Trauma
A biker flies over the handlebars and arrives with left sided abd pain. What bedside test would the RN prepare for?
FAST sonography
What are your two shockable rhythms in ACLS?
vfib / vtach
RN is caring for a victim of strangulation who has dyspnea and low oxygen sat. What should they do?
High flow O2/NRB
What immediate test should you get on any patient with AMS
BGL
Patient post gastric bypass surgery presents w/ RUQ pain radiating into shoulder. What do you suspect?
Cholecystitis.
Rapid weight loss is a risk factor. Location/presentation.
A patient presents with blunt chest trauma from MVC. What laboratory test would you expect?
Troponin and/or CK
What is preload?
Volume entering on the right side of the heart
A patient arrives via EMS with burns to the face, neck, and chest from a house fire and has carbonaceous sputum. The priority intervention for the ED RN is to
Prepare for intubation
Sign of inhalation injury. Progressive airway edema from thermal burns will result in loss of airway if not addressed early.
What is the appropriate HOB angle for a brain bleed
30
A patient was sprayed with a crop duster and presents with n/v, salivation, bradycardia. What med do you expect to give?
Atropine
A trauma patient receives multiple units of blood products. Which electrolyte is the highest priority for the ED RN to monitor?
Calcium.
The anticoagulant in blood products (citrate) can bind to calcium, causing hypocalcemia.
An RN caring for a patient with an inferior MI should question an order for which med?
Nitro
How do we reduce the risk of VAP (Ventilator associated pneumonia)?
Head of bed elevated, suctioning, oral care
They must know how to safely care for the child during and after a seizure, and know when to seek medical care.
A patient presents with angioedema and states they only take one single medication they recently started. What is it likely?
Lisinopril or other ACE inhibitor
A patient presents post bar fight after being hit with a bar stool multiple times. C-collar placed by EMS. Oriented to person. No recollection of event. Right otorrhea noted. What is the most appropriate intervention?
CT head and c spine
NEXXUS criteria
Following a precipitous delivery of an infant and established ventilation, the RN should start compressions if the HR is below
60
A patient with a femur fracture presents with acute dyspnea. What do you suspect?
A fat embolus.
The ED RN is caring for a patient with a SAH and gives mannitol. What indicates the medication is working to reduce ICP?
Increase in urine output.
A patient w/ bacterial vaginosis is prescribed clindamycin cream. What should you include in discharge teaching?
The cream may weaken a condom. Use alternative BC for 72 hours after use.
A patient thrown by a horse experiences right leg lack of pain or sensation but can move leg. Left leg is unable to move but can feel pain and touch. What does this indicate?
Brown-Sequard Syndrome
ipsilateral paralysis and loss of pressure, touch, vibration, contralateral loss of pain and temp sensation
In a cardiac arrest ETCO2 is 10. What should we do?
Attempt to improve compression quality
The ED RN is treating a patient with SCD who c/o SOB, wheezing, fever. What is the likely cause?
Acute chest syndrome
Lung infarction, attachment of sickle cells to inflamed lung endothelium
3 late signs of increased icp
Cushing's triad
bradycardia
widening pulse pressure
apnea
A patient being treated for DKA offers this concerning complaint that is a potential untoward effect of treatment
My head is killing me!
Rapid decrease in glucose can cause cerebral edema, obs for neuro changes