profiles suggests that patient has adequate hemodynamics to support tissue perfusion

Back 26

Map 70, cVP 12, PAWP 14, CI 2.8 L

Front 27

Nursing interventions to control sources of infection and the patient with MODS include

Back 27

Frequent oral care and position changes

Front 28

The hyper dynamic phase of the cardiovascular response to MODS includes

Back 28

mAP 60, CVP 5, PAOP 8, CI 2.8 L

Front 29

Patients with MO DS with renal involvement may present with the following signs

Back 29

Pulmonary edema, urinary output less than 0.5 ML/KG/HR, fluid overload, All the above.

Front 30

The cascade of organ dysfunction and secondary MODS usually starts with the lungs, and exhibits as acute respiratory distress syndrome or ARDS

Back 30

True

Front 31

Which patient profile suggests that the patient has adequate hemodynamics to support tissue perfusion

Back 31

Decreased SVR with increased cardiac output

Front 32

Circulation and perfusion of the – is selectively decreased during low flow states to preserve perfusion of the major organ systems

Back 32

Splanchnic bed

Front 33

Patients with MODSmay have blood glass analysis that reflects

Back 33

Early respiratory alkalosis, hypoxemia, progressing to metabolic acidosis

Front 34

Gastrointestinal dysfunction in MODS can be evidenced by

Back 34

And ileus and increase stool bacteria count

Front 35

The cardiovascular system initially responds to MODS by

Back 35

Decreasing SVR

Front 36

The evidence based vasoppressors used within the first six hours of sepsis therapy are

Back 36

Dopamine and norepinephrine

Front 37

Mediator activation in SIRS results in which four mechanisms of inflammatory response

Back 37

Vasodilation, increased vascular permeability, cell activation with adhesions to vessel walls, increased coagulation

Front 38

The typical sequela in organ dysfunction in MODS is

Back 38

Pulmonary, G.I., cardiac, hepatic, and/or renal

Front 39

The distinguishing feature of systemic inflammatory response syndrome is severe and infection

Back 39

False

Front 40

Which of the following best describes the purpose of inflammation in the body

Back 40

It brings immune cells and nutrients to the injured area

Front 41

Central nervous system symptoms of alcohol overdose me.

Back 41

Seizure

Front 42

All the following are true about the initial stage of shock except which statement. Tissue perfusion is inadequate. Cardiac output is increased. Lactic acid levels begin to increase. A decreased cardiac output can lead to cell damage

Back 42

Cardiac output is increased

Front 43

During the compensatory phase of shock, the compensatory mechanisms are activated and attempt to return the cells to a pre-shock state. Which of the following organ systems control the compensatory mechanism

Back 43

Endocrine system and neurologic System

Front 44

To compensate for cellular acidosis caused by shock, chemo receptors in the brainstem stimulate an increase in the rate and depth of respirations. This leads to a

Back 44

Decrease in PaCO2 and respiratory alkalosis