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NR 341 Final Exam – Questions With Complete Answers
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NR 341 Final Exam – Questions With Complete Answers
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NR 341 Final Exam – Questions With CompleteAnswers
Organ Donation Triggers Right Ans - 1. talk about ventilator
withdrawal/terminal wean
2. comfort care measures
3. GCS < or = 5
4. Brain death testing
5. Positive apnea test
Apnea Test Right Ans - -ran for 8-10 mins
-take patient off vent but keep O2
-positive: no respiratory movement = increased CO2
Support for Organ Donation Right Ans - -thyroid: levoythyroxine
-DI: DDAVP/vasopressin/desmopressin and monitor UO
-pancreas:(BG will run high) insulin, q 1 hour accu checks
-blood pressure: disconnect with SNS, neuro storm, put patient on levophed
and vasopressin
-respiratory: vent dependent, maintain Hgb around 10
Serum CO2 Right Ans - HCO3
Nursing role for the donor patient Right Ans - scripted and consistent
Brain death testing Right Ans - A: Apnea test
B: EEG
C: Cerebral angiography
D: Radionuclide cerebral perfusion scan
-will have A and C or D
Circulatory Death Right Ans - -after heart stops
-OD's
Organ Recipient Meds Right Ans - 1. Prednisone
2. Tacrolimus/Cyclosporine (need lab draws for therapeutic levels and
nephrotoxic)
3. Mycophenolate Mofetil
, Organ Recipient Precautions Right Ans - -need to wear a mask
-no raw fruit or veg unless properly washed
-no fresh flowers/plants
-no pet therapy
Complications to Immunusuppressants Right Ans - 1. HTN - put on BP
meds
2. Nephrotoxicity - keep all lab appointments
3. Hyperlipidemia - put on meds to control levels
4. Hyperglycemia - taught BG control
5. Infection - BS ABX, antifungal, antiviral
Rejection Right Ans - -need to biopsy first
Kidney Biopsy Right Ans - -apply a pressure dressing
-keep patient on effected side
-bed rest for 24 hrs
-assess for bleeding, flank pain, hematocrit, labs
-avoid lifting objects for 5-7 days
Liver Biopsy Right Ans - -need to coach the patient how to breathe through
the procedure since the liver is accessed through the ribs
-monitor for bleeding and pneumothorax
-keep patient lying on right side for minimum of 2 hours
Primary Survey Right Ans - -done in 1-2 mins to set priority for patient
-LOC: AVPU
-A: Airway -> fire, chemical, C spine injury
-B: Breathing -> contusion, fractured ribs, flail chest, neuro dysfunction to not
able to move diaphragm deep enough, abdominal trauma affected diaphragm
-C: Circulation -> control hemorrhage, 2 large bore IVs and administer fluids
-D: dysfunction - neuro disabilities and cranial nerves
-E: elements - is the patient safe, what is their exposure?
-F: full set of VS/family - get quick info, allergies, what happened at scene, med
hx
-G: Get resuscitation adjuncts: FAST and EFAST
FAST Right Ans - US to scan abdomen
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