Instructions for Answer to 4 Question
1- After Each DQ (question), write down references
2- 300 minimum words for every DQ, you can go up to 800 words but answer should be complete.
3- 2-3 Peer Reviewed/ scholarly references for each question
4- References should be within 4 years
5- I am in acute care nurse practitioner program.
6- The response to the DQ is expected to be a minimum of 300 words. A minimum of two peer reviewed/ scholarly  resources are expected. These need to be appropriate for a clinical professional to guide decisions about patient care. If a textbook is used for one of these responses, the other needs to be journal or professional-level website. The references need to be correctly formatted, as do the citations for those references.  “ Question words” don’t count towards 300 minimum count”

Q-1
You have received a patient from the cardiac catheterization lab after an early morning emergent presentation for an acute myocardial infarction. The patient has an intra-aortic balloon pump indwelling, and the cardiologist placed a pulmonary artery catheter for hemodynamic monitoring. The patient is experiencing cardiogenic shock.
· Explain the treatment for suppressed cardiac output, suppressed cardiac index, and altered systemic vascular resistance.
· Recommend possible environmental and nutritional interventions for treating the patient.
· Recognize that the patient received emergent stenting and still requires bypass graphing once stabilized.
Support your answer with two or three peer-reviewed resources.

Q-2
Septic shock can often be overlooked because of underlying conditions that are presented within the patient. The patient you are assessing upon arrival from the emergency department to the ICU has acute renal failure, fever, and leukocytosis; is hypotensive; and has altered mental status. Based on this type of patient, glean from your clinical experience and practicum and discuss the assessment, the shock stage, differential diagnoses, and treatment plan for the patient. Discuss how this will change for the different shock stages. Support your answer with two or three peer-reviewed resources.

Q-3
Sepsis and SIRS often present with a host of complications. Acutely, you need to provide stabilization for this geriatric patient. The common presenting sources of infection are urinary tract infections and pulmonary infections. How would you approach this population to determine the source of infection? How are the critical care and emergent situation conditions and disorders inclusive of systemic inflammatory response syndrome (SIRS) and sepsis different? Using a patient from your clinical practicum for whom you have provided care, describe and explain the diagnostic workup to determine the source of infection or inflammatory response. Support your answer with two or three peer-reviewed resources.

Q-4
You are making rounds in the intensive care and the nurse reports the patient has spiked a fever, oxygen saturations are below 85%, tachycardia, and variant hypotension. The patient is intubated and has been treated for COVID pneumonia for 10 days. What are some specific aspects of assessment and diagnostic workup on which you would want to focus? Provide three differential diagnoses at this point and what treatment parameters you need to start while ruling out complications. What are the risk factors necessary to take into considerations as you develop treatment parameters for this patient? Think about sepsis from multiple sources of a prolonged ICU stay. Support your answer with two or three peer-reviewed resources.




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