Neuro
Neuro
Cardiac
Cardiac
Mystery
100
What 2 things do you need to do before initiating a stroke alert in triage?
vital signs and blood sugar
100
True or false: if your patient comes in with a facial droop and you failed them on the dysphagia screening, and their facial droop resolves they don't have to be NPO.
false
100
what kind of tubing do I need for this medication?
Vented tubing
100
Wes RN is in room ED45 when suddenly his patients goes into Afib with RVR. The EDP orders a medication to help slow down the patients heart rate.
What medication is MOST likely to be ordered? what would be the starting and max rate of this medication?
Cardizem (Diltiazem) 2.5 - 15 mg/hr
100
True or false: Calcium gluconate has more elemental calcium compared to calcium chloride
False
200
What is the reason for permissive hypertension in a stroke patient? At what BP measurement would you give medications for an uncomplicated ischemic stroke?
Maintain Perfusion to the brain
BP: 220/120
200
What are the indications for the use of hypertonic saline? (name 2)
1. hyponatremia
2. increased intracranial pressure
200
A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse determines that the client is experiencing:
Ventricular tachycardia
200
Megan RN is taking care of a patient in ED RM 50 when her patient suddenly goes into Ventricular tachycardia. What would she expect the EDP to order? name dose and how it would be given.
The patient is AAOX3, she in no acute distress. complains of mild chest pain.
BP: 125/80 HR: 150 RR: 22 O2: 99% temp: 37
amiodarone 150 mg
200
They are performing a lip laceration repair for a 1-year-old boy. The physician orders Versed 0.2mg/kg intranasally for your patient. The patient weighs 22 pounds. Calculate the dose for this patient: __________ mg; _________ml
2mg= 0.4 ml
300
The nurse is caring for the client with increased intracranial pressure. The nurse would note which of the following trends in vital signs if the ICP is rising?
bradycardia, bradypnea, and widened pulse pressure
300
Nick RN is getting ready to administer insulin to his patient. what LABS are checked prior to administering insulin?
Potassium and blood glucose
300
What receptors does levophed work on?
Alpha adrenergic receptors
300
Nurse Diana is starting a Nicardipine drip. Based on the peak, onset, and duration of Nicardipine how often should she be checking vital signs when initiating the drip?
Peak: 45 minutes
Onset: 5-15 minutes
Duration: 14 hours
Every 5 minutes
300
What TWO is needed to start a heparin drip?
how often are labs checked?
1. Weight and PTT
Every 6 hours until desired range is met
400
Nicole RN is getting ready to administer mannitol. What tubing is needed in order to administer this medication?
Filter tubing
400
What is the mechanism of action of hypertonic saline?
causes an osmotic shift of fluid from the intracellular to intravascular space.
400
You have a patient passing out in triage and you connect him to the monitor and see polymorphic Ventricular tachycardia. What would you anticipate the EDP to order?
Magnesium Sulfate
400
What is the mechanism of action of Amiodarone?
Blocks myocardial calcium, potassium, and sodium channels, resulting in prolongation of the cardiac action potential and refractory period.
400
What first line vasopressor used in septic shock?
Norepinephrine
500
A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. The physician orders mannitol for which of the following reasons? What is the mechanism of action of mannitol?
To promote osmotic diuresis to decrease ICP.
Mannitol promotes osmotic diuresis by increasing the pressure gradient, drawing fluid from intracellular to intravascular spaces.
500
What neurological disorder results from rapidly correcting sodium?
Central Pontine Myelinolysis: The rapid rise in sodium concentration involves the movement of small molecules and pulls water from brain cells that leads to the destruction of myelin.
500
A nurse is viewing the cardiac monitor in a client’s room and notes that the client has just gone into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse would anticipate the physician to order which medication? name the dose, route, and how it would be given.
Amiodarone drip, 150 mg in a 100 ml in D5W over 10 min
500
Which vial would you use to prepare an epinephrine drip?
500
Name 4 medications used in the treatment of hyperkalemia.
Kayexalate, Lasix, albuterol, insulin, & sodium bicarb
calcium gluconate is an adjunct to prevent destabilization of the myocardial cells
D50 used to prevent hypoglycemia if given insulin