Ch. 66 - Shock, Sepsis, and Multiple Organ Dysfunction Syndrome fully solved & updated(100% accuracy)
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Course
Shock, Sepsis & Multiple Organ Dysfunction NCLEX
Institution
Shock, Sepsis & Multiple Organ Dysfunction NCLEX
A nurse has administered corticosteroids to a patient with multiple organ dysfunction syndrome (MODS). In what order should the results of this medication occur in this situation.
a. Renal excretion of potassium
b. Increased intravascular volume
c. Improved capillary permeability
d. Enhanced ...
Ch. 66 - Shock, Sepsis,
and Multiple Organ
Dysfunction Syndrome
fully solved &
updated(100%
accuracy)
A nurse has administered corticosteroids to a patient with multiple
organ dysfunction syndrome (MODS). In what order should the
results of this medication occur in this situation.
a. Renal excretion of potassium
b. Increased intravascular volume
c. Improved capillary permeability
d. Enhanced renal artery perfusion - answer C, B, D, A
(Corticosteroids are administered to patients who have MODS to
suppress the inflammatory response. If the patient responds
positively to the corticosteroids, capillary permeability should
improve, stopping leakage of intravascular fluid and helping restore
intravascular blood volume. Improved intravascular volume should
help improve the blood pressure, and if compensatory sympathetic
discharge is halted, renal blood flow increases. Increased renal
blood flow should increase the glomerular filtration rate and renal
excretion of potassium.)
,A massive gastrointestinal bleed has resulted in hypovolemic shock
in an older patient. What is a priority nursing diagnosis?
a. Acute pain
b. Impaired skin integrity
c. Decreased cardiac output
d. Ineffective tissue perfusion - answer d. Ineffective tissue
perfusion
(The many deleterious effects of shock are all related to inadequate
perfusion and oxygenation of every body system. This nursing
diagnosis supersedes the other diagnoses.)
A 50-yr-old woman with a suspected brain tumor is scheduled for a
CT scan with contrast media. The nurse notifies the physician that
the patient reported an allergy to shellfish. Which response by the
physician should the nurse question?
a. Infuse IV diphenhydramine before the procedure.
b. Administer lorazepam (Ativan) before the procedure.
c. Complete the CT scan without the use of contrast media.
d. Premedicate with hydrocortisone sodium succinate (Solu-Cortef).
- answer b. Administer lorazepam (Ativan) before the procedure.
(An individual with an allergy to shellfish is at an increased risk to
develop anaphylactic shock if contrast media is injected for a CT
scan. To prevent anaphylactic shock, the nurse should always
confirm the patient's allergies before diagnostic procedures (e.g.,
CT scan with contrast media). Appropriate interventions may include
cancelling the procedure, completing the procedure without
contrast media, or premedication with diphenhydramine or
hydrocortisone. IV fluids may be given to promote renal clearance of
, the contrast media and prevent renal toxicity and acute kidney
injury. The use of an antianxiety agent such as lorazepam would not
be effective in preventing an allergic reaction to the contrast
media.)
When caring for a critically ill patient who is being mechanically
ventilated, the nurse will monitor for which clinical manifestation of
multiple organ dysfunction syndrome (MODS)?
a. Increased serum albumin
b. Decreased respiratory compliance
c. Increased gastrointestinal (GI) motility
d. Decreased blood urea nitrogen (BUN)/creatinine ratio - answer b.
Decreased respiratory compliance
(Clinical manifestations of MODS include symptoms of respiratory
distress, signs and symptoms of decreased renal perfusion,
decreased serum albumin and prealbumin, decreased GI motility,
acute neurologic changes, myocardial dysfunction, disseminated
intravascular coagulation (DIC), and changes in glucose
metabolism.)
A 64-yr-old woman is admitted to the emergency department
vomiting bright red blood. The patient's vital signs are blood
pressure of 78/58 mm Hg, pulse of 124 beats/min, respirations of 28
breaths/min, and temperature of 97.2°F (36.2°C). Which physician
order should the nurse complete first?
a. Obtain a 12-lead ECG and arterial blood gases.
b. Rapidly administer 1000 mL normal saline solution IV.
c. Administer norepinephrine (Levophed) by continuous IV infusion.
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