NU 431 Exam Questions and Answers
Example of Hypermetabolic States - Answer-Sepsis
Fever
Burns
Example of Catabolic State - Answer-Acute renal failures
Conditions that may cause patient to be malnourished - Answer-Chronic Cardiac
Pulmonary
Liver diseases
Major benifit of enteral nutrition - Answer-Preserves structure and function of digestion
Contraindications to enteral therapy - Answer-unable to/cannot pass NG
Leaking of gastric contents
UC
Bowel obstruction
Short bowel syndrome
Possible indications for parenteral therapy - Answer-Paralytic ileus
Diffuse peritonitis
Intestinal obstruction
Pancreatitits
GI Ischemia
Intractable vomiting/diarrhea
Potential causes of anxiety in an intensive care setting - Answer-Threat to physical
health
Loss of control
Foreign environment
Ways nurses can mediate and reduce anxiety - Answer-Encourage patient to express
concerns
Bring in personal items
Explain all procedures
Pharmacological/CAM interventions
Reasons why ICU patients may have impaired communications - Answer-Sedation
Head injury
Delirium
Encephalopathy
Intubation
Is sedation pain medicine? - Answer-no
,Percentage of ICU patients with moderate to severe unrelieved pain? - Answer-70%
Sedation Vacation - Answer-Daily weaning of sedation medications to see how patient
tolerates
Delirium - Answer-State of temporary but acute mental confusion
Percentage of patients in the ICU that experience delirium? - Answer-80%
Conditions that may increase the likelihood of a patient experiencing delirium - Answer-
Advanced age
Preexisting cognitive impairment
Sensory impairment
Drug/ETOH abuse
Sleep deprivation
Sensory Overload
Hemodynamic instability
Management of delirium in critically ill older adults - Answer-Frequent assessments
Remove cause
Avoid malnutrition
Avoid physical restraints
D/C all unnecessary lines
Management of sleep disruption in the ICU - Answer-Structure activities and rest
periods
Dim lights at night
Limit noise
Time medications/PRNS
Locked in Syndrome - Answer-Individual is aware and capable of thinking but is
paralyzed and cannot communicate
Guiding principles when interacting with the crucially ill adult's family - Answer-Offer
realistic hope
Give honest answers and information
Give reassurance
How many lives one organ donation may save - Answer-eight
Two automatic organ procurement rule outs - Answer-Systemic infection
Active cancer
Religions that do not support organ donation - Answer-buddhism
Some sects of Islam
, HOPE Act - Answer-Signed in 2015
Allows individuals with hepatitis C infection to donate
Clinical triggers to contact OPO - Answer-GCS less than 5
Evaluation for brain death
Plan to withdraw care
Severe neurologic injury is confirmed
> obvious head trauma, poor neurodiagnostics, MD determination of brain stem reflexes
Organ Procurement Organization (OPO) - Answer-Facilitate the organ donation process
by assessing in-hospital deaths for donor eligibility
Consulting with families of potential donors; and retrieving, preserving and transporting
organs for transplantation
First Person Authorization - Answer-A person's legally binding decision to become an
organ and/or tissue donor after their death
Age at which someone may authorize an FPA for organ donation - Answer-15.5 Can be
overturned by a legal guardian until 18
Chain of command for consent for OPO - Answer-MPOA
Spouse
Oldest adult child
Parent
Oldest living sibling
What is a living donation? - Answer-Organ donor is alive
1 kidney
1 lobe of liver
1 lung
part of pancreas/intestines
Tissue
Donation after circulatory death - Answer-Patient does not meet criteria for brain death,
but has poor prognosis for meaningful existence
Typically withdrawn from life support
How long must a heart be stopped after extubation for OPO process to begin? -
Answer-5 consecutive minutes
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