CV
A patient with infective endocarditis develops tender red-purple nodules on the fingertips and toes, called what?
What are Osler’s nodes?
- Osler’s nodes are painful, raised lesions on fingers/toes caused by immune complex deposition in infective endocarditis.
pH 7.30, PaCO₂ 35 mmHg, HCO₃⁻ 18 mEq/L.
What imbalance does this represent?
What is metabolic acidosis?
- Low pH and low bicarbonate indicate metabolic acidosis with no respiratory compensation yet.
This type of shock is treated with epinephrine IM.
What is anaphylactic shock?
A patient with a stroke demonstrates poor impulse control or impaired decision-making. Which lobe is his stroke likely located in?
What is a frontal lobe stroke?
A patient with spinal cord injury suddenly develops hypertension, bradycardia, and flushing above the lesion. What is this?
What is autonomic dysreflexia?
A patient on Levophed (norepinephrine) is being treated for which condition?
What is hypotension or shock (it acts as a vasopressor)?
pH 7.50, PaCO₂ 28 mmHg, HCO₃⁻ 24 mEq/L.
What imbalance is this?
What is respiratory alkalosis?
- High pH and low CO₂ indicate alkalosis from hyperventilation.
A patient in neurogenic shock after spinal trauma presents with hypotension and bradycardia. Why?
Answer: What is loss of sympathetic tone?
A patient has a stroke that causes fluent but nonsensical speech and difficulty understanding language. Which part of the brain is affected?
What is Wernicke’s area?
The priority nursing action in autonomic dysreflexia is what?
What is to remove the triggering stimulus (check bladder, bowel, tight clothing)?
Cardene (nicardipine) is prescribed to a patient with a systolic BP of 190 mmHg. What is the nurse’s priority monitoring parameter?
What is blood pressure (Cardene is a calcium channel blocker that lowers BP)?
pH 7.28, PaCO₂ 55 mmHg, HCO₃⁻ 26 mEq/L.
What is the diagnosis?
What is respiratory acidosis?
- Retention of CO₂ due to hypoventilation.
A patient with pneumonia develops sepsis. Their skin, initially warm and flushed, is now cool and pale. What concerning sign should the nurse monitor for and report immediately?
What is cold and clammy skin?
In a patient with aneurysmal subarachnoid hemorrhage (aSAH), the nurse is planning care to prevent secondary brain injury from vasospasm. Which medication is indicated, and name other interventions?
What is Nimodipine
Maintain euvolemia with IV fluids
Monitor for delayed cerebral ischemia
A patient has difficulty breathing and requires ventilatory support after a spinal cord injury. Which level of injury is most likely?
What is C3 injury?
A patient’s ScvO₂ has decreased from 70% to 55%. Which cause should the nurse assess for?
What is decreased cardiac output, low hemoglobin, decreased arterial oxygen saturation₂, or increased metabolic demand?
pH: 7.49; PaCO₂: 48 mm Hg; HCO₃⁻: 32 mEq/L
What condition does this indicate, and what compensatory mechanism is occurring?
What is metabolic alkalosis with partial respiratory compensation?
The kidneys caused alkalosis by retaining bicarbonate (HCO₃⁻). The respiratory system compensates by retaining CO₂ (acid). The less abnormal PaCO₂ shows this compensatory response — it’s moving in the opposite direction to balance the pH.
A patient with sepsis develops oozing at IV sites, petechiae, and prolonged PT/PTT. Labs show low platelets and elevated D-dimer. What is the most likely complication?
What is DIC (Disseminated Intravascular Coagulation)?
- Widespread clotting consumes clotting factors → bleeding.
A patient with elevated ICP from TBI has a PbO₂ of 15 mmHg. What are appropriate nursing actions?
What is elevate HOB 30–45°, maintain PaO₂ > 100 mmHg, administer hypertonic saline, transfuse RBCs for anemia, and avoid coughing/straining?
A patient with a spinal cord injury demonstrates wrist extension and partial thumb/index finger flexion. Which level of injury would allow this movement?
What is C5–C6 injury?
CVP and PAWP values are used to assess what?
What is preload and overall fluid status?
pH = 7.33; PaCO₂ = 58 mmHg; HCO₃⁻ = 29 mEq/L
Which acid–base imbalance is present, and what compensatory mechanism is occurring?
What is respiratory acidosis with metabolic (renal) compensation? - In respiratory acidosis, the kidneys compensate by retaining bicarbonate (HCO₃⁻) and excreting hydrogen ions (H⁺) to help restore acid–base balance. The kidneys reabsorb most of the filtered bicarbonate back into the blood, excrete hydrogen ions in the urine, and generate new bicarbonate. This process increases serum HCO₃⁻ levels, which helps neutralize the excess acid and gradually bring the pH toward normal.
Progressive failure of two or more organ systems due to severe inflammation and poor perfusion that happens after septic or other types of shock?
What is Multiple Organ Dysfunction Syndrome?
What interventions should the nurse implement for a patient with a traumatic brain injury (TBI) to prevent ICP increases?
What is - Elevate the head of the bed to 30-45 degrees, Monitor for Cushing's triad (widened pulse pressure, bradycardia, irregular respirations), Monitor for changes in pupils
A patient presents with flaccid paralysis of the lower extremities, saddle anesthesia, and bowel/bladder incontinence. Which type of partial spinal cord injury is this?
What is Cauda Equina syndrome?