Nursing School Explained: Multiple Organ Dysfunction Syndrome (MODS) Lecture Notes

Introduction

• MODS Definition: Failure of 2+ organ systems.
• Mortality Rate:
  • 2+ organs: high mortality.
  • 3+ organs: 80-90% mortality.
  • 100% mortality if cardiovascular and neurologic systems fail.

Pathophysiology

• Sepsis: Common precursor to MODS.
  • Wide inflammation and massive vasodilation.
• Vascular Damage: Increased capillary permeability due to endotoxins.
• Circulation:
  • Vasodilation increases inflammatory mediators → low blood pressure.
  • Platelet activation → micro clots → mechanical obstruction.
• Organ Perfusion:
  • Decreased perfusion → stress response → increased glucose production → increased oxygen demand.
  • Tissue hypoxia → switch to anaerobic metabolism → metabolic acidosis.
  • Cell death → potential organ failure.

Signs and Symptoms of MODS by System

Respiratory System

• Symptoms: Increased respiratory rate, crackles, V/Q mismatch.
• Nursing Care:
  • Administer O2.
  • Monitor respiratory status and ABGs.
  • Prepare for intubation (ventilation necessary).

Cardiovascular System

• Symptoms: Decreased systemic vascular resistance, hypotension, increased heart rate.
• Interventions: IV fluids, vasopressors, monitor blood pressure and CVP.

Nervous System

• Symptoms: Decreased consciousness, risk of seizures due to fluid/electrolyte imbalances.
• Monitoring: Assess consciousness regularly.

Renal System

• Symptoms: Decreased urine output, elevated BUN and creatinine.
• Nursing Care:
  • Assess urine output and specific gravity.
  • Monitor kidney function tests and electrolytes (risk of hyperkalemia).

Gastrointestinal System

• Symptoms: Decreased peristalsis, absent bowel sounds, possible GI bleeding.
• Interventions:
  • Assess abdomen and bowel sounds.
  • Administer stress ulcer prophylaxis.
  • Monitor stools for blood.
  • Provide early nutrition (TPN likely).

Liver

• Indicators: Elevated liver function tests, increased ammonia.
• Implications: Possible jaundice, monitor for bleeding and clotting.

Hematologic System

• Symptoms: Decreased platelet count, elevated D-dimer and FSP.
• Interventions:
  • Monitor for bleeding.
  • Implement DVT prophylaxis.

Treatment Overview

• Intensive Care: Critical illness requiring ICU care.
• Nursing Care: Meticulous assessment and intervention to manage sepsis and prevent progression to MODS.
• Nutritional Support: Crucial for managing hypermetabolic state.

Conclusion

• MODS is a severe condition primarily resulting from sepsis.
• Requires diligent nursing care and monitoring.
• Early intervention in sepsis is key to prevention of MODS.