NUR 2115 Exam 4
- how to calculate cardiac output
Answer
CO = SV x HR
- Mean Arterial Pressure (MAP)
Answer
MAP= SBP + 2(DBP) / 3 Normal= 70-105mmHg
Needs to be >65mmHg to perfuse ONLY the vital organs. THIS IS NOT NORMAL Use A line to measure
- Pulmonary Artery Catheter Pressures
Answer
PA pressures- (distal port) PAS= 15-30mmHg
PAD 8-15mmHg
4. SIRS
Answer
systemic inflammatory response syndrome. does not have to be associated with an infection.
- SIRS criteria 1 / 3
Answer
need 2 or more s/s
-temp >100.4, temp <96.8 -HR >90bpm -RR >20 and /or PCO2 <32 (rapid breathing) -WBC >12,000 or <4,000
- WOTF is not criteria s/s for dx SIRS
- RR > 20
- HR <60
- Temp >100.4
- PaCO2 <32
Answer
- HR <60 ANSWER
7. DIC
Answer
disseminated intravascular coagulation DEATH IS COMING
NO PERFUSION
They will have an increased D Dimer
- DIC clinical presentation
Answer
Acute bleeding from multiple sites. Bleeding from everywhere. Organ dysfunction, Thrombosis. 2 / 3
- DIC nursing management
Answer
- Occult blood testing of all fluids
- avoid puncturing the pt.
- Apply pressure 10-15 MIN for arterial puncture. 5MIN for venous puncture.
- paper tape
- No BP cuff. NEED AN A LINE
- No rectal temp
- gentle personal care
- dec. pressure points
- monitor pupils for changes- Could be cerebral bleed.
- WOTF lab value is indicative of DIC
- dec PTT
- inc Platelet
- dec INR
- inc FDP (fibrin degradation product)
Answer
- inc FDP (fibrin degradation product) ANSWER
- hypovolemic shock
Answer
TANK PROBLEM inadequate fluid volume in the space
- cardiogenic shock
Answer
PUMP PROBLEM
- / 3