emergency & critical rescue
Clinical Manifestation
nursing interventions
prioritizing pharm
the "Do's and Don'ts" pt ed
100

This is the priority nursing action for a patient with preeclampsia who begins to experience a seizure.

What is staying with the patient, calling for help, and ensuring a patent airway?

100

This "classic" manifestation of left-sided heart failure involves the patient waking up at night with a sudden sense of breathlessness.

What is Paroxysmal Nocturnal Dyspnea (PND)?

100

To minimize the risk of infective endocarditis after a valve replacement, the nurse should instruct the patient to avoid these for 6 months.

What are dental procedures?

100

Patients taking this class of lipid-lowering drugs must be told to report any new muscle cramping or pain immediately.

What are Statins (HMG-CoA Reductase Inhibitors)?

100

Patients with a new permanent pacemaker should be instructed to avoid this specific medical imaging test indefinitely.

What is an MRI?

200

After an arterial thrombectomy, the nurse must monitor the affected extremity for these three things every hour for the first 24 hours.

What are color, temperature, and pulses?

200

These are the "Key Features" of Mitral Valve Prolapse, which differ from typical angina.

What are atypical chest pain, dizziness/syncope, and a systolic click?

200

When teaching a patient how to use sublingual nitroglycerin, the nurse should explain they should feel this sensation under their tongue if the medication is fresh.

What is a tingling or burning sensation?

200

This specific side effect of ACE inhibitors is the most common reason patients are switched to ARBs.

What is a dry, hacking cough?

200

Following a heart valve replacement, a patient must be taught to avoid this specific dental hygiene tool to prevent bacteria from entering the bloodstream.

What is an electric toothbrush (or water irrigation devices)?

300

A nurse assessing a patient 24 hours after cardiac surgery notes a urine output of less than 25 mL/hr and elevated BUN/Creatinine. These findings indicate this complication.

What is Acute Kidney Injury (AKI)?

300

This specific skin assessment finding—a reddish-brown discoloration along the ankles and lower calves—is indicative of venous insufficiency.

What is stasis dermatitis?

300

The nurse should maintain the head of the bed at 45 degrees during this type on crisis.

what is hypertensive

300

When giving a IV bolus of Magnesium Sulfate, the nurse should expect the patient to report these three common side effects.

What are flushing, sweating (feeling hot), and thirst?

300

To promote venous return in a patient with venous insufficiency, the nurse should teach the patient to elevate their legs for this amount of time several times a day.

What is 10 to 20 minutes?

400

If a patient receiving fibrinolytics develops a sudden change in neurological status, the nurse should immediately suspect this life-threatening complication.

What is a hemorrhagic stroke?

400

In PAD Stage III (Rest Pain), patients often report that their pain is relieved by placing their leg in this specific position.

What is a dependent position (hanging the leg over the side of the bed)?

400

A nurse is teaching a patient with a new permanent pacemaker to avoid lifting their arm above their head for 4 weeks for this reason.

What is to prevent dislodging the pacemaker leads/wires?

400

This is the "Black Box Warning" associated with the abrupt discontinuation of Beta Blockers like Atenolol.

What is an increased risk of angina and myocardial infarction?

400

A patient prescribed Sublingual Nitroglycerin should be taught they can take the medication how?

What is up to 3 pills with 5 minutes between each.

500

This condition is suspected when a post-CABG patient presents with muffled heart sounds, jugular venous distention (JVD), and decreased urine output.

What is cardiac tamponade?

500

These are the clinical manifestations of the transition from preeclampsia to eclampsia

what is Jaundice and seizures

500

What are the Primary nursing interventions for flash pulmonary edema?

Diuretics, and protecting the airway

500

Patients taking Warfarin (Coumadin) should be taught to maintain a consistent intake of this vitamin to keep their INR stable.

What is Vitamin K?

500

Patients with Heart Failure should be taught to notify their provider if they gain more than this amount of weight in one week.

What is 3 to 5 pounds (or 2 lbs in 24 hours)?

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