EKG
Acid- base balance
Fluid and electrolyte
Fluid and electrolyte 2
Mystery
100
a lethal rhythm that results in the quivering of the ventricles which leads to a rapid fall in cardiac output.
What is ventricular fibrillation (V-fib)
100
A patient is experiencing respiratory alkalosis. What is the most classic sign and symptom of this condition?
What is Tachypnea
100
A patient with a magnesium level of 3.6 would exhibit what symptoms ? Name 3.. and what med can you administer?
What is Hypotension, Profound Lethargy, Respiratory failure, reduced deep tendon reflex, prolonged PR interval... loop diuretics.
100
3 patients in the ER, one is currently prescribed/taking lithium, the second is receiving hypertonic fluids, the third has just been diagnosed with hyperaldosteronism ... what are all 3 patients at risk for?
What is hypernatremia aka actual sodium excess.
100
A patient's calcium level is 6.9. Which of the following is a nursing priority?
- A. Initiate seizure precautions
- B. Educate patient about foods rich in calcium
- C. Administer Calcitonin
- D. Administer Vitamin D supplements as ordered
What is Initiate seizure precautions
200
This rhythm has a saw-tooth appearance... and what medication would you expect to be ordered for this rhythm?
What is atrial flutter and calcium channel blocker/ beta blocker.
200
Your patient is dehydrates, has a K+ of 5.7, presenting with Kussmaul respirations, peak T waves, warm/flushed/dry skin and confusion. What is going on? and name 3 priority interventions?
What is metabolic acidosis and initiate tele monitoring, administer prescribed fluids, kayexalate, and bi carb for PH < 7.2.
200
A patient with a sodium level of 178 is ordered to be started on 0.45% Saline. What is the most IMPORTANT nursing intervention for this patient?
Give slowly and watch for signs and symptoms of cerebral edema
200
S/S: Ventricular dysrhythmias (premature atrial contractions, premature ventricular contractions, increased u waves, flat or inverted T waves – leading to cardiac arrest)
What is hypokalemia
200
You would expect to initiate/implement this fluid replacement order for a patient in DKA.
what is Hypotonic fluids after initial bolus, then switch to 5% dextrose in .45% NS at 250 mg/dL
300
If a patient has been in atrial fibrillation for more than 48 hours,____ is needed prior to a cardioversion due to the risk of what?
what is anticoagulation therapy and the risk of blood clot?
300
Respiratory alkalosis can affect other electrolyte levels in the body. Which of the following electrolyte levels can also be affected in this condition?
Calcium and potassium levels
300
A client with acute kidney failure states, "Why am I twitching and my fingers and toes tingling?" The nurse should respond, "This is caused by:
What is hypocalcemia
300
A patient has a calcium level of 12.5. Which medication will most likely be ordered for this patient?
What is calcitonin
300
Provide this discharge education for DKA PT
What is monitor glucose every 4-6 hours while over 250 mg/dl, check for ketones if >300mg/dL
400
Your patient has this rhythm, what is it and name 3 priority interventions you are going to do for them.
What is give 02, 12-lead EKG, administer amiodarone/lidocane... If cardioversion hold digoxin for 48 hours prior.
400
A patient has the following blood gases: PaCO2 25, pH 7.50, HCO3 19. Which of the following could NOT be the cause of this condition?
What is COPD
400
The physician has documented "insensible fluid loss of approximately 800 mL daily" .. The nurse plans to monitor, knowing that insensible fluid loss occurs through which types of excretion?
What is integumentary and respiratory system output .. aka lungs and skin
400
Name 3 medications/interventions for hyperkalemia
In emergency situation : - Calcium gluconate given IV – calms excitability of cells
- Sodium bicarbonate given IV – promotes excretion of K
-IV administration of regular insulin with dextrose shifts potassium into the cells
-Albuterol tx – promotes cellular uptake of K
-Peritoneal or hemodialysis
-Diuretics: loops/furosemide enhances renal excretion of K
400
Your patient has lab value of 1.8 INR and PT of 13 seconds, increased HR, palpations and decreased weight gain... what do you expect this patient to have and what do you expect the doctor to order for this patient? Name 3 things
What is Leukemia and bone marrow aspiration and/or biopsy, neutropenic precautions, intense combo drug therapy (chemo)
500
The patient's ECG shows this rhythm above. The patient is symptomatic and experiencing shortness of breath and chest pain. The patient's blood pressure in 80/44 with the heart rate fluctuating between 130-150s. The nurse calls a rapid response and prepares the patient for?
What is synchronized cardioversion
500
A patient states they have been vomiting for the last 4 days. The patient is irritable, weak, and reporting muscle cramping and weakness. On assessment, the patient is experiencing bradypnea with a respiratory rate of 10. The patient has the following ABGs result: HCO3 36, pH 7.52, PaCO2 48. Which condition below is presenting?
What is Metabolic alkalosis partially compensated
500
What electrolyte imbalance is a potential for digitalis toxicity
What is hypokalemia
500
An EKG shows a shortened QT interval. Which lab value below would be indicative of this change?
- A. Calcium level of 8.0
- B. Calcium level of 12.0
- C. Calcium level of 8.7
- D Calcium level of 9.2
- B. Calcium level of 12.0
500
A patients X-ray finding shows a swiss cheese bone loss, what do you expect the patient to have and what do you do for them? name 3
What is Multiple Myeloma and give analgesics for bone pain, Bisphosphonates, protesase inhibitors and immunomodulating drugs, steroid, autologous stem cell therapy and chemotherapy.