What is the focus during the primary survey?
Stabilizing life-threatening conditions
ABCDE
Loss of pacing artifact; does not pace at preset interval despite lack of intrinsic rhythm.
Failure to sense
Daily activity for an asthmatic patient.
Peak flow meter testing.
RN awareness about possible pandemic.
A large increase in ill people, increase fatalities, clusters of unusual illness from the same location
Patient is admitted with ETOH abuse. Her last drink was 15 hours ago. What will be the priority?
Prevent delirium tremens. CIWA protocol with Ativan.
Life threatening that commonly follows myocardial ischemia.
Cardiogenic shock
Patients who need airway protection.
ALOC
Seizures
Head or neck trauma
Neuromuscular weakness
Shock
VAP Protocol
HOB 30, PPI or H2 Blocker, chlorhexidine, DVT proph, SAT/SBT
Dry, waxy white, leathery, or hard skin.
3rd & 4th Degree
Nursing interventions when caring for a patient with heat stroke.
Cooling measures, ice to neck, axillae, groin, cold water immersion, sponge with cool water.
Heparin. aPTT.
Indicated after approx. 14 days of endotracheal intubation.
Tracheostomy
Constant headache, pupillary changes, confusion, restlessness, weakness on one side or one extremity
Early ICP
During the rehabilitation phase of wound injury, the contour of scarring can be controlled with this.
Pressure Garments
Category that a patient with a 40% TBSA would be placed.
What is immediate? Red.
Can be paroxysmal, persistent, or permanent with no discernible P waves.
Atrial fibrillation
Early signs of acute respiratory failure
Restlessness, headache, fatigue, tachycardia, air hunger, accessory muscle use
Precautions used to treat patients exposed to anthrax
Standard
A patient is burned over their entire posterior back and both legs, calculate the TBSA using the rule of nines.
54%
Patient is admitted with a lorazepam overdose. What medication will the nurse prepare to administer?
Romazicon (flumazenil)
ACLS treatment for pulseless ventricular tachycardia.
CPR, Shock as soon as possible, epinephrine, bag mask resuscitation
Conditions that decrease lung compliance
Pneumothorax/Hemothorax
Pleural Effusion
Pulmonary Edema
Pulmonary Fibrosis
ARDS
Sepsis Bundle
Lactate (repeat >2), cultures x2, Broad spectrum abx, IVF (30mL/kg if hypotensive or lactate > 4), Vasopressors