Page 444 - Critical Care Nursing Demystified

Chapter 9 CARE OF THE PATIENT WITH CRITICAL HEMATOLOGIC NEEDS 429

REVIEW QUESTIONS

1. An infectious disease physician and a medical resident are discussing the WBC
count with a differential on a patient they suspect has sepsis. The nurse is aware
that when they talk about a shift-to-the-left, they are referring to
A. An increase in the band neutrophils
B. A decrease in the basophils
C. An increase in the eosinophils
D. An increase in the lymphocytes

2. A patient is admitted with sepsis due to an indwelling suprapubic catheter that
was poorly maintained at home. He is hypotensive and tachycardic with a low
cardiac output and minimal renal perfusion. He will require intubation and me-
chanical ventilation, fluids, antibiotics, and other vasoactive medications to
maintain his CO and BP. Which sequence of sepsis is this patient most likely in?
A. Sepsis
B. Severe sepsis
C. SIRS (sudden inflammatory response syndrome)
D. MODS

3. The nurse is looking at all laboratory and assessment data on a patient with Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
MODS. Which of the following medications might be beneficial to this patient
to reverse the inflammatory responses occurring in MODS?
A. Dobutamine
B. Heparin
C. Antibiotics
D. Xigris

4. The nurse is evaluating the results of a patient’s CBC (complete blood cell count).
Which of the following would indicate a severe bleeding problem?
A. Red blood cell count of 5 million
B. Platelets of 30,000
C. White cell count of 15,000
D. Band neutrophils of 5%
5. A nurse is evaluating an elderly patient who was admitted to the ICU with sepsis
from an indwelling urinary catheter. Which of the following laboratory values
might indicate the beginning of disseminated intravascular coagulation (DIC)?
A. Increased urinary output
B. Decreased prothrombin time (PT)
C. Platelets less than 100,000/uL
D. Decreased fibrin degradation products (FDP)