PCCN Multisystem Conditions and Shock Flashcards

When titrating a norepinephrine infusion for a patient in septic shock, the nurse's target MAP is:

Answer: 65 mmHg

Surviving Sepsis guidelines recommend maintaining a MAP ≥ 65 mmHg as the initial resuscitation target for septic shock.

A patient recovering from septic shock develops bilateral pulmonary infiltrates, PaO2/FiO2 ratio of 150, and respiratory failure without cardiac cause. The nurse recognizes this as:

Answer: Acute respiratory distress syndrome (ARDS)

Bilateral infiltrates, severe hypoxemia (P/F < 200), and non-cardiac etiology following sepsis meet the Berlin criteria for ARDS.

Which intervention is a core component of sepsis bundle completion within 3 hours of identification?

Answer: Obtain blood cultures before antibiotics

Obtaining blood cultures before antibiotic administration is a mandatory component of the Surviving Sepsis 1-hour bundle.

A patient with crush injury from a building collapse develops tea-colored urine and rising creatinine. The nurse recognizes these findings as indicative of:

Answer: Rhabdomyolysis with acute kidney injury

Myoglobinuria from muscle breakdown causes tea-colored urine and tubular nephrotoxicity, leading to acute kidney injury in rhabdomyolysis.

A patient in the progressive care unit develops sudden hypotension, tachycardia, and jugular venous distension after a central line insertion. The nurse suspects:

Answer: Tension pneumothorax

Tension pneumothorax is a known complication of central line insertion presenting with hemodynamic instability and JVD from mediastinal shift.

Which parameter best reflects the adequacy of oxygen delivery during resuscitation from shock?

Answer: Central venous oxygen saturation (ScvO2) > 70%

ScvO2 > 70% indicates that tissues are receiving adequate oxygen relative to demand, reflecting successful resuscitation at the cellular level.