NSG 316 MEDICAL SURGICAL 3 FINAL EXAM ()|VERIFIED EXAM QUESTIONS AND CORRECT ANSWERS ALL GRADED A+|GURANTEED SUCCESS|Herzing
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NSG 316 MEDICAL SURGICAL 3
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NSG 316 MEDICAL SURGICAL 3
NSG 316 MEDICAL SURGICAL 3 FINAL EXAM ()|VERIFIED EXAM QUESTIONS AND CORRECT ANSWERS ALL GRADED A+|GURANTEED SUCCESS|Herzing
whats the order of tx of hypovolemic shock? - ANSWER-1-stop fluid loss!!
2- place 2 Lg bore IV (18 gauge)
3. admin 0.9%NS (isotonic), whole blood or PRBC.
MUST WARM...
NSG 316 MEDICAL
SURGICAL 3 FINAL EXAM
(2024-2025)|VERIFIED
EXAM QUESTIONS AND
CORRECT ANSWERS ALL
GRADED A+|GURANTEED
SUCCESS|Herzing
whats the order of tx of hypovolemic shock? - ANSWER-✅1-stop fluid loss!!
2- place 2 Lg bore IV (18 gauge)
3. admin 0.9%NS (isotonic), whole blood or PRBC.
MUST WARM FLUIDS W/ MASSIVE TRANSFUSION D/T HYPOTHERMIA RISK.;what
position should a hypovolemic shock pt be in? - ANSWER-✅modified Trendelenburg
- restores intravascular volume;pt is undergoing hypovolemic shock d/t a
hemorrhage, what should rn do to treat underlying cause? - ANSWER-✅Stop bleed -
pressure.;pt is undergoing hypovolemic shock d/t severe NVD, what should rn do to
treat underlying cause? - ANSWER-✅give meds to stop NVD;what types of fluids are
administered to a hypovolemic pt? - ANSWER-✅NS
LR
albumin
plasma/ RBC;pt comes in w/ poisoning. whats the most important for RN to maintain?
- ANSWER-✅airway stabilization;whats the s/s of carbon dioxide poisoning? -
ANSWER-✅headache
dizzy
confused
palpations
muscle weakness
,intoxication coma
death;whats the priority nursing assessment for a pt w/ carbon dioxide poisoning? -
ANSWER-✅access carboxyhemoglobin levels;what will the SPO2 of a Carbon Dioxide
Poision pt look like - ANSWER-✅it will be Nl;whats does Hypothermia put pt's at risk
for? - ANSWER-✅hypoxia
acidosis
dysrhythmias;a pt w/ dysrhythmias secondary to hypothermia is having secondary v-
fib, what should RN know? - ANSWER-✅pt must be rewarmed to >90F (32.2c) prior
to defibrillation!!!!!;who all is screened in IPV? - ANSWER-✅q pt.
ask "do you feel safe at home?";whats the pt w/ Compensatory Shock look like? -
ANSWER-✅Normal BP
tachycardia
tachypneic
PaCO2<32
cold, clammy
confused/agitated
respiratory alkalosis;whats Compensatory Shock? - ANSWER-✅first phase of shock,
pt is able to maintain fluid vol, normal BP;whats Progressive Shock? - ANSWER-
✅shocks begins to fail to meet metabolic needs
bp starts to lower;whats the pt w/ progressive Shock look like? - ANSWER-✅systolic
<90
MAP <65
NEEDS fluid for BP
TACHYYY >150
rapid, shallow RR
crackles
mottled, petechiae
lethargic
metabolic acidosis;whats the pt w/ irreversible Shock look like? - ANSWER-
✅REQUIRES MECHANICAL / PHARMACOLOGIC SUPPORT
erratic
REQUIRES INTUBATION/MECH VENT
jaundice
anuric - requires dialysis
profound acidosis;whats MODS - ANSWER-✅Multiple organ dysfunction syndrome
- altered organ function in acutely ill pt, requires mech vent for organ support
-can be a complication of shock
-common in sepsis pt;how do you assess a MODS pt? - ANSWER-✅tools such as
APACHE, SAPS, PIRO, SOFA;what can cause hypovolemic shock? - ANSWER-
✅external fluid loss - traumatic blood loss
internal fluid shifts - severe dehydration , severe edema, ascites;what does a
hypovolemic shock pt look like? - ANSWER-✅low intravascular volume
low Venus return
low stroke vol
low CO
low tissue perfusion;what can cause neurogenic shock? - ANSWER-✅spinal cord
injury
,spinal anesthesia
other CNS damage
depressant action of meds
lack of glucose - insulin;whats neurogenic shock? - ANSWER-✅Normally, during
states of stress, the sympathetic stimulation causes the BP and HR to increase.
In neurogenic shock, the sympathetic system is not able to respond to body stressors
= opposite CM;clinical manifestations of neurogenic shock? - ANSWER-✅sx of
parasympathetic stimulation
dry, warm skin
hypotension w/ bradycardia;whats the medication TX of anaphylactic shock? -
ANSWER-✅IM/ SCepinephrine - FIRST TX LINE
1:1,000 CONCENTRATION
NEVER IV
Diphenhydramine (Benadryl) - given IV - reverse effects
Albuterol (Proventil) - may given to reverse histamine induced bronchospasm;whats
the medical TX of neurogenic shock? - ANSWER-✅goal: -restoring sympathetic tone
via spinal stabilization or proper positioning
-prevent further damage
-maintain patent airway
cautious fluid resuscitation
vasopressors = increase bp
atropine = increase HR;whats the medical TX of septicemia? - ANSWER-✅collect
blood culture
broad spectrum IV antibiotics until organism identified
fluid first for hypotension - usually 0.9% NS
-vasopressors for pt non responsive to fluids
anticoagulants - prevent DIC;whats the medical TX of cariogenic shock? - ANSWER-
✅fix cause - ex: stent placement
tx like HF = decrease workload
decrease preload = diuretics
decrease SVR = arterial vasodilation
decrease HR
(digoxin, beta blocker)
increase contractibility (digoxin, dopamine);whats a pt w/ shock look like? overall. -
ANSWER-✅increased RR
decreased BP
Increased HR
Decreased urine output
increased blood sugar
cool, clammy skin;whats the interventions RN can due to help w/ family of shock pt?
- ANSWER-✅keep informed
encourage fam to stay w pt
Allowing family presence in the critical care areas of the hospital enhances the family
role and builds trust in the caregivers;how can an RN help w family cope w sudden
death of pt - ANSWER-✅- quiet location
- take whole fm together
, -reassure everything possible was done
-avoid using "passed on"
-use touch, offer coffee, water, Chaplin services
-encourage family support
-advoid giving sedation to fam member
-encourage viewing pt if desired
-cover misconfigured / injury areas on pt
-go w fam to see pt / dont leave fam alone
-allow fam to touch pt
-spend time w fam, listen to them
-encourage talking
-avoid unnecessary info;whats CISM - ANSWER-✅critical incident stress
management
facilitates healthy coping
3 steps :defusing, debriefing, and follow up;describe the Defusing process in CISM. -
ANSWER-✅immediately post critical incident
-staff encouraged to discuss feelings
-contact info to talk to someone;describe the debriefing process in CISM. - ANSWER-
✅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.
- by the end of this step : should feel closure;describe the follow-up process in CISM.
- ANSWER-✅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;describe the ESI for triaging pt's -
ANSWER-✅level 1: urgent
level 5: lease urgent
based on patient acuity and resources needed.;whats the responsibilities of triage
nurse? - ANSWER-✅pt assessment & reassessment
initiate emergency tx prn
manage/ communicate pt in waiting room
provide edu
sort pt into priory group
transport pt to appropriate tx area;whats the goals for pt w/ hemorrhage - ANSWER-
✅control bleed
maintain adequate blood vol of tissue oxygenation
prevent shock;whats the antidote for warfarin - ANSWER-✅vit K;What's the antidote
for heparin? - ANSWER-✅protamine sulfate;whats a pt w heat exhaustion look like?
- ANSWER-✅high body temp accompanied w/ :
headache
anxiety
syncope
profuse diaphoresis
gooseflesh
orthostasis;what position should a heat exhaustion pt be in? - ANSWER-✅supine in
cool environment;how are fluids given to heat exhaustion pt ? - ANSWER-✅IV
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