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Exam 2 Nur2115 latest 2023/ 119 Questions and Answers/ verified. $12.99   Add to cart

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Exam 2 Nur2115 latest 2023/ 119 Questions and Answers/ verified.

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Exam 2 Nur2115 latest 2023/ 119 Questions and Answers/ verified.

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  • August 22, 2023
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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

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