Perfusion in Practice
First stabilization step for AFib or HF crises?
Ensure oxygenation
Narrow pulse pressure suggests what?
Cardiogenic shock
What breathing pattern often appears near end‑of‑life?
Cheyne‑Stokes respirations
A patient with cardiogenic shock is dyspneic with crackles. What position is best?
Semi-Fowler's / Upright
BNP elevation helps diagnose this condition.
Heart failure exacerbation
AFib episodes may be triggered by which lifestyle factor?
Stress / caffeine / alcohol
A patient in early shock has normal vital signs but rising lactate. What is happening?
Compensation masking hypoperfusion.
What is a key early sign of ARDS seen within 72 hours of injury?
Rapid‑onset severe dyspnea
Why would a nurse expect to use braces / cervical collar and log-roll turn a patient with neurogenic shock?
Prevents further spinal cord injury
Echocardiogram helps identify what key HF measurement?
Ejection Fraction (EF)
Give ONE education point about energy conservation for acute HF patients.
Pace activities + rest frequently to reduce cardiac workload and dyspnea
A patient in compensatory shock becomes increasingly tachycardic. What does this indicate?
SNS activation attempting to maintain perfusion
COPD exacerbations commonly cause air trapping due to loss of what lung property?
Elastic recoil
First action after chest tube dislodgement?
Cover with sterile dressing taped on 3 sides (allows air escape)
ARDS CXR often shows what classic appearance?
Bilateral infiltrates (“white-out”)
Explain why AFib increases stroke risk using one patho mechanism.
Blood stasis in fibrillating atria → clot formation
A patient with neurogenic shock has a temperature of 95°F (35°C). What should the nurse do first?
Apply external warming due to poikilothermia
BiPAP is indicated in COPD exacerbation when what develops?
Hypercapnia or increased work of breathing
Electrical cardioversion is indicated in AFib when a patient is ________.
Hemodynamically unstable (hypotension, chest pain, altered mentation)
Explain why AFib patients need immediate assessment of electrolytes.
Electrolyte imbalances (K, Mg) precipitate arrhythmias
For AFib w/RVR, what is the FIRST goal: rate control or rhythm conversion?
Rate Control - First-Line in Stable AF w/RVR
Rhythm Control (If Indicated or Hemodynamically Unstable)
A patient with cardiogenic shock becomes more hypotensive after a fluid bolus. What should the nurse do next?
Notify the provider and anticipate inotropic support.
A tension pneumothorax shifts the trachea in which direction?
Away from affected side
What initial treatment is essential for a tension pneumothorax?
Immediate needle decompression
Thoracentesis helps distinguish transudative vs exudative pleural effusion by analyzing what?
Protein/LDH levels