Which of the following would help prevent the development of multiple organ dysfunction syndrome in a patient with sepsis and an infected foot ulcer?
1. turn and reposition every 4 hours
2. good hand hygiene before applying gloves for invasive procedures
3. keep blood pressure to <100 mm Hg systolic and <50 mm Hg diastolic
4. maintain blood glucose at identified protocol level
4
Rationale: Considerable attention has been paid to the role of hyperglycemia in the pathogenesis of multiple organ dysfunction syndrome since the finding that intensive insulin therapy with tight glycemic control resulted in decreased mortality and prevention of multiple organ dysfunction syndrome. High glucose levels are toxic to hepatocytes, neurons, renal tubular cells, endothelial cells and immune cells. Maintaining adherence to tight glycemic control protocols is an important nursing intervention to help prevent multiple organ dysfunction syndrome. The patient should be turned and repositioned every 2 hours to prevent the pooling of pulmonary secretions. Good hand hygiene should be practiced ongoingly and after removing gloves when participating in invasive procedures. There are no parameters established regarding blood pressure control to avoid the onset of multiple organ dysfunction syndrome.
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1. faith. 2. trust. 3. competence. 4. consistency.
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For what reason would breastfeeding be contraindicated?
a. Hepatitis B b. Everted nipples c. History of breast cancer 3 years ago d. Human immunodeficiency virus (HIV) positive