ER Nursing
Mass casualty incident (MCI) patients should be triaged by the RN in how many seconds?
What is 15 seconds?
Blood sugar >600 is indicative of...
What is HHS?
Name the 6 P's for compartment syndrome
What are pain, pressure, paresthesia, pallor, paralysis, pulselessness?
Name two causes of cardiogenic shock.
What are valvular and arrhythmogenic?
Name two causes of obstructive shock
What are cardiac tamponade, tension pneumothorax, superior vena cava syndrome?
The acronym AVPU helps RNs determine level of consciousness. What does AVPU stand for?
What is Alert, Voice, Pain, Unresponsive?
The 6 I's of DKA/HHS
What are Insulin, Infection, Inflammation, Intoxication, Infarction, Iatrogenic?
Name 4 SIRS criteria
Temp >101F or <96.8F, HR >90, RR >20, WBC >20,000 or less than 4000, >10% bands
Name two causes of hypovolemic shock
Name the 3 subtypes of distributive shock and their common causes.
What are septic shock (infection), anaphylactic shock (severe allergic response), and neurogenic shock (spinal cord injury)?
Biologic agents being used for terrorist attacks is a growing concern. What are at least 3 biologic agents of terrorism?
What are smallpox, anthrax, and tularemia?
Ketones are produced in this, leading to metabolic acidosis
What is DKA?
Name the elements of the 1 hour sepsis bundle.
What are: measure lactate, blood cultures, broad-spectrum antibiotics, rapid fluid resuscitation (30mL/kg), vasopressors if needed after fluid resuscitation to keep MAP >/= 65mmHg?
Describe the patho for cardiogenic shock.
What is a decrease in volume, decrease in venous return, decrease in preload, decrease in SV, decrease in CO, decreased tissue perfusion, impaired cell metabolism
Describe the treatments for anaphylactic shock
What is epinephrine IM, diphenhydramine (benadryl), nebulized bronchodilators, fluid resuscitation, IV corticosteroids?
Mass casualty incidents are tagged by color. Which color tag indicates a life-threatening injury that requires immediate intervention?
What is red?
What is 36-54 for DKA and 50-100 for HHS
Name the 4 stages of shock
Describe clinical manifestations for hypovolemic shock
What is tachycardia, decreased preload, decreased CO, increased SVR, anxiety, confusion, absent bowel sounds, oliguria, tachypnea (early), bradypnea (late), cool clammy skin?
the three pathophysiologic effects of septic shock
What is vasodilation, maldistribution of blood flow, and myocardial depression?
Describe the nursing management for a patient with eye trauma.
What is: determine MOI, Assess type of exposure, irrigate with saline if needed for chemical exposure, no pressure on the eye, do not blow nose, stabilize foreign object, cover injured eye when possible, elevate HOB?
Name 4 clinical manifestations for DKA.
What is dehydration (poor skin turgor, dry mucous membranes, sunken eyes), tachycardia, sweet fruity breath, Kussmaul's respirations, abdominal pain, anorexia, and/or N/V?
MODS is the failure of two or more organ systems in a patient. Describe the cardiac, respiratory, and neurologic manifestations of a patient with MODS.
What is:
Respiratory: alveolar collapse, shunting, V/Q mismatch, ARDS
CV: significant vasodilation, myocardial depression, dysrhythmias, tachycardia
Neurologic: ALOC; confusion, agitation, combativeness, disorientation, lethargic, comatose
The priority action for volume loss greater than 30% in hypovolemic shock
What is immediate replacement of fluid with blood products?
Describe the clinical manifestations of neurogenic shock.
What is: bradycardia, hypotension, bowel/bladder dysfunction, flaccid paralysis below level of injury, respiratory dysfunction dependent on level of injury, and cool/warm dry skin?