ER Basics
Advanced ER
OR
OR2
Other
100
What is the principles of emergency nursing?
What is ... ABCDE (Airway/Cervical, Breathing, Circulation, Disability, Exposure)
100
How do you know if a patient sustained liver damage in an Emergency? What about renal damage?
What is ... assess for bleeding, monitor labs (AST/ALT) - Liver. Urinary - monitor I&O. assess urine characteristics
100
Describe the classifications of surgery: Minor, Elective, Emergent, Major.
What is ... Minor: Procedure without significant risk; often done with local anethesia Elective: Planned for correction of a non-acute problem Emergent: Requires immediate intervention; may be life-threatening if treatment is delayed 24-48 hours Major: Procedure of major risk; usually longer and more extensive than a minor surgery
100
List 3 (each) clear liquid and full liquid diet options
What is ... clear: juice, jello, water, broth, etc. Full: milk, ice cream, strained cream soups, etc.
100
How will a pts VS change in hypovolemic shock?
What is ... BP will drop, pulse will increase. RR will be tachypneic
200
You are first responder at a MVA. The car has rolled in the middle of the intersection and the driver is trying to crawl out with his R arm held against his chest. You notice the strange angle of the arm and seen white protruding through. What do you do?
What is ... check for safety. Activate EMS. Assess ABCDE. pt breathing (A & B ok). Pt bleeding from compound fx. Pt alert and awake. Pt exposed to environment. Immobilize arm.
200
What actions do you take when you are at a park with your child and they just received a bee sting?
What is ... remove stinger by scrapping off, apply ice, keep below heart.
200
Who is responsible for obtaining informed consent?
What is ... the surgeon
200
Describe s/s of a DVT. What post op exercises do we teach to prevent venous stasis, thrombophlebitis, and DVT?
What is ... unilateral leg pain especially with Holmans Sign. Leg may be tender, swollen, hard, warm to touch. Exercises include dorsiflexion/plantar flexion every hour.
200
What is a tick and how do you remove them?
What is ... a tick is a insect in the arachnid family. You remove it by using tweezers to pull the tick away from the skin in a slow steady pressure
300
What do we do to provide an airway for a patient with suspected cervical trauma who needs CPR?
What is modified jaw thrust
300
Describe nursing considerations for a pt in the hospital setting after a near drowning in the ocean
What is ... Assess pulmonary status, Give O2, prepare for ETT, CPR if needed, gastric decompression
300
What is incentive spirometry and what is its purpose?
What is ... incentive spirometry is the use of a medical device in which you inhale to a determined point to help promote slow deep breaths. The purpose is to promote lung expansion after surgery and to prevent post-op complications
300
When transferring a pt from PACU to the surgical floor we need to monitor VS and general assessment more often. What is the "times four" rule for this?
What is ... VS every 15 min x4, every 30 min x4, every hour x4, then every 4 hours
300
What is the purpose of preop medication for surgery?
What is ...reduce the amount of anesthesia needed, promotes sedation (promote anesthesia induction)
400
A pt came into the ER with a snake bite on his forearm. What are our priority nursing considerations?
What is ... check for allergies prior to administering antivenin. Give O2 and admin isotonic fluids IV. Apply continuous cardiac and BP monitoring. Admin tetnus, wound care, and abx. Antivenin
400
Describe a full assessment for the airway and breathing parts of emergency ABCs
What is ... check for breathing or obstruction. Assess rate, rhythm, depth, effort, symmetry
400
What is a T-tube used for and what color secretions does it collect?
What is ... a t-shaped tube used in open cholecystectomy to drain bile. Bile is brown or green.
400
Defferentiate between evisceration and dehiscence. Describe s/s, and tx.
What is ... Dehiscence is partial or complete separation of the outer wound layers. Evisceration is total separation of all wound layers of a surgical incision with protrusion of internal organs. Both occur 5-10 days post op. Client may bee a pull, give, or pup with a sudden gush of serosanguinous drainage. Place in supine position with knees/hip bent. Cover with a sterile moist saline dressing. Notify MD and surgical team.
400
What safety issues are you monitoring with versed?
What is ... -tolerance -less effective with repeated use -cardio depression - shock hypotension -fall risk
500
A local hospital has been notified of a recent terrorist event. Media has been contacted through broadcast messaging and the Disaster Medical Assistance Team has been activated to help out with the situation. It has been determined that anthrax has been released at a local post office. You understand that the hospital will need what on hand to combat this bacteria?
What is ...antibiotic Ciprofloxacin (Cipro)
500
A family member was quickly chopping vegetable for dinner when the phone rang. She was so startled the knife slipped out of her hand and cut her inner wrist. She is bleeding profusely when you come across her. You first action is to... She is diaphoretic and breathing quickly. What do you think is happening to her? If the bleeding doesn't stop what can you do? What will they do at the hospital?
What is...put firm pressure on the wound and if possible put in modified trendelenberg (supine with feet elevated), she is going into hypovolemic shock. Apply indirect pressure at pulse superior/proximal to wound. Tourniquet as last resort. At the hospital they will replace blood volume with isotonic fluids and blood products and administer vassopressors
500
List/describe 4 post-op teachings and when should they be completed
What is ... should be taught in pre-op. 1) Leg exercises to prevent DVT and use of TED hose 2) How to assess pain and use PCA 3) How to use incentive spirometer 4) How to use the pillow to splint for coughing, TCDB, moving, etc 5) Multiple others
500
Define informed consent. What does it indicate?
What is ... consent implies the pt has been given sufficient info to understand the following: nature and reason for surgery, who will be performing and whether others will be present, all available options and risks associated with those options, risks associated with surgery and anesthesia. Informed consent indicates that the patient has been given the info and understands the upcoming surgery and is voluntarily choosing to undergo this surgery.
500
Using your triaging skills order (color code) the following pts: A) pt with arm laceration (oozing blood), pulse and CRT present, RR 18, wandering around B) Pt with burned face and singed nasal hairs, coughing, RR 32, pulse 98, CRT 2 secs 3) Pt with 80% TBSA burns, pulse weak 108, RR absent, unable to obtain CRT 4) pt unable to move either legs, RR 18, pulse 89, CRT 1 sec
What is ... 1) Green 2) Red 3) Black 4) yellow
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