114 Unit 4

Anemias

100

Vitamin B12 is also called __________.

Pernicious anemia 

200

Which portion of hemoglobin does oxygen bind to?

heme (the iron portion)

300

A patient with hemophilia has an injury to their leg. Do you apply ice, heat, or alternate both?

Ice; cold promotes vasoconstriction & limits bleeding 

400

True or false: The first line treatment for a patient having a sickle cell crisis is to administer a “clot buster”.

False, there is no way to ”bust up” these clots like you would a platelet-based clot because sickle cell clumps are RBC’s clotting on top of one another.  

500

What is the importance of serum MMA?

Distinguishes between folic acid & B12 anemia (they can look alike)

Cardiac

100

Which side heart failure has s/s of JVD?

Right-sided heart failure 

200

Yesterday, your patient had a BNP that was slightly elevated. Today their BNP is severely elevated. What does a BNP show and what does this mean for your patient?

BNP reflects fluid volume status; the higher the BNP the worse the heart failure is. 

300

What is a VAD and what does it do?

Ventricular Assist Device; it is implanted around the ventricle to squeeze it from the outside & push blood forward & restore perfusion 

400

Name the 2 surgical interventions for CAD

Cardiac Cath & CABG 

500

3 truths & 1 lie. Which is the lie?

1. Morphine decreases cardiac demand 

2. Nitroglycerin is light-sensitive

3. Chewing aspirin prevents RBC’s from clumping onto plaque

4. Morphine is given if nitro does not relieve the pain 

3. Chewing aspirin prevents PLATELETS from clumping onto plaque 

Strips

100

A 16 YO Male comes into the ER with a possible ankle sprain after his track meet. His initial vitals are: T 98.2, BP 128/76, HR 54, RR 20, O2 99% on room air. What medication will you give him for his heart rate?

None. Only treat bradycardia when it is symptomatic. This patient is a young, healthy athlete. 

200

What is wrong with this scenario?

You are defibrillating a patient in pulseless V-tach. As another RN is performing CPR, you charge the defibrillator to 360 joules. Another RN administers EPI. Once the defibrillator is charged, the you press the button for the shock to be delivered. The patient is now in NSR. 

You forgot to yell ”CLEAR”!!!!!

300

Name the dysrhythmia & how you treat it. 

Heart quivers in a totally uncontrolled, irregular pattern. 

Ventricular Fibrillation (V-fib)

CPR, Epi, Amiodarone, Defibrillate 

400

You walk into a patients room to introduce yourself. They don’t respond when you call their name or touch them. They’re strip shows NSR. What do you do?

Check for a pulse. They may be in PEA. 

500

When you see a _______, think digoxin toxicity or __________. For any dysrhythmia, check hypoxia & __________ first. 

U wave; Hypokalemia; electrolytes 

Med Emergencies

100

What does ABCD stand for in universal triage?

A = Airway 

B = Breathing

C= Circulation

D = Disability 

200

What is the START triage mnemonic?

Respirations, Perfusion, Mental status 

300

Organize these into primary & secondary survey.

Hemorrhage control

Foley catheter

Intubation

V-tach

Vital signs

Antiemetic administration  

Primary: Hemorrhage control, Intubation, V-tach 

Secondary: Foley catheter, Vital signs, Antiemetic administration 

400

A male patient comes into the ER after a house fire. His face, anterior chest & abdomen, both palms of his hands & fingers, and genitalia have 3 degree burns. What is his TBSA?

Face = 9%

Anterior chest & abdomen = 18%

Both palms + fingers = 2%

Genitalia = 1% 

TBSA is 30%

500

A patient with head trauma comes into the ER. They open their eyes & make sounds when you apply pressure to their sternum and have normal flexion. What is their GCS? 

Eye opening: pressure = 2

Verbal response: sounds = 2 

Motor response: normal flexibility = 4 

GCS score of 8

Meds

100

What 4 medications do you give for anaphylaxis?

First: Epinephrine

Then: antihistamines, corticosteroids, and inhaled bronchodilators 

200

What is tPA and which type of stroke cannot have it?

Tissue plasminogen activator: dissolves/ breaks down the clot to restore blood flow; hemorrhagic strokes cannot have tPA

300

True or false:

Adenosine is given for symptomatic bradycardia

Amiodarone is given for V-fib 

Atropine is given for SVT 

False. 

Adenosine is given for SVT

Amiodarone is correct 

Atropine is given for symptomatic bradycardia 

400

What is FabAV used for?

Crotaline snake bites 

500

Name the 5 medications used to treat CAD.

Beta blockers, Digoxin, Calcium channel blockers, Statins, Anti-platelet aggregator