What are some ways to prevent VAP?
Brush teeth every 6-8hrs, adequate hydration, HOB 30-45 degrees, get off ventilator as soon as possible
What are some clinical manifestations of pneumothorax?
SOB, chest pain, pulsus paradoxus, asymmetrical excursion, decreased or no breath sounds, tracheal deviation (late sign)
What happens during the second stage of acetaminophen overdose?
Symptoms will subside and feel better
RUQ pain
What is the rhythm? If they are asymptomatic, what is the initial treatment?
SVT, vagal maneuvers
What is the treatment for hypovolemic shock?
Fluids (LR) or blood
What are the complications of massive blood transfusions?
Temperature down, acidosis, coagulopathy, K+ raised, Mg down, air embolism, calcium down
What lab/diagnostic should be monitored during smoke inhalation?
Carboxyhemoglobin
What is the treatment for acetaminophen OD?
Gastric decontamination
Acetaminophen assay
Acetylcysteine
What is the rhythm and what is your initial nursing assessment?
Vfib, check the patient
What drug would be given in cardiogenic shock?
Dobutamine
What are the 5 Ps of ARDs?
Perfusion, positioning, PEEP, Protocol weaning, Preventing complications
What are the late signs of increasing ICP?
Diminished level of conscious, dilated and non reactive pupils, positive babinski reflex, seizures, vomiting without nausea, posturing, cushing’s triad (impending herniation)--wide pulse pressure, increased systolic blood pressure, decreased heart rate, and decreased respiration rate
12-48 hrs since last drink
2nd degree heart block type 1
What is the immediate treatment of anaphylactic shock and the dose?
Epinephrine 1:1000
When would you know to stop titrating Nitroglycerin IV?
reached maximum infusion of top dose, BP can’t be maintained, BP is getting to low, or not having chest pain anymore
What are the complications of spinal cord injury?
Pneumonia, pleural effusions, sepsis, ARDs, pneumothorax, barrel trauma, Autonomic Dysreflexia
What are the harmful effects of opioid overdose?
drowsiness, confusion, constipation, respiratory depression, hypotension, hypoxia, coma, permanent brain damage,death
What is the treatment if no pulse?
Defibrillate
Elevate HOB, anti embolism hoe
Which direction would the balloon pump move if upper body loss of pulses was present?
Down
What treatment would be expected in a patient with a GCS of 6?
Intubation
What are the adverse effects of acestyleine?
Nausea, vomiting, diarrhea, GI upset, anaphylaxis, bronchospasm, rash
Third degree heart block
What are the hemodynamics of septic shock?
Increased HR. Low SVR. Decreased CVP and PAP/PAWP from vasodilation