Which of the following is an early sign of SIRS and MODS?
Increased blood pressure
Decreased respiratory rate as the patient becomes somnolent.
Mental status changes due to hypoxemia
Normal assessment findings. Early signs of MODS are often not noticed.
The Correct Answer is C
A. Increased blood pressure:
Hypotension, not hypertension, is more typical as perfusion worsens in SIRS/MODS.
B. Decreased respiratory rate as the patient becomes somnolent:
Early on, tachypnea is more common as the body attempts to compensate for metabolic acidosis. Decreased RR is a late sign.
C. Mental status changes due to hypoxemia:
This is an early and sensitive indicator of worsening oxygen delivery to the brain and other organs in SIRS/MODS.
D. Normal assessment findings. Early signs of MODS are often not noticed:
Early signs can be detected, especially changes in mental status, urine output, or respiratory rate. Saying they are “not noticed” may result in missed intervention opportunities.
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Related Questions
Correct Answer is C
Explanation
A. Brain, pancreas, and gallbladder:
These are not the primary targets in early MODS. Brain dysfunction may follow later but is not typical initially.
B. Colon, small and large intestines, and stomach:
The GI tract can be affected, but not among the most commonly affected organs in early MODS.
C. Heart, lungs, liver, and kidneys:
These are the primary organs affected in MODS. Lung failure often presents first (as in ARDS), followed by cardiovascular, hepatic, and renal dysfunction.
D. Spleen and bone marrow:
Not typical primary targets in MODS, though immune and hematologic effects may occur.
Correct Answer is A
Explanation
A. Insulin resistance, lactic acidosis, and liver dysfunction:
These are hallmark features of the hypermetabolic state seen in critically ill patients. Inflammatory mediators cause insulin resistance, impaired tissue oxygenation leads to lactic acidosis, and hepatic stress can result in liver dysfunction, including altered glucose metabolism and coagulation.
B. Decreased glucose utilization and improved cellular oxygenation:
Glucose utilization often increases due to stress hyperglycemia, while oxygenation is impaired due to cellular hypoxia.
C. Reduced metabolic rate and enhanced liver function:
The metabolic rate increases in response to systemic inflammation. Liver function is often compromised, not enhanced.
D. Increased insulin sensitivity and decreased lactic acid production:
The opposite occurs - insulin resistance increases and lactic acid accumulates due to anaerobic metabolism in hypoperfused tissues.
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