Unit 6 Home Quiz

The nurse has been administering 0.9% Normal Saline (30ml/kg total) to a patient with a lactic acid of 9 mmol/L. To evaluate the effectiveness of the fluid bolus, which PHYSIOLOGICAL parameters would be MOST important for the nurse to assess?

Right atrial pressure and urine output.

Failure of which of the following organ systems results in the highest mortality? 

Neurologic

The nurse understands that when clots break down in a patient diagnosed with a hematological disorder, that which value will increase? 

Fibrin split products

Which aspect of assessment is the MOST important in a patient with a platelet count of 10,000/mm3?

Level of consciousness

A 45-year-old male is flown into the critical care unit as a direct admit from Kernville. He was hiking and sustained a rattle snake bite. The antivenom is being flown into the hospital from Fresno. He is bleeding from his IV insertion sites and continues seeping blood from the bite wound. Treatment for disseminated intravascular coagulation, in this particular case would include which of the following?

Clotting factors and antivenom

A patient is admitted to the Intensive Care Unit with a diagnosis of septic shock secondary to aspiration pneumonia. Within 24 hours hematuria, hemoptysis, petechiae and purpura, and oozing from IV sites and wounds are noted. Disseminated Intravascular Coagulation (DIC) is suspected. The laboratory findings MOST SPECIFICALLY indicative of DIC as the cause of bleeding are: 

Elevated fibrin degredation products and d-dimer

A 52 year old patient is admitted to the Intensive Care Unit with a massive GI Bleed. The patient has a history of alcohol abuse and variceal banding in the past. The patient has had multiple blood transfusions. The toxic effects of citrate in stored blood are caused by a fall in which electrolyte? 

Calcium

A 54 year old male is admitted to the ICU with a massive bleed from ruptured esophageal varices. The patient has a hemoglobin of 6 g/dL and hematocrit of 20%. BP 90/60mmHg, HR 124 (sinus tachycardia), RR 22 and shallow. The patient received 4 units of PRBCs in the ED and 4 more units of PRBCs are ordered. He will also need to receive:

Platelets

A 42 year old female is admitted with a deep vein thrombosis. The physician enters orders for the hospital's heparin drip protocol (DVT/PE pathway) with a bolus. If the patient develops heparin-induced thrombocytopenia (HIT), what clinical sign would the nurse expect to see first?

Petechiae

Bleeding in disseminated intravascular coagulation (DIC) results from:

Consumption of clotting factors