I know my electrolytes
Burn baby Burn
Hematologic problems
My achey breaky heart
100
Ranges for sodium, potassium and calcium
What is:
Sodium: 135-145
Potassium: 3.5-5.0
Calcium: 9.0-10.5
100
Explain the 5 levels in the emergency severity index
Level 1: immediate care (cardiac arrest)
Level 2: <15 min. (acute stroke)
Level 3: 15-20 min (gynecologic disorders)
Level 4: <30 min (simple laceration)
Level 5: 30 min or more (cold symptoms)
100
Acute interventions for anemia
Blood transfusions, drug therapy (iron supplements), oxygen therapy, telemetry, pulse oximetry, safety, collaboration with dietitian
100
What is myocarditis?
Inflammation of the heart muscle. Can be a result of a viral, bacterial, or fungal infection and can also be caused by radiation and chemotherapy.
200
Manifestations of hypercalcemia vs. hypocalcemia
What is:
Hypercalcemia: fatigue, lethargy, confusion, weakness, seizures, cardiac dysrhythmias
Hypocalcemia: arrhythmias, positive trousseau and chvostek, convulsions, tetany
200
Explain how you would calculate TBSA using the rule of 9's chart.
200
What are some foods that are rich in iron that is necessary for RBC production?
Lean beef, poultry, legumes and beans!
200
Describe erythema marginatum - what is this a manifestation of?
Rash of the skin that looks like wine stains on the skin. This is a manifestation of major jones criteria of rheumatic fever.
300
Manifestations of hypernatremia vs. hyponatremia
What is:
Hypernatremia: fever, flushed skin, restlessness, increased fluid retention, edema, confusion, dry mouth and skin
Hyponatremia: seizures, abdominal cramps, lethargy, orthostatic hypotension, shallow RR, spasms of muscles
300
When should a client be transferred to a burn center?
- if TBSA injured is >10%
- Involves hands, feet, genitalia, perineum, or major joints.
- Full thickness (3rd or 4th degree)
- Electrical burn
- Burn occurred with additional trauma 9fracture)
300
When is oral iron replacement therapy best absorbed?
Oral iron is best absorbed when taken with vitamin C
300
What is the difference between aortic valve stenosis vs. mitral valve regurgitation
Aortic valve stenosis: causes obstruction of blood flow from the left ventricle to the aorta during systole.
Mitral valve regurgitation: allows blood to flow backward from the left ventricle to the left atrium because of incomplete valve closure during systole.
400
Manifestations of hyperkalemia vs. hypokalemia
What is:
Hyperkalemia: changes in cardiac conduction, confusion, tetany, muscle cramps, paresthesia, weakness and paralysis of skeletal muscles, vomiting
Hypokalemia: Lethal ventricular dysrhythmias, skeletal muscle weakness and paralysis, high urine output, decreased DTR
400
What different structures of the skin are affected with partial thickness burns, deep thickness burns, and full thickness burns
Partial (1st degree) - Superficial epidermal damage with hyperemia and tactile and pain sensation intact.
Deep thickness (2nd degree) - Epidermis and dermis are involved in varying depths. Skin elements, from which epithelial regeneration occurs, remains viable.
Full thickness (3rd and 4th degree) - All skin elements and local nerve endings destroyed. Coagulation necrosis present. Surgical intervention required for healing.
400
What is some patient education you can provide to your client with sickle cell disease to teach prevention of crisis?
Education on taking breaks, participating in genetic counseling, use of incentive spirometer.
400
Manifestations of pericarditis
- Severe sharp chest pain that is made worse when lying flat and with deep inspiration.
- Dyspnea
- Pericardial friction rub (do you know what position your client should be in to hear this?)
- JVD
500
What is the difference between isotonic, hypotonic and hypertonic fluids? Which solution should your patient be monitored very closely with?
What is:
Isotonic: no net movement of water occurs (0.9% NS, LR)
Hypotonic: Solutions that are less concentrated than in the cells (cell swells) (0.45% NS (1/2 NS))
Hypertonic: Fluids with solutes more concentrated in cells (cell shrinks) (3% saline, 5% dextrose in LR) Usually given in ICU because patient's condition can change very fast.
500
What is a curling ulcer and how is this disorder prevented?
A type of gastroduodenal ulcer characterized by diffuse superficial lesions. The stress response can decrease blood flow to the GI tract.
- Prevented by feeding the patient as soon as possible after burn injury.
500
What are the steps in the blood transfusion process?
Complete a baseline physical assessment as a basis to assess changes during and after the transfusion.
• Ensure that the IV line is appropriate and patent.
• Double-check patient identification and blood product identification data with another licensed nurse (consider state nurse practice act and agency policy).
• Adjust the transfusion rate according to the HCP orders and agency policy.
Assess for signs of transfusion reactions.
Delegate AP to take vital signs as directed.
• Evaluate for therapeutic effect of blood product (improvement in CBC, ↑ BP, ↓ bleeding).
• Monitor for circulatory overload (e.g., shortness of breath) if the transfusion is given rapidly.
500
Priority nursing management of pericarditis
- Assess pain (OLDCARTS)
- Administer pain meds (can raise HOB to 45 degree level to take pressure off of heart)
- Monitor for S/S of tamponade (increased SOB, tachypnea, tachycardia, JVD, muffled heart sounds)