Medications
The name of the non-steriodal anti-inflammatory drug (NSAID) that can be used to treat fevers, reduce inflammation, and treat headaches. However, it is no longer primarily used to treat these issues due to the a side effect. This "side effect" is now what the drug is typically used for in current clinical pratice.
What is: Aspirin.
A cardiovascular disease that is one of the leading causes of myocardial infarctions (MIs/heart attacks), renal failure and strokes in the United States. It is most common among the African American population.
What is: high BP or Hypertension
Occurs when you use or lose more fluid than you take in, and your body doesn't have enough to carry out its normal functions. Without replacement, this can become extremely dangerous. It is most dangerous in young children and older adults.
What is: Dehydration.
A deficit, excess, or imbalance of the body's essential nutrients. This process affects the body composition and functional status.
What is: Malnutrition
A patient arrives to the ED with a possible exposure to COVID-19. What precautions, arrangements and personal protective equipment would you need for this case?
What is: airborne precautions. Arrange for patient to be placed in a negative air pressure room. Don a gown, gloves, face mask (N92), face shield.
Name at least one broad spectrum antibiotic used to treat bacterial infections.
What is...
Ampicillin, amoxicillin, aminoglycosides, erythromycin, ciproflaxin, etc.
A disorder characterized by episodes of binge-eating, followed by inappropriate behaviors to avoid the weight gain (such as excessive laxative use, vomiting, over-exercising), and persistent concern with one's body image. The patient may present with normal or slightly low body weights for height (BMI). Electrolyte imbalances are common.
What is: bulimia nervosa
Name at least 2 body functions that are maintained by the electrolyte Calcium (Ca2+).
What is:
Bone density (bones, teeth). Blood clotting. Transmission of nerve impulses. Myocardial contractions. Smooth and skeletal muscle contractions.
Paralysis or complete loss of sensation in bilateral (both) legs.
What is: Paraplegia
The most effective position for a patient who is experiencing respiratory distress.
What is: Prone position (on their stomach).
List at least 3 anti-depressant medications.
What is:
SSRI- fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro).
SNRIs- duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq) and levomilnacipran (Fetzima).
Atypicals- trazodone, mirtazapine (Remeron), vortioxetine (Trintellix), vilazodone (Viibryd) and bupropion (Wellbutrin SR, Wellbutrin XL, others).
Tricyclics- mipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin and desipramine (Norpramin)
This disorder is also known as a "phenomenon" where there are episodic vasospasms of small the cutaneous arteries, most often of the fingers and/or toes. Clinical findings may include: skin color changes related to decreased perfusion and subjective numbness or coldness.
What is: Raynaud's phenomenon.
This clinical manifestation is often a result of fluid overload within the body, increased hydrostatic pressure and/or a lack of plasma oncotic pressure within the blood vessels.
What is: edema.
This is the largest organ of the body and it is also considered an entirely separate body system from the rest. Use the proper medical terminology for this system.
What is: Integumentary (Medical term for skin)
A chronic alcoholic presents to the ED experiencing signs of only minor signs of withdraw. He states that he decided to quit cold turkey and had his last drink approximately 4 hours prior to arrival. As time passes and withdraw progresses, what signs and symptoms of alcohol withdraw should the nurse prepare for? Name at least 3.
What is:
tremors, coarsening over time. diaphoresis. elevated pulse. increased BP. agitation. anxiety.
(late) hallucinations. seizures. delirium. death.
A new nurse working in the ED is assigned to a patient who is presenting with an ischemic stroke. What drug are they likely to give to this patient? Name at least 7 of the contraindications for that the nurse should be aware of when assessing the patient as a candidate for this drug.
(Must answer both questions correctly to receive any and all points.)
What is:
active internal bleeding. recent surgery within the last 2 weeks. low platelet count. pregnancy. previous intracranial hemorrhage. uncontrolled hypertension. currently healing wounds. certain bleeding or clotting disorders. GI bleeding. recent MI (3 months).
Intracranial bleeding into the cerebrospinal fluid-filled space between the arachnoid and pia mater membranes on the surface of the brain. This is commonly caused by a rupture of a cerebral aneurysm, typically within the Circle of Willis.
Name at least 5 ways fluid or electrolyte imbalances could occur.
Hint: Think of how the patient may gain or lose too much of one substance.
What is:
Excessive urination (DI). Diarrhea. Vomiting. Hemorrhaging. Insensible water loss. Inadequate/excessive intake. Poor renal or intestinal filtration (e.g. AKI). Diuretic use without replacement. Poor diet. Tissue catabolism (burns). Tumor lysis syndrome.
A disturbance in the muscular control of speech, typically occurring after a stroke. Impairment may include pronunciation, articulation, and phonation.
What is: dysarthria.
What is: Neurogenic Shock.
Spinal shock is also a risk, but does not involve the cardiovascular system. It is strictly a loss of reflexes, sensation, and thermoregulation as well as flaccid paralysis. Spinal shock is r/t the nervous system only.
A patient with cardiogenic shock presents to the ED in need of medication. The order is written for Dobutamine. Explain the mechanism of action and at least 1 important nursing consideration that will be helpful during administration of the drug.
Mechanism of action) increase myocardial contractility, increase CO, SV, and CVP. Decrease PAWP and SVR (decrease pulmonary and peripheral HTN)
Nursing implications) give through central line. monitor HR and BP, stop if tachy-arrhythmias occur. Hypotension may worsen, which indicates need for vasopressor.
This acute (rarely chronic) disease is considered to be an autoimmune process which occurs several days to weeks after a viral or bacterial infection of the upper respiratory tract or gastrointestinal system. Clinical presentation includes acute, ascending, rapidly progressive symmetrical weakness of all extremities with areflexia.
Hints: The primary nursing consideration is respiratory distress/failure. Most commonly proceeds a cytomegalovirus jejuni bacterial infection.
What is: Guillain Barre syndrome.
A patient presents to the ED for severe nausea, vomiting, and diarrhea for the past 2 days. Subjective complaints include extreme fatigue and muscle weakness, leg cramps, paresthesias, and constipation. Upon physical exam, you note 1+ reflexes in the lower extremities bilaterally, shallow respirations, hyperglycemia accompanied by a prolonged QRS and flat T waves on the EKG. What is the most likely diagnosis?
What is: hypokalemia.
The "flapping" tremor commonly affecting the and hands. It is a clinical manifestation of hepatic encephalopathy.
What is: asterixis.
A patient with septic shock presents to the ED and is in need of hemodynamic monitoring. Give at least 8 hemodynamic results, assessment findings and/or lab values that the nurse should expect to see.
Hint: Go through each body system and recall the pathology of sepsis.
What is:
CV) hypo/hyperthermia, dysrhythmias, decreased CO, EF (HF), increased PAWP
Resp) crackles, respiratory alkalosis (early) > acidosis (late), hypoxemia, ARDS, pulmonary HTN, hyperventilation.
Renal) decreased UOP
Integ) warm flushed (early), pale, mottled (late)
Neuro) AMS, agitation
GI) GI bleeding, paralytic ileum
Diagnostics) abnormal WBC, low platelets, increase lactate, increased BG, increased urine SG, positive blood cultures.