{"id":131283,"date":"2024-01-11T07:51:57","date_gmt":"2024-01-11T07:51:57","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=131283"},"modified":"2024-01-11T07:51:59","modified_gmt":"2024-01-11T07:51:59","slug":"exam-1-nsg233-nsg-233-latest-2023-2024-update-med-surg-3-exam-questions-and-verified-answers-100-correct-grade-a-herzing","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2024\/01\/11\/exam-1-nsg233-nsg-233-latest-2023-2024-update-med-surg-3-exam-questions-and-verified-answers-100-correct-grade-a-herzing\/","title":{"rendered":"Exam 1: NSG233\/ NSG 233 (Latest 2023\/ 2024 Update) Med Surg 3 Exam| Questions and Verified Answers| 100% Correct| Grade A- Herzing"},"content":{"rendered":"\n<p>Exam 1: NSG233\/ NSG 233 (Latest 2023\/ 2024 Update) Med Surg 3 Exam| Questions and Verified Answers| 100% Correct| Grade A- Herzing<\/p>\n\n\n\n<p>Exam 1: NSG233\/ NSG 233 (Latest 2023\/<br>2024 Update) Med Surg 3 Exam| Questions<br>and Verified Answers| 100% Correct| Grade<br>A- Herzing<br>Q: what will the SPO2 of a Carbon Dioxide Poision pt look like<br>Answer:<br>it will be Nl<br>Q: whats does Hypothermia put pt&#8217;s at risk for?<br>Answer:<br>hypoxia<br>acidosis<br>dysrhythmias<br>Q: a pt w\/ dysrhythmias secondary to hypothermia is having secondary v-fib, what should RN<br>know?<br>Answer:<br>pt must be rewarmed to &gt;90F (32.2c) prior to defibrillation!!!!!<br>Q: who all is screened in IPV?<br>Answer:<br>q pt.<br>ask &#8220;do you feel safe at home?&#8221;<\/p>\n\n\n\n<p>Q: whats the pt w\/ Compensatory Shock look like?<br>Answer:<br>Normal BP<br>tachycardia<br>tachypneic<br>PaCO2&lt;32 cold, clammy confused\/agitated respiratory alkalosis Q: whats Compensatory Shock? Answer: first phase of shock, pt is able to maintain fluid vol, normal BP Q: whats Progressive Shock? Answer: shocks begins to fail to meet metabolic needs bp starts to lower Q: whats the pt w\/ progressive Shock look like? Answer: systolic &lt;90 MAP &lt;65 NEEDS fluid for BP TACHYYY &gt;150<br>rapid, shallow RR<br>crackles<br>mottled, petechiae<br>lethargic<\/p>\n\n\n\n<p>metabolic acidosis<br>Q: whats the pt w\/ irreversible Shock look like?<br>Answer:<br>REQUIRES MECHANICAL \/ PHARMACOLOGIC SUPPORT<br>erratic<br>REQUIRES INTUBATION\/MECH VENT<br>jaundice<br>anuric &#8211; requires dialysis<br>profound acidosis<br>Q: whats MODS<br>Answer:<br>Multiple organ dysfunction syndrome<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>altered organ function in acutely ill pt, requires mech vent for organ support<br>-can be a complication of shock<br>-common in sepsis pt<br>Q: how do you assess a MODS pt?<br>Answer:<br>tools such as APACHE, SAPS, PIRO, SOFA<br>Q: what can cause hypovolemic shock?<br>Answer:<br>external fluid loss &#8211; traumatic blood loss<br>internal fluid shifts &#8211; severe dehydration , severe edema, ascites<br>get pdf at<strong> <a href=\"https:\/\/learnexams.com\/search\/study?query=\" target=\"_blank\" rel=\"noopener\">learnexams.com<\/a><\/strong><\/li>\n<\/ul>\n\n\n\n<p>whats the order of tx of hypovolemic shock?<br>1-stop fluid loss!!<br>2- place 2 Lg bore IV (18 gauge)<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"3\">\n<li>admin 0.9%NS (isotonic), whole blood or PRBC.<br>MUST WARM FLUIDS W\/ MASSIVE TRANSFUSION D\/T HYPOTHERMIA RISK.<\/li>\n<\/ol>\n\n\n\n<p>what position should a hypovolemic shock pt be in?<br>modified Trendelenburg &#8211; restores intravascular volume<\/p>\n\n\n\n<p>pt is undergoing hypovolemic shock d\/t a hemorrhage, what should rn do to treat underlying cause?<br>Stop bleed &#8211; pressure.<\/p>\n\n\n\n<p>pt is undergoing hypovolemic shock d\/t severe NVD, what should rn do to treat underlying cause?<br>give meds to stop NVD<\/p>\n\n\n\n<p>what types of fluids are administered to a hypovolemic pt?<br>NS<br>LR<br>albumin<br>plasma\/ RBC<\/p>\n\n\n\n<p>pt comes in w\/ poisoning. whats the most important for RN to maintain?<br>airway stabilization<\/p>\n\n\n\n<p>whats the s\/s of carbon dioxide poisoning?<br>headache<br>dizzy<br>confused<br>palpations<br>muscle weakness<br>intoxication coma<br>death<\/p>\n\n\n\n<p>whats the priority nursing assessment for a pt w\/ carbon dioxide poisoning?<br>access carboxyhemoglobin levels<\/p>\n\n\n\n<p>what will the SPO2 of a Carbon Dioxide Poision pt look like<br>it will be Nl<\/p>\n\n\n\n<p>whats does Hypothermia put pt&#8217;s at risk for?<br>hypoxia<br>acidosis<br>dysrhythmias<\/p>\n\n\n\n<p>a pt w\/ dysrhythmias secondary to hypothermia is having secondary v-fib, what should RN know?<br>pt must be rewarmed to &gt;90F (32.2c) prior to defibrillation!!!!!<\/p>\n\n\n\n<p>who all is screened in IPV?<br>q pt.<br>ask &#8220;do you feel safe at home?&#8221;<\/p>\n\n\n\n<p>whats the pt w\/ Compensatory Shock look like?<br>Normal BP<br>tachycardia<br>tachypneic<br>PaCO2&lt;32<br>cold, clammy<br>confused\/agitated<br>respiratory alkalosis<\/p>\n\n\n\n<p>whats Compensatory Shock?<br>first phase of shock,<br>pt is able to maintain fluid vol, normal BP<\/p>\n\n\n\n<p>whats Progressive Shock?<br>shocks begins to fail to meet metabolic needs<br>bp starts to lower<\/p>\n\n\n\n<p>whats the pt w\/ progressive Shock look like?<br>systolic &lt;90 MAP &lt;65 NEEDS fluid for BP TACHYYY &gt;150<br>rapid, shallow RR<br>crackles<br>mottled, petechiae<br>lethargic<br>metabolic acidosis<\/p>\n\n\n\n<p>whats the pt w\/ irreversible Shock look like?<br>REQUIRES MECHANICAL \/ PHARMACOLOGIC SUPPORT<br>erratic<br>REQUIRES INTUBATION\/MECH VENT<br>jaundice<br>anuric &#8211; requires dialysis<br>profound acidosis<\/p>\n\n\n\n<p>whats MODS<br>Multiple organ dysfunction syndrome<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>altered organ function in acutely ill pt, requires mech vent for organ support<br>-can be a complication of shock<br>-common in sepsis pt<\/li>\n<\/ul>\n\n\n\n<p>how do you assess a MODS pt?<br>tools such as APACHE, SAPS, PIRO, SOFA<\/p>\n\n\n\n<p>what can cause hypovolemic shock?<br>external fluid loss &#8211; traumatic blood loss<br>internal fluid shifts &#8211; severe dehydration , severe edema, ascites<\/p>\n\n\n\n<p>what does a hypovolemic shock pt look like?<br>low intravascular volume<br>low Venus return<br>low stroke vol<br>low CO<br>low tissue perfusion<\/p>\n\n\n\n<p>what can cause neurogenic shock?<br>spinal cord injury<br>spinal anesthesia<br>other CNS damage<br>depressant action of meds<br>lack of glucose &#8211; insulin<\/p>\n\n\n\n<p>whats neurogenic shock?<br>Normally, during states of stress, the sympathetic stimulation causes the BP and HR to increase.<br>In neurogenic shock, the sympathetic system is not able to respond to body stressors = opposite CM<\/p>\n\n\n\n<p>clinical manifestations of neurogenic shock?<br>sx of parasympathetic stimulation<br>dry, warm skin<br>hypotension w\/ bradycardia<\/p>\n\n\n\n<p>whats the medication TX of anaphylactic shock?<br>IM\/ SCepinephrine &#8211; FIRST TX LINE<br>1:1,000 CONCENTRATION<br>NEVER IV<\/p>\n\n\n\n<p>Diphenhydramine (Benadryl) &#8211; given IV &#8211; reverse effects<br>Albuterol (Proventil) &#8211; may given to reverse histamine induced bronchospasm<\/p>\n\n\n\n<p>whats the medical TX of neurogenic shock?<br>goal: -restoring sympathetic tone via spinal stabilization or proper positioning<br>-prevent further damage<br>-maintain patent airway<br>cautious fluid resuscitation<br>vasopressors = increase bp<br>atropine = increase HR<\/p>\n\n\n\n<p>whats the medical TX of septicemia?<br>collect blood culture<br>broad spectrum IV antibiotics until organism identified<br>fluid first for hypotension &#8211; usually 0.9% NS<br>-vasopressors for pt non responsive to fluids<br>anticoagulants &#8211; prevent DIC<\/p>\n\n\n\n<p>whats the medical TX of cariogenic shock?<br>fix cause &#8211; ex: stent placement<br>tx like HF = decrease workload<br>decrease preload = diuretics<br>decrease SVR = arterial vasodilation<br>decrease HR<br>(digoxin, beta blocker)<br>increase contractibility (digoxin, dopamine)<\/p>\n\n\n\n<p>whats a pt w\/ shock look like? overall.<br>increased RR<br>decreased BP<br>Increased HR<br>Decreased urine output<br>increased blood sugar<br>cool, clammy skin<\/p>\n\n\n\n<p>whats the interventions RN can due to help w\/ family of shock pt?<br>keep informed<br>encourage fam to stay w pt<br>Allowing family presence in the critical care areas of the hospital enhances the family role and builds trust in the caregivers<\/p>\n\n\n\n<p>how can an RN help w family cope w sudden death of pt<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>quiet location<\/li>\n\n\n\n<li>take whole fm together<br>-reassure everything possible was done<br>-avoid using &#8220;passed on&#8221;<br>-use touch, offer coffee, water, Chaplin services<br>-encourage family support<br>-advoid giving sedation to fam member<br>-encourage viewing pt if desired<br>-cover misconfigured \/ injury areas on pt<br>-go w fam to see pt \/ dont leave fam alone<br>-allow fam to touch pt<br>-spend time w fam, listen to them<br>-encourage talking<br>-avoid unnecessary info<\/li>\n<\/ul>\n\n\n\n<p>whats CISM<br>critical incident stress management<br>facilitates healthy coping<br>3 steps :defusing, debriefing, and follow up<\/p>\n\n\n\n<p>describe the Defusing process in CISM.<br>immediately post critical incident<br>-staff encouraged to discuss feelings<br>-contact info to talk to someone<\/p>\n\n\n\n<p>describe the debriefing process in CISM.<br>participating staff are encouraged to discuss their feelings about the incident and are reassured that their negative reactions and feelings are normal and that their negative feelings will diminish over time.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>by the end of this step : should feel closure<\/li>\n<\/ul>\n\n\n\n<p>describe the follow-up process in CISM.<br>Follow-up may occur after the debriefing session is completed for those participants who have persistent negative symptoms and may consist of continued individual or group counseling and therapy<\/p>\n\n\n\n<p>describe the ESI for triaging pt&#8217;s<br>level 1: urgent<br>level 5: lease urgent<br>based on patient acuity and resources needed.<\/p>\n\n\n\n<p>whats the responsibilities of triage nurse?<br>pt assessment &amp; reassessment<br>initiate emergency tx prn<br>manage\/ communicate pt in waiting room<br>provide edu<br>sort pt into priory group<br>transport pt to appropriate tx area<\/p>\n\n\n\n<p>whats the goals for pt w\/ hemorrhage<br>control bleed<br>maintain adequate blood vol of tissue oxygenation<br>prevent shock<\/p>\n\n\n\n<p>whats the antidote for warfarin<br>vit K<\/p>\n\n\n\n<p>What&#8217;s the antidote for heparin?<br>protamine sulfate<\/p>\n\n\n\n<p>whats a pt w heat exhaustion look like?<br>high body temp accompanied w\/ :<br>headache<br>anxiety<br>syncope<br>profuse diaphoresis<br>gooseflesh<br>orthostasis<\/p>\n\n\n\n<p>what position should a heat exhaustion pt be in?<br>supine in cool environment<\/p>\n\n\n\n<p>how are fluids given to heat exhaustion pt ?<br>IV<br>Po &#8211; if tolerated &#8211; sodium supplement &amp; electrolytes<\/p>\n\n\n\n<p>whats the goal for a frost bite pt?<br>restore nl body temp<br>-Constrictive clothing\/jewelry are removed, remove wet clothes<br>if involving lower extremities &#8211; dont allow ambulation.<\/p>\n\n\n\n<p>whats the medical tx for frost bite pt?<br>controlled, rapid rewarming<br>frozen extremities placed in 37-40C bath for 30-40 mins<br>analgesics given -rewarming can be painful<br>dont handle altered body part<br>once rewarmed : protect\/prevent further injury, elevated. sterile gauze\/cotton placed between affected phalanges = prevents maceration, bulky dressing placed.<\/p>\n\n\n\n<p>whats frost bite?<br>trauma d\/t freezing temperatures and freezing of the intracellular fluid and fluids in the intercellular spaces.<br>results in cellular and vascular damage<br>may result in venous stasis and thrombosis<\/p>\n\n\n\n<p>what body parts are commonly affected by frost bite?<br>feet<br>hands<br>nose<br>ears<\/p>\n\n\n\n<p>how are frost bite degrees labeled?<br>1 degree : numbness, redness<br>2 degree :blistering, no major damage<br>3 degree: all skin layers &#8211; permanent damage<br>4 degree : full depth tissue destruction<\/p>\n\n\n\n<p>whats Nonfatal drowning?<br>survival for at least 24H post submersion that caused respiratory arrest.<br>common consequence = hypoxia<\/p>\n\n\n\n<p>whats Corrosive poison?<br>alkaline and acid agents that can cause tissue destruction after coming in contact with mucous membranes.<\/p>\n\n\n\n<p>nursing management for poisoning pt.<br>control airway, ventilation, O2<br>determine substance ingested, amount, time since ingested<br>s\/s<br>age, wt<br>health hx<br>Gastric lavage<br>actived charcoal<\/p>\n\n\n\n<p>how is Gastric Lavage Use in pt who Ingested Poisons?<br>only useful within 1 hour of ingestion, sustained-release substances, or massive life-threatening amounts of a substance.<\/p>\n\n\n\n<p>why is gastric aspirate said &amp; sent to the lab?<br>for toxicology screenings<\/p>\n\n\n\n<p>how is activated charcoal administered?<br>PO or NGT<br>small intermittent doses to decrease vomiting<br>should be diluted as a slurry &#8211; easier to drink<\/p>\n\n\n\n<p>what potions can&#8217;t be used w activated charcoal?<br>corrosives<br>heavy metals<br>hydrocarbons<br>ions<br>lithium<\/p>\n\n\n\n<p>why is potassium administered w\/ or after meals?<br>decreases gastric irritation<\/p>\n\n\n\n<p>how to administer potassium<br>mix orals liquids, powders, and effervescent tablets in atheist 120ml of water, juice or carbonated beverages<\/p>\n\n\n\n<p>when is IV K+ indicated?<br>cannot take PO<br>severe hypokalemia<br>rn establishes adequate urine output<br>never give undiluted via IV<\/p>\n\n\n\n<p>the the goals of pts undergoing alcohol withdrawal?<br>adequate sedation- usually via benzoos<br>pt rest &amp; recover w\/o injury to peripheral vascular damage<\/p>\n\n\n\n<p>why is a drug Hx required for pts undergoing alcohol withdrawal?<br>to elicit information that may facilitate adjustment of any sedative requirements.<\/p>\n\n\n\n<p>whats the purpose of bentos in a pt w\/ alcohol withdrawal<br>reduce agitation<br>prevent exhaustion<br>prevent seizures<br>promote sleep<\/p>\n\n\n\n<p>meds given to alcohol withdrawal patients?<br>lorazepam<br>Haloperidol<br>esmolol<\/p>\n\n\n\n<p>whats the main goal of tx for a pt w a wound?<br>restore physical integrity and function to injured tissue while minimizing scarring and preventing infection<\/p>\n\n\n\n<p>what should a documented wound look like in a chart?<br>photographs &#8211; especially for DM case<br>size, color, shape, drainage, depth<br>when\/how wound happened<\/p>\n\n\n\n<p>why is it important to determine when a wound occurred?<br>tx delay = increased infection risk<\/p>\n\n\n\n<p>what the aspects of a wound assessment?<br>inspection<br>extend of damage \/ presence of foreign body<br>sensory motor ad vascular function<\/p>\n\n\n\n<p>laceration<br>skin tear w irregular edges &amp; vein bridging<\/p>\n\n\n\n<p>avulsion<br>tearing away of tissue from supporting structures<\/p>\n\n\n\n<p>abrasion<br>denuded skin<\/p>\n\n\n\n<p>ecchymosis\/ contusion<br>blood trapped under skin &#8211; bruise<\/p>\n\n\n\n<p>hematoma<br>tumorlike mass of blood under skin<\/p>\n\n\n\n<p>stab<br>incision. of skin w well defined edges<br>usually by sharp object<br>typically deeper than is long<\/p>\n\n\n\n<p>cut wound<br>incision of the skin with well-defined edges<br>usually longer than deep<\/p>\n\n\n\n<p>patterned wound<br>wound represents outline of an object<\/p>\n\n\n\n<p>whats the nursing management of hypothermic patients<br>remove wet clothing<br>continuous monitoring<br>rewarming &#8211; active internal &amp; passive external<br>supportive care<br>monitor ABC<br>monitor core body temp via esophageal, rectal or bladder<\/p>\n\n\n\n<p>what is supportive care in a pt w hypothermia?<br>external cardiac compression<br>defibrillation of ventricular fibrillation (pt w temp under 90F has spontaneous Vfib)<br>mechanical vent &amp; heated humidified oxygen<br>administer iv fluids<br>administer sodium bicarb<br>anti arrhythmic meds<br>inser cath<\/p>\n\n\n\n<p>what does the administration of warmed IV fluids correct in a hypothermic pt?<br>corrects hypotension<br>maintain urine output maintain core rewarming<\/p>\n\n\n\n<p>whats the purpose of administering sodium bicarb to a hypothermic pt?<br>correct metabolic acidosis PRN<\/p>\n\n\n\n<p>why do we insert indwelling catheters in hypothermic pts?<br>to monitor urinary output and kidney function<\/p>\n\n\n\n<p>When is active rewarming used and give examples of what it is?<br>moderate &#8211; severe hypothermia<br>less than 28\u00b0C to 32.2\u00b0C [82.5\u00b0F to 90\u00b0F])<br>cardiopulmonary bypass<br>warm fluids<br>warmed humidified o2<br>warmed peritoneal lavage<\/p>\n\n\n\n<p>When is passive rewarming used and give examples of what it is?<br>mild hypothermia<br>32.2\u00b0C to 35\u00b0C [90\u00b0F to 95\u00b0F]).<br>over the bed heaters<br>warming blankets<\/p>\n\n\n\n<p>why might pts w mild hypothermia experience dysrhythmias or electrolyte disturbances?<br>cold blood from peripheral tissues has high lactic acid levels<br>so when blood goes to core = decreased core temp<br>= dysthymia and electrolyte disturbance<\/p>\n\n\n\n<p>whats decompression sickness?<br>AKA &#8220;the bends&#8221;<br>occurs in pt who engaged in high diving or high altitude flying<\/p>\n\n\n\n<p>nursing tx for decompression sickness?<br>patent airway and adequate ventilation<br>100% o2<br>chest xray for aspiration<br>start 1 IV line w LR or NS<\/p>\n\n\n\n<p>s\/s of decompression sickness<br>joint\/extremity pain<br>numbness<br>hypesthesia<br>loss of ROM<br>neurologic sx mimic those of a stroke &#8211; indicating an air embolus<br>&#8212; transfer pt to hyperbaric chamber<\/p>\n\n\n\n<p>when is Antivenin most effective?\/<br>given within 4 -12 hour after snakebite<br>assess circumference of affect part q 15 mins<\/p>\n\n\n\n<p>whats the premedication of Antivenin<br>Benadryl or cimetidine<br>-antihistamines decrease allergic response<\/p>\n\n\n\n<p>how to administer Antivenin<br>premeditate<br>give within 4-12 hours<br>give Antivenin via IV infusion ( sometimes IM)<br>may be diluted in 500-1000ml of NS<br>infuse slowly, increase rate after 10 mins if no reaction<br>total dose infused after first 4-6 hours post bite<br>no limit of how many Antivenin vials to give<\/p>\n\n\n\n<p>whats the three stages of Lyme disease<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>bulls-eye rash -5cm w red borders &#8211; erythema migrans typically in axilla groin or thigh within 4 wk of tick bite. accompanied w flu like sx.<\/li>\n\n\n\n<li>stage 2 occurs is antibiotics not initiated. within 4-10wks. sx of joint pain memory loss poor motor function and cardiac abnormalities. facial nerve palsy most common sx.<\/li>\n\n\n\n<li>weeks- years post bite. long term affects such as arthritis, neuropathy. 10-20% of pt experience this even w proper tx.<\/li>\n<\/ol>\n\n\n\n<p>whats flail chest frequently a complication of ?<br>blunt trauma from steering wheel<\/p>\n\n\n\n<p>describe flail chest<br>3 + adjacent ribs fractured at 2+ sites resulting in free floating rib segments.<br>during inspiration detached rib moves paradoxical manner, pulling inward, reducing amount of air inhaled. on expiration, flail segment bulges outward.<\/p>\n\n\n\n<p>s\/s of Pneumothorax<br>depend on size\/cause<br>pain sudden and pleuritic<br>minimal respiratory distress w slight chest discomfort &amp; tachypnea w a small\/uncomplicated Pneumothorax.<br>large Pneumothorax = ARDS, axioms, air hungry, dyspnea, use of accessory muscle , cyanosis<\/p>\n\n\n\n<p>assessing Pneumothorax<br>tracheal alignment<br>expansion of the chest<br>breath sounds<br>percussion of the chest.<br>simple Pneumothorax = midline trachea, chest expansion decreased , diminished breath sounds<\/p>\n\n\n\n<p>goal of Pneumothorax<br>The goal of treatment is to evacuate the air or blood from the pleural space.<\/p>\n\n\n\n<p>medical Tx of Pneumothorax<br>chest tube (28 Fr) is inserted near the second intercostal space; this space is used because it is the thinnest part of the chest wall, minimizes the danger of contacting the thoracic nerve, and leaves a less visible scar.<br>tube is directed posteriorly to drain the fluid and air<br>then suction applied<\/p>\n\n\n\n<p>whats a simple Pneumothorax<br>spontaneous Pneumothorax<br>air enters plural space through a breach of parietal or pleura<br>commonly &#8211; rupture of a bleb<\/p>\n\n\n\n<p>whats a Traumatic Pneumothorax<br>air escapes from a laceration in the lung itself and enters the pleural space or from a wound in the chest wall.<\/p>\n\n\n\n<p>whats Tension Pneumothorax<br>air is drawn into the pleural space from a lacerated lung or through a small opening or wound in the chest wall.<br>could be complications of another Pneumothorax<\/p>\n\n\n\n<p>whats PCA Pump<br>patient-controlled analgesia<br>any method that allows a person in pain to administer his or her own pain relief.<br>commonly IV morphine bolus<\/p>\n\n\n\n<p>considering for a PCA pump<br>cognitive assessment<br>LOC<br>developmental status<br>assess pt\/ fam teaching about pain management<br>is pt opioid tolerant? (pt taking 60mg + morphine for 1 week+)<br>asses pain level<br>sedation assessment via RASS<br>respiratory assessment<br>o2 sat<\/p>\n\n\n\n<p>what should an RN observe a crush injury pt for\/<br>hypovolemic shock dt extravasation of blood into injured tissues once compression was released<br>spinal cord injury<br>erythema<br>fractures<br>acute kidney injury<\/p>\n\n\n\n<p>what causes septic shock<br>invading organisms<\/p>\n\n\n\n<p>whats a septic pt look like<br>proinflammatory cytokinesLeads to Systemic Inflammatory Response Syndrome<br>= low bp decreased co, tissue perfusion, impaired cellular metabolism<\/p>\n\n\n\n<p>whats the Compensatory Stage of Shock<br>mild decrease in BP triggers RAAS system to compensate<br>increases epinephrine\/ norepinephrine<br>Adrenals also release cortisol = increase glucose<br>adrenal glands to release renin &amp; aldosterone = fluid \/ NA retention = increasing BP<\/p>\n\n\n\n<p>whats the Progressive Stage of Shock<br>bp low enough body can&#8217;t compensate<br>lack of o2 to muscle = heart ischemia<br>increased capillary leakage = hypovolemia, fluid overload<br>high metabolic demand = metabolic acidosis<\/p>\n\n\n\n<p>whats the Irreversible Stage of Shock<br>profund hypotension hypoxia and acidosis<br>needs mechanical vent<br>MODS<br>recovery unlikely<br>plan for end of life w fam<\/p>\n\n\n\n<p>nursing interventions in the tx of septic shock<br>collect blood culture<br>broad spectrum IV until organism identified then switch to narrow<br>fluid for hypotension<br>add vasopressors for shock<br>anticoagulants prevent DIC<\/p>\n\n\n\n<p>Inotropic Medications<br>DobutamineDopamine<br>Epinephrine<br>Milrinone<br>Improve contractility, increase stroke volume, increase cardiac output<\/p>\n\n\n\n<p>Vasodilators<br>Nitroglucerine<br>Nitroprusside<br>Reduce preload and afterload, reduce oxygen demand of the heart<br>can cause hypotension<\/p>\n\n\n\n<p>vasopressors<br>Norepinephrine<br>Dopamine<br>Phenylephrine<br>Vasopressin<br>Epinephrine<br>increase blood pressure<\/p>\n\n\n\n<p>what are abnormal carboxyhemoglobin levels?<br>nonsmokers: &gt;2%<br>smokers : &gt;9%<\/p>\n\n\n\n<p>Rhabdomyolysis<br>Destroyed skeletal muscle cells empty contents into circulation, causing kidney problemsS\/S: muscle pain &amp; weakness, elevated CK, dark brown urineCan lead to acute kidney failure (Tx: Fluids)<\/p>\n\n\n\n<p>septicima<br>growth of bacteria in the blood<\/p>\n\n\n\n<p>Intra-abdominal injury care<br>Risk for hemorrhage &#8211; monitor for shockLiver &#8211; right shoulder painSpleen &#8211; left shoulder painIf stable &#8211;&gt; CTIf unstable &#8211;&gt; FAST exam (focused assessment with sonography for trauma)Management: ABCs, C-spine precautions, NPO, antibiotics\/tetanus, monitoring, surgery PRN<\/p>\n\n\n\n<p>Sepsis<br>Life threatening response to septicemia<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Exam 1: NSG233\/ NSG 233 (Latest 2023\/ 2024 Update) Med Surg 3 Exam| Questions and Verified Answers| 100% Correct| Grade A- Herzing Exam 1: NSG233\/ NSG 233 (Latest 2023\/2024 Update) Med Surg 3 Exam| Questionsand Verified Answers| 100% Correct| GradeA- HerzingQ: what will the SPO2 of a Carbon Dioxide Poision pt look likeAnswer:it will be [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-131283","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/131283","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=131283"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/131283\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=131283"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=131283"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=131283"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}