who is at risk for MDRO infection - ✔✔patients with severe disease, including compromised host
defenses from underlying medical conditions, recent surgery, or indwelling medical devices (ex: foleys or
ET tubes)
what a
...
who is at risk for MDRO infection - ✔✔patients with severe disease, including compromised host
defenses from underlying medical conditions, recent surgery, or indwelling medical devices (ex: foleys or
ET tubes)
what are classic signs of cardiac tamponade? - ✔✔hypotension, narrowing pulse pressure, tachycardia
with weak, thready pulse, and tachypnea
what arrhythmia is mitral valve insufficiency associated with? - ✔✔afib
what defines oliguira? - ✔✔less than 500 ml of output per day
what does renal failure result in? - ✔✔acidosis
what type of HF are patients with OSA at risk for? - ✔✔right-sided HF
what is one of the hallmark features of pancreatitis? - ✔✔dehydration
what is treatment for pancreatitis? - ✔✔hydration, maintenance of electrolyte balance, nutritional
supportwhat is unstable angina characterized by? - ✔✔new onset pain or increase in frequency/duration of
pain. pain generally lasts 15-30 minutes. may be experienced at low exertion or rest and pain tends not
to respond to SL nitro. symptoms may be accompanied by diaphoresis or dyspnea.
what is stable angina characterized by? - ✔✔pain on exertion or stress that is relieved by rest or SL
Nitro. pain generally does not increase in severity over time
what characterizes an acute MI? - ✔✔constant, severe pain and may be accompanied by nausea,
weakness, fatigue, anxiety. not relieved with rest, duration exceeds 30 minutes.
what are characteristics of dissection aortic aneurysm? - ✔✔pain is severe and unrelenting, commonly
experienced in chest/abdomen and radiates to the back. pain does not improve spontaneously.
what procedure is most appropriate for obtaining heart pressure measurements and diagnosing
pulmonary HTN? - ✔✔right sided heart cath
what is the best noninvasive test for pulmonary HTN? - ✔✔transthoracic echocardiogram
what is a reasonable goal for the first day Blood Pressure in a stroke patient? - ✔✔lower by 15-20% in
the first day
what may improve the prognosis of patients with stroke? - ✔✔lowering body tempwhat are the causes of afib in post-cardiac surgery patients? - ✔✔advanced age, pre-existing medical or
cardiac conditions, electrolyte abnormalities, conduction disturbances that wil likely resolve, and preexisting atrial or valve conditions that contribute to the development of this arrythmia
what is a life threatening condition that most commonly occurs with renal dysfunction? -
✔✔hyperkalemia
what medication is contraindicated in RV infarct? - ✔✔nitro bc it will reduce preload, and patients with
RV infarct are preload dependent
what are the manifestations of hepatic encephalopathy? - ✔✔changes in mental state, behavior,
personality, decreased self-care ability, deterioration of handwriting, or loss of other small movements,
and asterixis ("liver flaps")
what are the manifestations of cerebral edema? - ✔✔decreased LOC, bradycardia, HTN, bradypnea,
posturing, unequal pupils, decreased pupillary reaction to light
what are impending delirium tremens manifested by? - ✔✔tremors, irritability, n/v, hallucinations
(auditory, visual, or olfactory), confusion, delusions, and severe agitation
what is impending azotemia manifested by? - ✔✔tachycardia, hypotension, and signs of dehydration
what is hyponatremia associated with? - ✔✔SIADH
what are neuro complications of hyponatremia? - ✔✔HA, nausea, vomiting, lethargy, coma, seizurewhat is common with sepsis ? - ✔✔DIC
what is common in patients with DIC? - ✔✔jaundice due to increased bilirubin production secondary to
hemolysis
what type of cardiomyopathy in pt with LV having increased muscle mass and fibrosis causing stiffness? -
✔✔hypertrophic
what defines mild COPD exacerbation? - ✔✔not requiring mechanical ventilation and having only one of
the three cardinal symptoms: increased dyspnea, sputum purulence or sputum production
what test should NOT be performed during most COPD exacerbations? - ✔✔sputum culture
what does management of cardiogenic shock include? - ✔✔decreasing afterload (because CO is greatly
diminished)
treat with ASA
IV heparin infusion bc at risk for LV ventricular and DV thrombosis and maintains coronary artery
patency
what dysrhythmia is associated with chronic alcohol abuse? - ✔✔afib
what can trigger afib? - ✔✔hypoglycemia, surgery, chronic infections, binge drinkingwhat are the main complications from ETOH abuse? - ✔✔cardiomyopathy, atrial and ventricular
dysrhythmias, variant angina
a patient with life threatening hyperkalemia is likely experiencing - ✔✔metabolic acidosis
to maintain physiologic pH during acidosis, hydrogen ions are driven from the blood and into the cell. to
maintain electrical neutrality, potassium is expelled from the cell and serum potassium levels rise
what EKG changes with hyperkalemia? - ✔✔the earliest EKG change seen with hyperkalemia is peaked T
waves. this can progress to widened QRS complexes and Vfib
position for patients with acute ischemic stroke? - ✔✔as flat as possible in bed for at least 24 hours from
stroke onset, ideally with HOB between 0 to 30 degrees. some patients with acute ischemic stroke may
develop increased ischemic symptoms upon standing, sitting, or elevating HOB due to reduction flow
thru stenotic vessels or collateral pathways
what is one of most important cornerstones in management of patients with moderate to severe burn
injury? - ✔✔nutrition. the hypermetabolic response in burn patients is characterized by hyperdynamic
circulatory, physiologic, catabolic, and immune system responses. the administration of specific
nutrients is an essential component of the management of the patient
what are the mechanisms for pulmonary HTN? - ✔✔excessive pulmonary blood flow, impeded
pulmonary drainage, vasoconstriction from hypoxia or uncompensated hypercarbia, or hindered blood
flow thru the pulmonary arterieswhat happens with ARDS? - ✔✔most often seen as part of a systemic inflammatory process, particularly
systemic sepsis, where there is a widespread destruction of the capillary endothelium, extravasation of
protein-rich fluid, and interstitial edema. in addition, the alveolar basement membrane is damaged, and
fluid seeps into the airspaces, stiffening the lungs and causing ventilation-perfusion mismatch
what does R sided HF cause? - ✔✔JVD, dependent peripheral edema, ascites
what does endocarditis cause? - ✔✔damage to heart valves that usually manifests in regurgitant
murmor
what does pulmonary HTN cause - ✔✔a systolic murmur, dyspnea, and tachycardia
occurs over period of time, not acutely
why is morphine administered in acute HF? - ✔✔decrease preload with vasodilation
may also decrease afterload
what is an absolute contraindication of t-Pa - ✔✔history of hemorrhagic stroke, AV malformation, or
aneurysm within 3 months
what is the recommended initial position to improve oxygenation for a patient with unilateral
pneumonia? - ✔✔sidelying on unaffected side to optimize perfusion to the healthy lung
what is implied consent? - ✔✔refers to following a patient's wishes/requests that were made known
prior to the patient becoming incapacitated and unable to make his preferences knowntreatment of hypoglycemia is focused on reversing - ✔✔neural starvation - the brain is sensitive to low
glucose states
what is the somogyi effect? - ✔✔tendency of the body to react to extremely low blood sugar by
overcompensating, resulting in high blood sugar.
what type of MI is Mobitz II most commonly associated with? - ✔✔anteroseptal wall MI
what are idioventricular rhythms associated with? - ✔✔defects in the conduction system of the heart
following right pneumonectomy, how should nurse position the patient? - ✔✔on the right side.
facilitates best gas exchange and ventilation
the best rational for using therapeutic touch is - ✔✔it decreases perception of pain in adult patients
what is indicated as initial treatment for complete heart block? - ✔✔atropine
what is key to medical management in descending dissection aortic aneurysm? - ✔✔controlling BP to
maintain CO
family support techniques should begin with nurse - ✔✔establishing a rapport with the familyhow long does ARDS take to develop? - ✔✔longer than 12 hours
what is ARDS associated with? - ✔✔multiple organ fialure
how is NSTEMI diagnosed? - ✔✔EKG signs are ambiguous and troponin is positive
how is unstable angina diagnosed? - ✔✔EKG signs are ambiguous and troponin is negative
what are the six risk factors for delirium? - ✔✔cognitive impairment, sleep deprivation, immobility,
vision impairment, hearing impairment, and dehydration
what is first priority with acute GI bleed? - ✔✔start large bore IV
what is a coarse, grating sound with S1 and S2? - ✔✔pericardial friction rub
what does a pleural friction rub sound like? - ✔✔leather rubbing on leather, synchronous with
respiratory movements
what does a ventricular septal defect produce? - ✔✔a systolic murmor
what are hallmark signs of ARDS? - ✔✔refractory hypoxemia and diffuse crackless/s of pneumothorax - ✔✔cough, sharp CP, abnormal or absent movement of chest wall on affected
side
what arrhythmia may be associated with valvular surgery? - ✔✔complete heart block
what does pneumonia typically produce? - ✔✔fever, chills, a productive cough, purulent sputum, and
crackles
when would a mediastinal shift occur? - ✔✔pneumothorax due to large pleural effusion
as CO2 levels rise, patient exhibits... - ✔✔somnolence, could result in apnea
patients with hyperkalemia and associated diabetes will likely develop... - ✔✔depressed ST segments
prominent U waves will be present with... - ✔✔hypokalemia
in non-cardiac patients undergoing surgical procedures, which lead is valuable for identifying ACS? -
✔✔V5
what are common complications of aortic valve disease? - ✔✔arrhythmia and HF
what is the drug of choice to treat MI associated pericarditis? - ✔✔NSAIDswhat electrolyte imbalances with initial DKA? - ✔✔hyperkalemia and hyponatremia
sodium is lost in urine with DKA
first hyperkalemia with extracellular shift of potassium in exchange of hydrogen, which is accumulated
in acidosis, then the serum potassium is excreted and develops hypokalemia
classic s/s of pericarditis - ✔✔dull, aching substernal CP
pericardial friction rub
diffuse ST segment elevation
interventions for pericarditis - ✔✔have patient sit up and lean forward and administer morphine
what drug is indicated for anticoagulation therapy in patient with history of heparin induced
thrombocytopenia - ✔✔lepirudin (refludan)
what lab data should nurse anticipate with acute hepatic failure? - ✔✔decreased glucose, respiratory
alkalosis
what are the two acid-base disturbances associated with acute hepatic failure? - ✔✔respiratory alkalosis
and metabolic acidosis
what clotting factors does liver failure tend to decrease? - ✔✔prothrombin, fibrinogen, factors II, V, VII,
and X
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