Sexy Organs
What is the nursing priority when proning a patient?
Airway
What type of penetrating trauma has the highest probability for extensive internal organ damage?
GSW
Following the placement of a nasogastric tube, what is the next priority step?
CXR
The primary purpose of a pulmonary artery catheter is to best assess what?
Fluid Volume Status!
A patient with a Hgb of 5.5 receives 2 units of PRBCs. What is the anticipated post-infusion Hgb value?
7.5
What EKG finding & Lab Value would indicate a patient is experiencing an active STEMI?
ST Elevation
+ Troponins
For a patient in Rhabdomyolysis, fluids should be given to acheive an hourly urine output of:
100 mL/h
What 2 laboratory values confirm DKA rather than HHS?
Ketones +
What are the normal values and/or ranges for the following:
CVP / RAP
PAOP
MAP
SVR
Lactic Acid
CVP/RAP 2-6
PAOP 8-12
MAP > 65
SVR 800-1200
Lactic Acid < 2.0
When initiating ventilations on an intubated patient during an ACLS cardiac arrest, the nurse should deliver breaths following what ACLS ventilation guideline?
Deliver 1 breath every 6 seconds (about 10 breaths per minute) while continuous chest compressions are performed.
A nurse is assessing a patient who reports sudden, severe chest and back pain. The provider suspects either a myocardial infarction or an aortic dissection. Which assessment finding would most strongly support a diagnosis of aortic dissection?
Unequal blood pressure readings between the arms
What rate of infusion (mL/hr) should a patient who is 200 lbs with 25% TBSA burned receive in the first 8 hours of care per the ABLS formula?
284 mL/hr
(200/2.2 x 2 x 25 = 4545mL / 2 = 2272mL / 8h = 284mL/h)
A patient is admitted after severe vomiting and diarrhea for three days. The patient is hypotensive and has decreased urine output. The provider suspects acute kidney injury. What type of AKI is most likely?
Pre-renal AKI
A patient is diagnosed with severe sepsis with hypotension.
What provider order (with dosage) would the nurse anticipate receiving and initiating first?
Rapid administration of IV fluids (30 mL/kg crystalloid bolus).
A 52-year-old male with a history of COPD has been taking prednisone 40 mg daily for 3 months for an exacerbation. He abruptly stopped taking the medication without tapering. He now presents to the emergency department with severe fatigue, dizziness, nausea, and hypotension.
What condition does the nurse anticipate this patient is experiencing and what is the cause?
Acute adrenal insufficiency (Addisonian/Adrenal crisis) due to abrupt steroid withdrawal
Name 2 Ventilator Modes that would be inappropriate for a patient with a GCS of 3:
Pressure Support
CPAP
SIMV
A patient is experiencing hypovolemic shock due to acute hemorrhage. Which hemodynamic profile (CO, PAOP, CVP, MAP, Lactate) would the nurse expect (i.e. increased or decreased)?
CVP ↓
PAOP ↓
CO ↓
MAP ↓
Lactate ↑
Name three laboratory values that would be altered in liver failure, and indicate whether each would be increased or decreased.
Bilirubin – Increased
AST/ALT – Increased
Albumin – Decreased
PT/INR - Increased
Ammonia - Increased
The nurse is caring for a patient in the cardiac care unit (CCU) following a STEMI. The patient is hypotensive, diaphoretic, tachypneic, and tachycardic. The patient is intubated and has an SpO₂ of 90% on 70% FiO₂.
What continuous IV medication would the nurse anticipate being ordered as a priority for this patient?
Dobutamine
After completing a 1 L IV normal saline bolus for a patient with severe Diabetes Insipidus, name:1 laboratory value & 4 nursing assessments that would best help determine the effectiveness of fluid volume replacement & organ perfusion.
Lactic Acid
HR
BP
UOP
LOC
Name 4 possible causes of ARDS:
Sepsis
Trauma
Pneumonia/Infection
Aspiration
A trauma patient with severe hemorrhage is developing the Trauma Triad of Death. What are the three components of this triad, and how would we assess those components?
Hypothermia - temp
acidosis - pH on ABG, LA
coagulopathy - PT, PTT, INR, signs of uncontrolled bleeding
You are caring for a patient who does not open their eyes, cannot follow commands, mumbles & grunts when attempting to speak, and withdraws from pain when you apply a trapezius pinch.
1. What is the patient’s Glasgow Coma Scale (GCS) score?
2. Based on this score, what is the priority intervention for this patient?
GCS Calculation
Eye Opening: None = 1
Verbal Response: Incomprehensible sounds (mumbling/grunting) = 2
Motor Response: Withdraws from pain = 4
Total GCS = 7
A GCS ≤ 8 indicates severe brain injury, and the priority is airway, intubation
What hemodynamic values would the nurse anticipate in a patient with severe heart failure following an extensive left ventricular myocardial infarction? Indicate whether each value would be increased or decreased.
CVP
PAOP (PCWP)
Cardiac Output (CO)
Systemic Vascular Resistance (SVR)
CVP – Increased
PAOP (PCWP) – Increased
Cardiac Output – Decreased
SVR – Increased
Identify the rhythms on the handout!
A: A flutter
B: 3rd degree heart block
C: junctional ryhthm