Neuro
Name one clinical manifestation of left-brain stroke
depression, anxiety, impaired language/speech, aphasia, impaired comprehension related to language/math, right side paralysis
What does central venous pressure measure?
indirect measurement of pressure in the right ventricle
How do you calculate for burn fluid replacement using the parkland formula?
weight in kg x TBSA x ordered fluid volume
A client at home on peritoneal dialysis is experiencing pain during inflows, he calls the on-call nurse for advice - what should the nurse tell the client?
slow the infusion down and reposition frequently
A patients mechanical ventilator is alarming high pressure. What should the nurse do?
check for biting of the tube, mucus plugs
Which assessment finding is the EARLIEST indicator of increased intracranial pressure?
change in LOC
Name one drug used in cardiogenic shock when a patient is presenting with hypotension.
dopamine, norepi
What is the priority in a patient with >20% TBSA burns
fluid resuscitation
A burn client receiving aggressive IV fluids suddenly develops crackles, dyspnea, and pink frothy sputum.
What complication is the nurse concerned about?
hypervolemia, pulm edema
A client in newly diagnosed ARDS from a near drowning event has just been intubated. The spo2 on 100% fio2 and 12 PEEP still remains low (85%). What should the nurse do?
advocate for prone positioning
Which medication is given to a patient with a subarachnoid hemorrhage to prevent vasospasm
nimodipine
What are 2 clinical manifestations in the progressive stage of shock?
hypotension, cool/clammy skin, oliguria, tachycardia, confusion
entrance and exit wounds, pathway internal
A client with a known history of Addison’s disease calls the triage nurse and reports:
“I’ve had vomiting and diarrhea all day. I can’t keep my steroid pills down, and I feel dizzy when I stand up." What would the appropriate treatment for this client be?
IV steroid and IVF infusions
What is the difference between subdural hematoma and epidural hematoma?
slow bleed with slow changes in mental status (SDH) versus rapid bleed with rapid loss of consciousness and lucid intervals (epi)
What is the most important question to ask a client coming in with stoke symptoms, in their triage assessment?
what time did the symptoms begin
Name a hemodynamic value in cardiogenic shock. (low or high)
PAWP high CVP high CO low BP variable SVR high
What phenomenon is seen when caring for a patient with carbon monoxide poisoning?
pulse ox is normal but arterial level is hypoxemic
Which type of shock can you suspect with these findings.. Lactate 3.4, WBC 42,000, BP 70/38, HR 126, Temp 101.6, skin warm and flushed, urine output 15 ml/hr
septic shock
Interpret this ABG - 7.47 - CO2 44 HCO3 39
Metabolic alkalosis
What is happening in autonomic dysreflexia?
Miscommunication between brain/spinal cord and site of noxious stimuli below injury. brain doesn't know that there is a source of distress because there is a cut in communication below level of spinal cord injury .
What does a chest pain work up look like in the ED?
EKG, VS, sit patient up, MONA, cardiac biomarkers
What can we teach a patient who survived 3rd and 4th degree burns to 40% of the body, upon discharge
stay out of sunlight for a year, wear splints often to help hypertrophic scarring
A client is admitted after a thoracic spinal cord injury. The blood pressure is 72/40 mmHg, heart rate is 52 beats/min, and skin is warm and dry.
What is the nurse’s PRIORITY intervention to support perfusion?
administer vasopressors and atropine
A client suddenly becomes unresponsive. Telemetry shows wide-complex ventricular tachycardia. No pulse is detected. What is the nurses immediate action?
Call a code, followed by immediate CPR and rapid defib