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Chapter 02: Ethical and Legal Issues
|a.||is more concerned with the why of behavior.|
|b.||provides a framework for evaluation of the behavior.|
|c.||is broader in scope than morals.|
|d.||concentrates on the right or wrong behavior based on religion and culture values.|
Ethics are concerned with the basis of the action rather than whether the action is right or wrong, good or bad.
The nurse has been placed in a situation initially causing moral distress and is struggling with determining the ethically appropriate action to take. Moral courage is the freedom to advocate for oneself, patients, and peers. Autonomy is an ethical principle. Moral doubt is not part of the AACN framework The 4As to Rise Above Moral Distress.
|a.||presenting only the information to prevent relapse in a patient.|
|b.||assisting with only tasks that cannot be done by the patient.|
|c.||providing the patient with all of the information and facts.|
|d.||guiding the patient toward the best choices for care.|
Clients and families must have all the information about a certain situation to make an autonomous decision that is best for them.
Veracity is important when soliciting informed consent because the client needs to be aware of all potential risks of and benefits to be derived from specific treatments or their alternatives.
|a.||confidentiality and privacy.|
|b.||truth and reflection.|
|c.||autonomy and paternalism.|
|d.||beneficence and nonmaleficence.|
Confidentiality is a right involving the sharing of client information with only those involved in the clients care. Privacy includes confidentiality but goes further to include the right to privacy of person and personal space, such as ensuring that a client is adequately covered during a procedure.
|a.||Limitations of resources force reexamination of goals of critical care for clients.|
|b.||Care is provided equally to all those who need the resources.|
|c.||Equal access is available for those with the same condition or diagnosis.|
|d.||Technologic advances are available to most of those in a given community.|
Limited resources force society and critical care health practitioners to reexamine goals of critical care for clients.
|a.||examine ones own beliefs to guide the family to a correct decision.|
|b.||approach the family with honesty and provide clear information.|
|c.||simply follow the advance directive if available.|
|d.||allow the physician to approach the family.|
This is a difficult time, and the nurse needs to be attuned to the familys needs by providing timely information, honesty, and clear treatment options and by listening to the family.
|a.||is usurped by state or federal laws.|
|b.||allows the nurse to focus on the good of society rather than the uniqueness of the client.|
|c.||was recently adopted by the American Nurses Association.|
|d.||provides society with a set of expectations of the profession.|
The Code of Ethics for Nursing provides a framework for the nurse to follow in ethical decision making and provides society with a set of expectations of the profession.
|a.||following the guidelines of a framework or model.|
|b.||having the client discuss alternatives with the physician or nurse.|
|c.||prioritizing the greatest good for the greatest number of persons.|
|d.||careful consideration by the Ethics Committee after all diagnostic data are reviewed.|
To facilitate the ethical decision-making process, a model or framework must be used so that all involved will consistently and clearly examine the multiple ethical issues that arise in critical care.
|a.||consulting with an authority.|
|b.||identifying the health problem.|
|c.||delineating the ethical problem from other types of problems.|
|d.||identifying the client as the primary decision maker.|
Step one involves identifying the major aspects of the clients medical and health problems. Consulting an authority is not always necessary in the process. Delineating the ethical problem from other types of problems may not be necessary. Identification of the client as primary decision maker is not part of the process.
|a.||Avoid the use of open-ended questions.|
|b.||Use multiple sessions to cross-examine the client to ensure he or she is clear about personal values.|
|c.||Use appropriate questions to assist the client in reflecting on the situation and what is personally important.|
|d.||Encourage members of the health care team to relate how they would make the decision.|
As a patient advocate, the nurse provides more information as needed, clarifies points, reinforces information, and provides support during the decision-making process.
|a.||consultation with purely binding recommendations.|
|b.||support and education to health care providers.|
|c.||conflict resolution for moral dilemmas.|
|d.||recommendations that are binding in all cases.|
The IEC can function in a variety of ways, serving as consultants, providing education, and helping resolve ethical conflicts or dilemmas for health care providers. Recommendations from the formal IEC may or may not be binding and are relative to the situation at hand.
|a.||an outcome for each action must be predicted.|
|b.||the team must determine which options to present to the patient or family.|
|c.||the choice of one option compromises the option not chosen.|
|d.||no action is not an option in this step of the decision-making process.|
After the identification of alternative options, the outcome of each action must be predicted. Consideration also must be given to the no action option, which is another choice.
Autonomy is a freedom of choice or a self-determination that is a basic human right. It can be experienced in all human life events.
|a.||1, 4, 6, 7, 8, 3, 2, 5|
|b.||1, 4, 3, 2, 5, 6, 7, 8|
|c.||1, 4, 2, 3, 5, 6, 7, 8|
|d.||4, 1, 3, 2, 5, 6, 7, 8|
The steps in ethical decision making mirror those in the nursing process.
|a.||An awareness of different options|
|b.||An issue in which only one viable option exists|
|c.||The choice of one option compromises the option not chosen|
|d.||An issue that has different options|
ANS: A, C, D
The criteria for identifying an ethical dilemma are threefold: (1) an awareness of the different options, (2) an issue that has different options, and (3) the choice of one option over another compromises the option not chosen.
Chapter 14: Pulmonary Clinical Assessment and Diagnostic Procedures
|a.||To provide evidence of hypoxia|
|b.||To provide evidence of dyspnea|
|c.||To provide evidence of dehydration|
|d.||To provide evidence of nutritional status|
Severe hypoxia will be manifested by central cyanosis, which is evident in the oral and circumoral areas. Although dehydration and nutritional status can both be partially assessed by oral cavity inspection; this information is not as vital as determining hypoxia. Dyspnea means difficulty breathing.
|b.||Pleural friction rub|
Wheezes are high-pitched, squeaking, whistling sounds produced by airflow through narrowed small airways. They are heard mainly on expiration but may also be heard throughout the ventilatory cycle. Depending on their severity, wheezes can be further classified as mild, moderate, or severe. Rales are crackling sounds produced by fluid in the small airways or alveoli or by the snapping open of collapsed airways during inspiration. A pleural friction rub is a dry, coarse sound produced by irritated pleural surfaces rubbing together and is caused by inflammation of the pleura.
|a.||Tachypnea has increased rate; hyperventilation has decreased rate.|
|b.||Tachypnea has decreased rate; hyperventilation has increased rate.|
|c.||Tachypnea has increased depth; hyperventilation has decreased depth.|
|d.||Tachypnea has decreased depth; hyperventilation has increased depth.|
Tachypnea is manifested by an increase in the rate and decrease in the depth of ventilation. Hyperventilation is manifested by an increase in both the rate and depth of ventilation.
|a.||PaO2 of 88 and PCO2 of 55|
|b.||Absent breath sounds in all right lung fields|
|c.||Absent breath sounds in all left lung fields|
|d.||Diminished breath sounds in all fields|
The clinical picture described is most consistent with left pneumothorax. This would cause the trachea to deviate to the right, away from the increasing pressure of the left. A pneumothorax this severe would completely collapse the right lung, thus causing absent breath sounds in that lung.
|a.||bilateral pleural effusion.|
|c.||a normal finding.|
Fremitus is described as normal, decreased, or increased. With normal fremitus, vibrations can be felt over the trachea but are barely palpable over the periphery. With decreased fremitus, there is interference with the transmission of vibrations. Examples of disorders that decrease fremitus include pleural effusion, pneumothorax, bronchial obstruction, pleural thickening, and emphysema.
|a.||a funnel chest.|
|b.||a pigeon breast.|
|c.||a barrel chest.|
Normal ratio of anteroposterior diameter to lateral diameter ranges from 1:2 to 5:7. A barrel chest is characterized by displacement of the sternum forward and the ribs outward and is suggestive of chronic obstructive pulmonary disease. Funnel chest, pectus excavatum, creates a pit-shaped depression. Pigeon chest, pectus carinatum, causes an increase in anteroposterior diameter. Both are related to restrictive pulmonary disease. Harrisons groove, a rib deformity, is a result of rickets.
|a.||Collect an overview of past medical history, present history, and current health status.|
|b.||Do not obtain any history at this time.|
|c.||Curtail the history to just a few questions about the clients chief complaint and precipitating events.|
|d.||Complete the history and then provide measures to assist the client to breathe easier.|
The initial presentation of the client determines the rapidity and direction for the interview. For a client in acute distress, the history should be curtailed to just a few questions about the clients chief complaint and the precipitating events.
Tachypnea is manifested by an increase in the rate and decrease in the depth of ventilation. Hyperventilation is manifested by an increase in both the rate and depth of ventilation. Obstructive breathing is characterized by progressively more shallow breathing until the client actively and forcefully exhales. Bradypnea is a slow respiratory rate characterized as less than 12 breaths/min in an adult.
Examples of disorders that increase tactile fremitus include pneumonia, lung cancer, and pulmonary fibrosis. Emphysema, pleural effusion, and pneumothorax are disorders that decrease fremitus.
|a.||Right side, top to bottom, then left side, top to bottom|
|b.||Left side, top to bottom, then right side, top to bottom|
|c.||Side to side, bottom to top|
|d.||Side to side, top to bottom|
Auscultation should be done in a systematic sequence: side to side, top to bottom, posteriorly, laterally, and anteriorly.
Diminished to absent breath sounds on the right side, tracheal deviation to the left side, and asymmetrical chest movement are indicative of tension pneumothorax.
|d.||pleural friction rubs.|
Crackles or rales are short, discrete, popping or crackling sounds produced by fluid in the small airways or alveoli.
|a.||pneumonia with consolidation.|
Voice sounds are increased in pneumonia with consolidation because there is increased vibration through material. Bronchophony and whispering pectoriloquy are heard as clear transmission of sounds on auscultation; egophony is heard as an a sound when the client is saying e.
Discoloration of the fingers is an indication of peripheral cyanosis. Central cyanosis occurs when the unsaturated hemoglobin of arterial blood exceeds 5 g/dL and is considered a life-threatening situation. Clubbing refers to an abnormality of the fingers caused by chronically low blood levels of oxygen often related to a heart or lung disease.
The percussion tone of hyperresonance is heard with emphysema related to overinflation of the lung. Resonance can be found in normal lungs or with the diagnosis of bronchitis. Tympany occurs with the diagnosis of large pneumothorax and emphysematous blebs. Dullness occurs with the diagnosis of atelectasis, pleural effusion, pulmonary edema, pneumonia, and a lung mass.
|d.||pleural friction rub.|
A pleural friction rub is the result of irritated pleural surfaces rubbing together and is characterized by a leathery, dry, loud, coarse sound. A pleural friction rub is seen with pleural effusions or pleurisy and is not indicative of emphysema.
|a.||Deep sighing breaths without pauses|
|b.||Rapid, shallow breaths|
|c.||Normal breathing pattern interspersed with forced expirations|
|d.||Irregular breathing pattern with both deep and shallow breaths|
Air trapping is described as a normal breathing pattern interspersed with forced expirations. As the patient breathes, air becomes trapped in the lungs, and ventilations become progressively shallower until the patient actively and forcefully exhales.
|a.||a shift to the right.|
|b.||a shift to the left.|
With a pneumothorax, the trachea shifts to the opposite side of the problem; with atelectasis, the trachea shifts to the same side as the problem. Subcutaneous emphysema is more commonly related to a pneumomediastinum and is not specifically related to the trachea but to air trapped in the mediastinum and general neck area.
|a.||atelectasis and emphysema.|
|b.||hepatomegaly and ascites.|
|c.||atelectasis and paralysis.|
|d.||pneumonia and pneumothorax.|
Normal diaphragmatic excursion is 3 to 5 cm and is part of the percussion component of the physical examination. An assessment finding other than normal would indicate the need for further evaluation such as chest radiographic examination.
Palpation is the process of touching the patient to judge the size, shape, texture, and temperature of the body surface or underlying structures. Inspection is the process of looking intently at the patient. Percussion is the process of creating sound waves on the surface of the body to determine abnormal density of any underlying areas. Auscultation is the process of concentrated listening with a stethoscope to determine characteristics of body functions.
Inspection is the process of looking intently at the patient. Palpation is the process of touching the patient to judge the size, shape, texture, and temperature of the body surface or underlying structures. Percussion is the process of creating sound waves on the surface of the body to determine abnormal density of any underlying areas. Auscultation is the process of concentrated listening with a stethoscope to determine characteristics of body functions.
Percussion is the process of creating sound waves on the surface of the body to determine abnormal density of any underlying areas. Palpation is the process of touching the patient to judge the size, shape, texture, and temperature of the body surface or underlying structures. Inspection is the process of looking intently at the patient. Auscultation is the process of concentrated listening with a stethoscope to determine characteristics of body functions.
|a.||1, 2, 5|
|b.||3, 5, 6|
|c.||2, 3, 4|
|d.||1, 2, 4|
The normal lung, bronchiectasis, and acute bronchitis will commonly present with an inspiration greater than expiration ratio. Acute bronchitis can also have inspiration that equals expiration ratio as also seen with emphysema, diffuse pulmonary fibrosis, and consolidating pneumonia. Noting that many conditions present with the same findings affirms the need for further assessment and evaluation.
|a.||uncompensated metabolic alkalosis.|
|b.||uncompensated respiratory acidosis.|
|c.||compensated respiratory acidosis.|
|d.||compensated respiratory alkalosis.|
The pH is closer to the acidic level, so the primary disorder is acidosis. Compensated respiratory acidosis values include a pH of 7.35 to 7.39, PACO2 greater than 45 mm Hg, and HCO3 greater than 26 mEq/L. Uncompensated respiratory acidosis values include a pH below 7.35, PACO2 above 45 mm Hg, and HCO3 of 22 to 26 mEq/L. Compensated respiratory alkalosis values include a pH of 7.41 to 7.45, PACO2 below 35 mm Hg, and HCO3 below 22 mEq/L. Uncompensated metabolic alkalosis values include a pH above 7.45, PACO2 of 35 to 45 mm Hg, and HCO3 above 26 mEq/L.
|a.||Acute pulmonary embolism|
|b.||Acute myocardial infarction|
|c.||Congestive heart failure|
|d.||Chronic obstructive pulmonary disease|
The fact that the HCO3 level has increased enough to compensate for the increased pCO2 level indicates that this is not an acute condition because the kidneys can take several days to adjust. The other choices would present with a lower HCO3 level. The values indicate respiratory acidosis, and one of the potential causes is chronic obstructive pulmonary disease. Potential causes for respiratory alkalosis are pulmonary embolism, acute myocardial infarction, and congestive heart failure.
|a.||Increase O2 to 6 L/min.|
|b.||Prepare for emergency intubation.|
|c.||Administer 1 ampule of sodium bicarbonate.|
|d.||Repeat ABG testing in 4 hours.|
Increasing the FiO2 on this patient could decrease the respiratory rate and increase the severity of the patients CO2 retention. The patients arterial blood gas (ABG) values do not warrant intubation at this time. Additional sodium bicarbonate is not indicated because this patient has a fully compensated pH. A repeat ABG may be ordered to assess the patients ongoing respiratory status. Other factors must be considered when reviewing a patients ABGs, including oxygen saturation, oxygen content, base excess and deficit, and anion gap analysis.
|a.||uncompensated respiratory acidosis.|
|b.||uncompensated metabolic acidosis.|
|c.||compensated metabolic acidosis.|
|d.||compensated respiratory acidosis.|
The pH is below normal range (7.35-7.45), so this is uncompensated acidosis. The PaCO2 is markedly elevated, and the HCO3 is normal. This indicates uncompensated respiratory acidosis. Uncompensated respiratory acidosis values include a pH below 7.35, PACO2 above 45 mm Hg, and HCO3 of 22 to 26 mEq/L. Uncompensated metabolic acidosis values include a pH below 7.35, PACO2 of 35 to 45 mm Hg, and HCO3 above 22 mEq/L. Compensated metabolic acidosis values include a pH of 7.35 to 7.39, PACO2 below 35 mm Hg, and HCO3 below 22 mEq/L. Compensated respiratory acidosis values include a pH of 7.35 to 7.35, PACO2 above 45 mm Hg, and HCO3 above 26 mEq/L.
|c.||Residual volume (RV)|
Capnography is the measurement of exhaled carbon dioxide (CO2) gas; it is also known as end-tidal CO2 monitoring. Normally, alveolar and arterial CO2 concentrations are equal in the presence of normal V/Q relationships. In a patient who is hemodynamically stable, the end-tidal CO2 (Petco2) can be used to estimate the PaCO2. Normally, the PaO2/FiO2 ratio is greater than 286; the lower the value, the worse the lung function. The a?2-a gradient (P[a ?2- a]O2) is normally less than 20 mm Hg on room air for patients younger than 61 years. This estimate of intrapulmonary shunting is the least reliable clinically, but it is used often in clinical decision making. Residual volume is the amount of air left in the lung after maximal exhalation. A normal value is 1200 to 1300 mL.
|a.||uncompensated respiratory acidosis.|
|b.||uncompensated metabolic acidosis.|
|c.||uncompensated metabolic alkalosis.|
|d.||uncompensated respiratory alkalosis.|
The pH indicates acidosis, and the HCO3 is markedly decreased, indicating a metabolic disorder. Uncompensated metabolic acidosis values include a pH below 7.35, PACO2 of 35 to 45 mm Hg, and HCO3 above 22 mEq/L. Uncompensated respiratory acidosis values include a pH below 7.35, PACO2 above 45 mm Hg, and HCO3 of 22 to 26 mEq/L. Uncompensated respiratory alkalosis values include a pH above 7.45, PACO2 below 35 mm Hg, and HCO3 of 22 to 26 mEq/L. Uncompensated metabolic alkalosis values include a pH above 7.45, PACO2 of 35 to 45 mm Hg, and HCO3 above 26 mEq/L.
|b.||Ineffective clearance of secretions|
|c.||Upper gastrointestinal bleed|
|d.||Instillation of surfactant|
Bronchoscopy visualizes the bronchial tree. If secretions are present, they can be removed by suctioning and sent for culture to help adjust antibiotic therapy.
|c.||Ventilation/perfusion (V/Q) scan|
|d.||Repeat chest radiograph|
Thoracentesis is a procedure that can be performed at the bedside for the removal of fluid or air from the pleural space. It is used most often as a diagnostic measure; it may also be performed therapeutically for the drainage of a pleural effusion or empyema. No evidence is present that would necessitate a V/Q scan. A bronchoscopy cannot assist in fluid removal. A problem with this chest radiograph is not indicated.
|b.||Acute myocardial infarction|
|d.||Acute respiratory distress syndrome|
This test is ordered for the evaluation of pulmonary emboli. Electrocardiography or cardiac enzymes are ordered to evaluate for myocardial infarction; arterial blood gas analysis, chest radiography, and pulmonary function tests are ordered to evaluate for emphysema. Chest radiography and hemodynamic monitoring are ordered for evaluation of acute respiratory distress syndrome.
|a.||Stat chest radiographic examination|
|b.||End-tidal CO2 monitor|
|d.||Pulmonary artery catheter insertion|
Although a stat chest radiography examination would be helpful, it has a long turnaround time, and the patients respiratory status can deteriorate quickly. An end-tidal CO2 monitor gives an immediate response, and the tube can then be reinserted without delay if incorrectly placed. The other tests are not for endotracheal tube placement.
|a.||Prepare to intubate.|
|b.||Assess the patients condition.|
|c.||Turn off the alarm and reapply the oximeter sensor.|
|d.||Increase O2 level to 4L/NC.|
The first nursing action would be to assess the patient to see if there is a change in his or her condition. If the patient is stable, then the nurse would turn off the alarm and reapply the oximeter sensor. The pulse oximeter cannot differentiate between normal and abnormal hemoglobin. Elevated levels of abnormal hemoglobin falsely elevate the Spo2. The ability of a pulse oximeter to detect hypoventilation is accurate only when the patient is breathing room air. Because most critically ill patients require some form of oxygen therapy, pulse oximetry is not a reliable method of detecting hypercapnia and should not be used for this purpose.
|a.||A 70-year-old man with a PaO2 of 72|
|b.||A 50-year-old woman with a PaO2 of 65|
|c.||An 84-year-old man with a PaO2 of 96|
|d.||A 68-year-old woman with a PaO2 of 80|
Normal PaO2 is 80 to 100 mm Hg in persons younger than 60 years. The formula for determining PaO2 for a person older than 60 years of age is 80 mm Hg minus 1 mm Hg for every year of age above 60 years of age, for example, 70 years old = 80 mm Hg 10 mm Hg = 70 mm Hg; 84 years old = 80 mm Hg 20 mm Hg = 60 mm Hg; and 68 years old = 80 mm Hg 8 mm Hg = 72 mm Hg.
The bicarbonate (HCO3) is the acidbase component that reflects kidney function. The bicarbonate is reduced or increased in the plasma by renal mechanisms. The normal range is 22 to 26 mEq/L. pH measures the hydrogen ion concentration of plasma. PaO2 measures partial pressure of oxygen dissolved in arterial blood plasma. PaCO2 measures the partial pressure of carbon dioxide dissolved in arterial blood plasma.
Proper evaluation of the oxygen saturation level is vital. For example, an Sao2 of 97% means that 97% of the available hemoglobin is bound with oxygen. The word available is essential to evaluating the Sao2 level because the hemoglobin level is not always within normal limits and oxygen can bind only with what is available.
|a.||After the specimen is in the container, dilute thick secretions with sterile water.|
|b.||Apply suction when the catheter is advanced to obtain secretions from within the endotracheal tube.|
|c.||Do not apply suction while the catheter is being withdrawn because this can contaminate the sample with sputum left in the endotracheal tube.|
|d.||Do not clear the endotracheal tube of all local secretions before obtaining the specimen.|
To prevent contamination of secretions in the upper portion of the endotracheal tube, do not apply suction while the catheter is being withdrawn. Clear the endotracheal or tracheostomy tube for all local secretions, avoiding deep airway penetration. This will prevent contamination with upper airway flora. Do not dilute thick secretions with sterile water. This will compromise the specimen.
|a.||Re-expansion pulmonary edema|
Re-expansion pulmonary edema can occur when a large amount of effusion fluid (~10001500 mL) is removed from the pleural space. Removal of the fluid increases the negative intrapleural pressure, which can lead to edema when the lung does not re-expand to fill the space. The patient experiences severe coughing and shortness of breath. The onset of these symptoms is an indication to discontinue the thoracentesis.
|a.||Flattening of the diaphragm|
|b.||Shifting of the mediastinum to the right|
|c.||Presence of a gastric air bubble|
|d.||Increased radiolucency of the left lung field|
Shifting of the mediastinal structures away from the area of involvement is a sign of a pneumothorax.
|a.||normal gas exchange of venous blood.|
|b.||an abnormal finding indicative of a shunt-producing disorder.|
|c.||a serious and potentially life-threatening condition.|
A shunt greater than 10% is considered abnormal and indicative of a shunt-producing disorder. A shunt greater than 30% is a serious and potentially life-threatening condition that requires pulmonary intervention.
|a.||5, 1, 2, 4, 3|
|b.||5, 3, 1, 4, 2|
|c.||1, 2, 4, 3, 5|
|d.||1, 3, 4, 5, 2|
A methodic approach when assessing arterial blood gases allows the nurse to detect subtle changes. A methodic approach includes look at the Pao2 level, look at the pH level, look at the Paco2 level, look at the HCO3, and look again at the pH level.
|a.||Provides direction for the rest of the assessment|
|b.||Exposes key clinical manifestations|
|c.||Aids in developing the plan of care|
|d.||The degree of the clients distress determines the extent of the interview|
|e.||Determines length of stay in the hospital setting|
ANS: A, B, C, D
The initial presentation of the patient determines the rapidity and direction of the interview. For a patient in acute distress, the history should be curtailed to just a few questions about the patients chief complaint and precipitating events.
|c.||Chronic obstructive pulmonary disease|
ANS: A, B, E
Assessment of tracheal position assists in the diagnosis of pneumothorax, unilateral pneumonia, pulmonary fibrosis, and pleural effusion.
|b.||intra-aortic balloon pump.|
ANS: A, B, D
No absolute contraindications to thoracentesis exist, although some risks may contraindicate the procedure in all but emergency situations. These risk factors include unstable hemodynamics, coagulation defects, mechanical ventilation, the presence of an intra-aortic balloon pump, and patients who are uncooperative. It is used most often as a diagnostic measure; it may also be performed therapeutically for the drainage of a pleural effusion or empyema.
|a.||positioning the patient for the procedure.|
|b.||monitoring the patients responses to the procedure.|
|c.||monitoring vital signs.|
|d.||teaching the patient about the procedure.|
|e.||medicating the patient before and after procedure.|
ANS: A, B, C, D, E
Preparing the patient includes teaching the patient about the procedure, answering any questions, and positioning the patient for the procedure. Monitoring the patients responses to the procedure includes observing the patient for signs of pain and anxiety and monitoring vital signs, breath sounds, and oxygen saturation. Assessing the patient after the procedure includes observing for complications of the procedure and medicating the patient for any postprocedural discomfort.
Chapter 26: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome
|a.||physiologic state resulting in hypotension and tachycardia.|
|b.||generalized systemic response to inadequate tissue perfusion.|
|c.||degenerative condition leading to death.|
|d.||condition occurring with hypovolemia that results in irreversible hypotension.|
Shock is a complex pathophysiologic process that often results in multiple organ dysfunction syndrome and death. All types of shock eventually result in ineffective tissue perfusion and the development of acute circulatory failure.
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