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Chapter 5 Organ Donations
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Chapter 5 Organ Donations
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Chapter 5 Organ Donations"I need to notify TransLife (OPO) of my patient's impending death."
Hospitals that receive Medicare or Medicaid reimbursement must notify the local OPO in cases
of impending death. It is the responsibility of the organ procurement organization, not the
physician, to obtain family consent for organ donation and to evaluate the patient for potential
suitability as a donor. Notification of the organ procurement organization must occur prior to
death, not after the patient has been pronounced dead. - ANS-The nurse is working for a
hospital that holds an agreement with a local organ procurement organization (OPO). The
patient has a Glasgow Coma Scale (GCS) score of 3 and discussions have been held with the
family about withdrawing life support. Which statement by the nurse best describes
requirements that must be met to sustain Centers for Medicare and Medicaid Services (CMS)
Conditions of Participation?
a.
"I need to notify TransLife (OPO) of my patient's impending death."
b.
"I will contact the physician to obtain informed consent for organ donation."
c.
"The charge nurse will notify TransLife (OPO) once the patient has been pronounced brain
dead."
d.
"I need the physician to evaluate my patient's suitability for organ donation."
pH 7.30; PaCO2 38 mm Hg; HCO3 16 mEq/L
Donor management, focuses on maintaining hemodynamic stability and normal
laboratory parameters. Care of the patient is under the direction of the OPO coordinator working
collaboratively with the physician and critical care nurses. Standardized order sets are usually
used, and they focus on preserving organ function and viability.Immediate action is required for
an arterial blood gas value of pH 7.30; PaCO2 38 mmHg; HCO3 16 mEq/L which indicates
metabolic acidosis. All other values are within normal limits. - ANS-The nurse is managing a
,donor patient six hours prior to the scheduled harvesting of the patient's organs. Which
assessment finding requires immediate action by the nurse?
a.
Morning serum blood glucose of 128 mg/dL
b.
pH 7.30; PaCO2 38 mm Hg; HCO3 16 mEq/L
c.
Pulmonary artery temperature of 97.8° F
d.
Central venous pressure of 8 mm Hg
A 36-year-old patient with a Glasgow Coma Scale score of 3 with no activity on
electroencephalogram
A patient with a GCS score of 3 and no activity on EEG is facing impending death. The OPO
should be notified. There are no indications of impending death in any of the other patient
scenarios. - ANS-The charge nurse is reviewing the status of patients in the critical care unit.
Which patient should the nurse notify the organ procurement organization to evaluate for
possible organ donation?
a.
A 36-year-old patient with a Glasgow Coma Scale score of 3 with no activity on
electroencephalogram
b.
A 68-year-old male admitted with unstable atrial fibrillation who has suffered a stroke
c.
A 40-year-old brain-injured female with a history of ovarian cancer and a Glasgow Coma Scale
score of 7
d.
, A 53-year-old diabetic male with a history of unstable angina status post resuscitation
A 35-year-old female with a history of food allergies; blood type O negative
To qualify as a living donor, an individual must be free from hypertension, diabetes, cancer,
kidney disease, and heart disease and generally between 18 and 60 years of age. A 35-year-old
female with a history of food allergies; blood type O negative (universal donor) best qualifies for
evaluation. The brother and mother, although blood-type compatible, are outside of acceptable
age ranges for living donation. The minor son does not qualify based on blood type. - ANS-The
transplant clinic coordinator is evaluating relatives of a patient with end-stage renal disease,
whose blood type is A positive, for suitability as a living donor for kidney transplantation. Which
family member best qualifies for evaluation?
a.
A 65-year-old brother with a history of hypertension; blood type A positive
b.
A 35-year-old female with a history of food allergies; blood type O negative
c.
A 14-year-old son, otherwise healthy with no history; blood type B negative
d.
A 70-year-old mother, with a history of sinus infections; blood type A positive
Absence of a corneal reflex
Absence of a corneal reflex indicates altered brainstem activity and is a component used in the
clinical evaluation of brain death. Reactive pupils, withdrawal reaction to painful stimuli, and the
ability to maintain core temperature indicate brainstem activity. - ANS-The nurse is caring for a
patient who is being evaluated clinically for brain death by a physician. Which assessment
findings by the nurse support brain death?
a.
Absence of a corneal reflex
b.
Unequal, reactive pupils
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