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CASE STUDY 14 - SEPTIC SHOCK QUESTIONS N ANSWERS
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CASE STUDY 14 - SEPTIC SHOCK QUESTIONS N ANSWERS
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CASE STUDY 14 - SEPTIC SHOCKQUESTIONS N ANSWERS 2024 - 2025
2,,ANS,-
,,Ms.,D,(54,yo,is,brought,to,ED,by,daughter,for,weakness,,decreasing,LOC).,Pt,responds,to,brief,commands,
to,open,eyes,and,move,arms,and,legs,,but,unable,to,answer,any,questions.,The,daughter,tells,you,that,,w
hen,she,stopped,by,her,mother's,house,today,,she,was,complaining,about,abdominal,and,back,pain.,She,a
lso,was,N/V,small,amount,twice.,Although,usually,very,alert,and,oriented,,today,she,was,lethargic,,increas
ingly,sleepy.,B/c,of,her,lethargy,and,nausea,,she,has,not,had,anything,to,eat,or,drink,today.,Her,medical,hx
,includes,HTN,,PAD,,DM,type,2.,The,daughter,brings,in,list,of,her,usual,home,meds,including,enalapril,,insu
lin,lispro,,metformin,,atorvastatin.,The,VS,are,as,follows:
BP,102/38
HR,102
SaO2,76%
RR,40
temp,102.4
Based,on,the,initial,hx,and,assessment,,which,action,prescribed,by,the,HCP,will,you,do,first?
1.,insert,Foley,and,send,urine,specimen,for,culture,and,sensitivity
2.,start,O2,and,titrate,to,maintain,O2,at,90%+
3.,place,pt,on,cardiac,monitor
4.,check,glucose
2,,ANS,-
,,Ms.,A,(20,yo,college,student,who,had,been,drinking,at,a,frat,party,before,she,fell,from,a,second,floor,balc
ony),has,just,arrive,in,the,ED.,Fellow,college,student,accompanying,tells,you,"She,was,completely,knocked
,out,right,after,the,fall.,But,then,she,woke,up,a,little,so,we,thought,she,was,okay--
then,she,stopped,moving,again).,There,is,no,response,to,commands,or,to,having,her,name,called.,She,ext
ends,her,arms,and,legs,stiffly,when,nail,bed,pressure,is,applied,but,no,verbal,response.,Her,eyes,are,shut,,
does,not,open,them,even,with,nail,bed,pressure.,When,you,open,her,eyelids,,you,see,that,her,pupils,are,u
nequal,,with,the,right,pupil,larger,than,the,left.,The,pupil,response,when,you,shine,a,flashlight,into,her,ey
es,is,sluggish.,Her,BP,is,70/30,,she,is,in,sinus,brady,with,rate,40,,RR,is,6,and,irregular,with,20-
second,periods,of,apnea.,You,note,that,she,has,a,large,occipital,laceration,and,that,her,left,leg,is,misaligne
d.,The,paramedics,have,a,cervical,collar,and,backboard,in,place.,A,16-gauge,IV,in,left,AC,,LR,at,150,mL/hr.
, Which,method,of,O2,admin,wil,be,best,to,increase,O2,sat?
1.,NC
2.,nonrebreather
3.,venturi,mask
4.,simple,face,mask
126,,ANS,-
,,Available,staffing,includes,you,and,an,experienced,UAP.,Which,actions,can,you,give,to,the,UAP?,(select,al
l)
1.,measure,VS
2.,attach,pt,to,tele
3.,document,head,to,toe
4.,check,orientation,and,alertness
5.,insert,IV
6.,monitor,output,hourly
1,,ANS,-,,The,cardiac,monitor,shows,aFib,with,rate,of,90-
114.,Routine,tx,orders,for,dysrhythmias,are,included,in,ED,protocols.,Which,action,will,you,prepare,to,tak
e,next?
1.,continue,to,monitor,cardiac,rhythm
2.,give,metoprolol,5,mg,IVP
3.,prepare,to,perform,cardioversion,50,J
4.,give,adenosine,6,mg,IVP
2,,ANS,-,,ABGs,obtained,show:
PaCO2,62,,PaO2,50,,HCO3-,22,,SaO2,87%,,pH,7.23
Based,on,your,analysis,of,these,,which,intervention,do,you,anticipate?
1.,sodium,bicarb,bolus,IV
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