RASS/Sedation
This is the RASS value of a patient that is combative and violent.
What is +4 RASS?
Besides the 100% Oxygen breaths button, this is the only other button the RN can push on a ventilator
Silence
A central venous pressure (CVP) reading directly reflects pressure in this location.
What is Right Atrium?
This must be "wrenched in" to your EPIC flowsheet for your preop patient.
What is the preop checklist?
A significant sign of sepsis would be a lactate greater than
What is 4?
This medication has an increased risk of bradycardia
Precedex
The high pressure alarm is sounding on the ventilator. As you troubleshoot the alarm, you understand the patient likely needs this.
Endotracheal suctioning
One thick and 2 thin lines on a PA Catheter is at this cm mark.
What is 70cm?
These must be removed from the patient prior to going to the OR
What is jewelry or metal?
This acid-base imbalance would be seen in clients with sepsis.
What is metabolic acidosis?
A patient on a ventilator has a pH of 7.47 and a paCO2 of 30mmHg. What breathing pattern do you suspect this patient doing?
Hyperventilating
This will need to be assessed if the patient is able to speak to you while intubated
What is the cuff/balloon pressure?
A patient has a CVP of 2 mmHg and a mean arterial pressure (MAP) of 65 mmHg. What does the CVP value most likely indicate?
Hypovolemia
What is the primary purpose of a preoperative assessment in a patient scheduled for surgery?
To establish a baseline for postoperative care
A patient in septic shock has a MAP of 58 mmHg despite adequate fluid resuscitation. What class of medication would be appropriate to administer next?
Administer a vasopressor
A nurse is caring for a patient who has been intubated and is receiving mechanical ventilation. The patient’s most recent arterial blood gas (ABG) results show a pH of 7.32, PaCO2 of 56 mmHg, and PaO2 of 85 mmHg. Based on these findings, what action should the nurse prioritize?
Increase the tidal volume setting on the ventilator
Interpret this ABG
pH: 7.15
CO2: 67
HCO3: 23
What is uncompensated Respiratory Acidosis?
A patient in cardiogenic shock has a blood pressure of 80/50 mmHg, cardiac index of 1.5 L/min/m², and systemic vascular resistance of 2000 dynes·s/cm⁵. Which type of medication would you suspect to use?
Positive inotrope
What is most the important intervention in preventing surgical site infections (SSIs) prior to the procedure?
Administration of prophylactic antibiotics
What is the recommended time frame for administering antibiotics in suspected sepsis?
Within 1 hour of recognition
The doctor's order for sedation medications should include these 4 things about the medication
Initial Dose, Titration amount, Titration frequency, Max Dosage
List four ways to prevent VAE.
Handwashing, elevate head of bed, oral hygiene, Daily SBTs, prophylactic antibiotics, manage secretions.
List three positive inotropes
Pure inotropes: Dobutamine, Milrinone, Isoproterenol, Digoxin
Ino-pressors (both vasopressor and inotropic contractility effects at moderate to high doses): Epinephrine, Norepinephrine, Dopamine
List four responsibilities of your role is when a PA Cath is being inserted?
Ensure sterile technique is followed, monitor hemodynamics, administer medications per MD order, ensure Time out is completed, ensure consent has been obtained, crowd control
These three lab values can indicate early signs of DIC in your septic patient.
What is AST, ALT and D-Dimer?