Vitals
Normal Adult Temperature Range
96.8-100.4
What drug should we stop if the patient starts to twist their neck and smacking their lips?
Signs/symptoms of Tardive dyskinesia
Metoclopramide
If a patient needs Chemotherapy would we insert a PIV or a CVC? Why?
CVC, chemo is a highly vesicant drug that can cause extraversion and necrosis to small veins.
Normal Blood pH
7.35-7.45
Patient comes in who was just in a car accident where in which they hurt their arm. They complain to you about loss of sensation and pain, and after the doctor administers morphine the pain still does not go away. What should you suspect is happening with your patient?
Compartment Syndrome
5 P's and pain meds are not effective
Normal Oxygen Saturation in Hemoglobin
95-100%
Doxorubicin
What line can we leave in for a year? and what does the acronym stand for?
PICC (Peripherally Inserted Central Catheter)
Normal Platelet range
150,000-400,000
a patient comes in with a broken ankle. Upon inspection you notice that the bone has also broken the skin. The foot has no pulse and you suspect bacteria has mixed with the open wound. the patient's foot looks black and has excessive pus?
What should you suspect is going on with your patient?
(Be as specific as possible)
Necrosis-Gangrene-Wet
Normal Systolic Blood Pressure Range
Normal Diastolic Blood Pressure Range
(need both correct)
100-139
60-89
Increases uric acid
allopurinol
What are the three locations you can insert a CVC line and which should be avoided if possible and why?
Jugular, Subclavian, Femoral
Avoid Femoral because of the risk for infection
Normal Hemoglobin range
12-16
Your patient is on TPN. After a day or so you notice the sclera of their eyes are yellowish, they have ascites and impaired blood clotting? What should you suspect?
Liver failure due to the TPN
Normal CO2 Levels
35-45
A patient is on epoetin. What is the indication to start this drug and what should the nurse monitor while the patient is on this drug? finally what should the nurse pair with this drug in order for it to be effective
to increase RBC's
Watch for HTN and HTN seizures
Take with iron
When you put in an NJ tube and you meet resistance what should you do first?
Try rotating the tube
Normal Creatinine?
Less than 1.3
You have two patients one patient is 94 y/o who is receiving morphine for severe back pain and the other is a 30 y/o receiving morphine after a bad fall where she broke multiple bones. You're 94 y/o patient starts going into respiratory depression and your 30 y/o patient is fine. You gave both the same dose and the 94 y/o got it almost an hour earlier.
What should you suspect is the physiology behind the two reactions?
Because older adults have impaired blood flow it delays the response (why it took longer than the 30 y/o to take effect) and have a decreased renal and hepatic function so the drug can become more toxic easily. We need to lower the dose (i.e. why the same dose could be fine with a younger person but toxic to an older person)
Normal Pulse Pressure and how to calculate it
30-60
Oprelvekin vs Ondansetron
What does each treat?
Which causes drowsiness and headaches?
oprevekin- increase platelets
Ondansetron- antiemetic that causes drowsiness due to the drug blocking serotonin
You walk into a patient's room and you see two bags connected to primary tubing leading into their IV. Each of the bags "takes turns" dripping solution into the patient's IV. What is this setup called?
IV piggy back
# of platelets that would be called a "platelet crisis"
under 50,000
A patient comes to the ER unconscious and extremely diaphoretic and tachycardic. The nurse is a very smart nurse so she knows exactly what to test for and how to intervene. What does the nurse check and what intervention does she (with the doctors permission) perform?
Extra 100 poin
Checks blood glucose
Administers glucagon
Extra 100 points if you can name what the nurse would do if the patient were conscious?