Exam (elaborations)
NUR 213 Test 4 2024
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Exam of 16 pages for the course NUR 213 at NUR 213 (NUR 213 Test 4 2024)
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NUR 213 Test 4 2024DIC - Answers-Severe SIRS response --> sepsis can develop. Characterized by
simultaneous bleeding and clotting throughout the vasculature. Sepsis injures blood cells,
causing platelet aggregation and decreased blood flow --> blood clots form throughout
microcirculation. Clotting shows circulation further while stimulating excess fibrinolysis.
Body's stores of clotting factors depleted, generalized bleeding begins.
Watch for early signs of sepsis, infections from catheter and IV use are a major cause,
aseptic technique, immunization against organisms that cause PNA, hand washing techniques
- Answers-What are some ways to prevent sepsis?
Septic shock - Answers-Persistently low MAP as result of overwhelming infection despite
adequate fluid resuscitation
Refractory septic shock - Answers-Persistently low MAP despite vasopressor therapy and
adequate fluid resuscitation
Septicemia/Bacteremia - Answers-The presence of bacteria, pathogens, and toxins in the
blood
SIRS - Answers-The body's response to a critical illness that can result from an infectious
of noninfectious cause (burns, pancreatitis, trauma) precipitating a whole-body
inflammatory process
,Sepsis - Answers-SIRS resulting from an infections
Severe sepsis - Answers-sepsis with acute organ failure
Sepsis patho - Answers-Infection begins with pathogens/toxins in the blood. Pathogen cells
destroyed, toxins leak into plasma triggering inflammatory response, damaging blood
vessels. (kidneys and lungs more susceptible). Cellular damage triggers -->
-Peripheral vasodilation = hypotension
-Increased capillary permeability = hypovolemia
-Coagulation factors = multiple intravascular clots
Cellular oxygenation and metabolism affected.. may progress to septic shock, DIC, death.
Gram positive bacterial infections (Staph, strep) and gram negative bacterial infections
(pseudomonas, E.Coli) - Answers-What are causes of sepsis?
Urinary system (catheterization, suprapubics, cysto's)
Respiratory system (suctioning, aspiration, tracheostomy, endotracheal tubes, respiratory
therapy, mechanical ventilators)
GI system (peptic ulcers, ruptured appendix, peritonitis)
Integumentary system (surgical wounds, IV catheters, intra-arterial catheters, invasive
monitoring, decubitus ulcers, burns, trauma)
Female reproductive system (elective surgical abortions, ascending infections, tampon use,
STI's) - Answers-What are some portals of infection that lead to sepsis?
, Hospitalization, debilitating chronic illness, poor nutritional status, invasive procedures or
surgery, compromised immunity, children and/or elderly, chemo and radiation,
menstruation and improper tampon use - Answers-Sepsis risk factors?
Fever/hypothermia, tachycardia, tachypnea, peripheral vasodilation, septic shock, ALOC,
increased CO, abnormal CBC (leukocytosis or leukopenia), alteration in clotting factors
(thrombocytosis or thrombopenia), elevated liver enzymes, elevated creatinine, positive
blood cultures - Answers-What are clinical manifestations of sepsis?
temp instability, abd distention, poor feeding, lethargy, respiratory distress, hepatomegaly,
vomiting, jaundice - Answers-What are the clinical manifestations of sepsis in infants?
Children under 3 months of age - at increased risk d/t immature immune systems and
inadequate response to infection - Answers-What age group must require diagnostic testing
to R/o sepsis when experiencing a temp >100.4 rectally?
Thickened left ventricular wall, decreased elasticity of the myocardium, rigid valves -
Answers-What are cardiac changes that increase older adults risks or acquiring sepsis?
BP normal, pulse increased and thready, RR rapid and deep, skin warm and flushed, alert and
oriented but anxious, UO normal, increased body temp, chills, weakness, N&V, diarrhea,
decreased CVP - Answers-What are the manifestations of early (warm) septic shock?
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