ER, ICU, Emergency

  1. List characteristics and VS of Heat exhaustion
    • VS: 
    •  - Hypotension, tachycardia, elevated temp (99.6-104F)
    • Characteristics:
    •  - n/v, thirst, anxiety, diaphoresis
  2. Define Heatstroke
    • Most serious form of heat stress, resulting in the failure of the hypothalamic thermoregulatory processes
    • Leading to altered mentation, absence of perspiration, and circulatory collapse
  3. What core temp. is considered to be hypothermia?
    What is considered life-threatening?
    • <35 C
    • Life threatening: <30 C
  4. How can a pt. look from moderate hypothermia to severe hypothermia?
    • Moderate s/s:
    •  - Bradycardia and bradypnea
    •  - BP hard to get (use doppler)
    •  - rigidity
    •  - Shivering disappears at temp 86 F
    • Severe s/s:
    •  - Bradycardia
    •  - Vfib -> Asystole
  5. List tx for hypothermia
    • Manage ABCs
    • Rewarm pt. 
    • Correct dehydration and acidosis
    • Treat cardiac dysrhythmias
  6. Difference between passive and active rewarming?
    • Passive: move pt. to warm, dry place, remove damp clothing; place warm blanket
    • Active: body to body contact, fluid or air filled warming blankets, radiant heat lamps
    •  - Invasive: peritoneal, gastric, or colonic lavage with warmed fluids
  7. At what core temp should you d/c core temp? F/C
    Rewarming should be d/c at 95F/35C
  8. List initial tx for animal/human bites
    • Initial: clean with copious irrigation, debridement, tetanus and analgesics
    •  - abx
  9. How many injections are given for the rabies prophylaxis?
    • Initial injection IG
    • Five series vaccine injection: 0, 3, 7, 14, 28
    • (half injected into wound, half IM)
  10. What's the hour limit you can perform gastric lavage after poison ingestion?
    List 3 contraindications
    • 2 hours
    • Contraindications:
    • 1. caustic agents
    • 2. co-ingested sharp objects
    • 3. nontoxic
  11. Contraindications of activated charcoal.
    When can you give an antidote when also giving charcoal?
    • 1. diminished bowel sounds
    • 2. Paralytic ileus
    • 3. ingestion of substance poorly absorbed by charcoal
    • Do not give antidote immediately before, with, or shoftly after charcoal
  12. What is the indication of Cathartics (Sorbitol)
    • To be given with first dose of charcoal to stimulate intestinal motility
    • whole-bowel irrigation
  13. Fill in: Hemodialysis / hemoperfusion is used with poisonings and is reserved for __a__.
    Severe acidosis
  14. When are chelating agents used?
    During an Iron overdose
  15. This organization is the largest specialty nursing in the world who care for acute and critically ill patients. 

    They manage and certifies/renews processes for most critical care nurses
    AACN: american association of critical care nurses
  16. What are each acronym?

    CCRN
    CCRN-E
    PCCN
    CMC
    CSC
    CNML

    ACNPC
    CCNS
    • CCRN: Critical Care RN
    • CCRN-E: Adult tele, ICU, CCRN
    • PCCN: progressive care nursing cert
    • CMC: cardiac medicine subspecialty
    • CNML: clinical nurse manager and leader

    • ACNPC: Acute Care NP Cert
    • CCNS: Critical care clinical nurse specialist
  17. List the 4 reasons for admission to the ICU
    • 1. Physiologically unstable
    • 2. risk for serious complications
    • 3. Need for invasive interventions and frequent assessment
    • 4. require intensive and complicated nursing support
  18. What is DOPE
    • Troubleshooting mechanical ventilation
    • D: Dispalced Tube
    • O: Obstruction
    • P: Pneumothorax
    • E: Equipment failure
  19. What is the purpose of the CRRT?
    • For continuous renal replacement therapy
    • Large volumes of fluid replacement
  20. What is the purpose of Hemodynamic Monitoring?
     List the 4 tests that can be done
    • It is the measurement of pressure, flow, and oxygenation within the cardiovascular system
    • Tests include:
    • 1. ARt line: for continuous invasive BP monitor
    • 2. CVP: right atrial pressure (preload)
    • 3. Pulmonary artery: intracardiac pressure and CO
    • 4. SVO2 and ScVO2: tissue oxygenation
  21. Match the purpose Hemodynamic Monitoring test: Art line




    B.
  22. Match the purpose Hemodynamic Monitoring test: CVP




    D.
  23. Match the purpose Hemodynamic Monitoring test: Pulmonary artery




    D.
  24. Match the purpose Hemodynamic Monitoring test: SVO2 and ScVO2




    C.
  25. List normal values of each (oxygen extraction)
    SVO2%
    SaO2%
    CO (L/min)
    VO2 (mL/min) *VO2 max is the maximum rate of oxygen consumption measured during incremental exercise
    • SVO2%: 60-80%
    • SaO2%: 95-98%
    • CO (L/min): 4-8 L/min
    • VO2 (mL/min): 225-275 mL/min
  26. Select all that apply: Which of these causes high-pressure alarms

    a. Kinks in tubing
    b. Secretions, coughing, gagging
    c. resp. arrest
    d. Ventilator disconnection
    e. Water in tubing
    f. Oversedation
    g. Bronchospasm
    h. Loss of airway
    • a. Kinks in tubing
    • b. Secretions, coughing, gagging
    • c. resp. arrest
    • d. Ventilator disconnection
    • e. Water in tubing
    • f. Oversedation
    • g. Bronchospasm
    • h. Loss of airway
  27. Select all that apply: Which of these causes Apnea Alarm

    a. Kinks in tubing
    b. Secretions, coughing, gagging
    c. resp. arrest
    d. Ventilator disconnection
    e. Water in tubing
    f. Oversedation
    g. Bronchospasm
    h. Loss of airway
    • a. Kinks in tubing
    • b. Secretions, coughing, gagging
    • c. resp. arrest
    • d. Ventilator disconnection
    • e. Water in tubing
    • f. Oversedation
    • g. Bronchospasm
    • h. Loss of airway
  28. Select all that apply: Which of these cause low-pressure alarms 

    a. Kinks in tubing
    b. Secretions, coughing, gagging
    c. resp. arrest
    d. Ventilator disconnection
    e. Water in tubing
    f. Oversedation
    g. Bronchospasm
    h. Loss of airway
    • a. Kinks in tubing
    • b. Secretions, coughing, gagging
    • c. resp. arrest
    • d. Ventilator disconnection
    • e. Water in tubing
    • f. Oversedation
    • g. Bronchospasm
    • h. Loss of airway
Author
edeleon
ID
343188
Card Set
ER, ICU, Emergency
Description
ADN-D EXAM 4
Updated