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CEN2 > CEN BOOK REVIEW > Flashcards

CEN BOOK REVIEW Flashcards

1
Q

What is the first priority?

A

Airway unless pt is bleeding out or on fire

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2
Q

MAP Formula

A

Systolic + (2 x Diastolic) / 3

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3
Q

Pulse pressure formula

A

Systolic pressure minus diastolic pressure

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4
Q

What kind of pulse pressure is seen in early septic shock? What kind of pulse pressure is seen in early hypovolemic shock?

A

Septic = widened

Hypovolemic = narrowing

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5
Q

What kind of pulses indicate shock states?

A

Weak peripheral + strong central

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6
Q

Formula for acceptable systolic BP in kids <10yo

A

70 + (age x 2)

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7
Q

What kind of patients are always an emergency and should not be put back in the waiting room?

A

neutropenic patients

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8
Q

Primary + Secondary Survey

A

A: airway
B: breathing
C: circulation
D: disability
E: exposure/environmental
F: full set of VS/family
G: get adjuncts:
L: labs
M: monitor
N: NG/OG tube
O: oxygenation/ventilation
P: pain control
H: head to toe
I: inspect posterior surface (always check for pelvic injuries first!)

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9
Q

Left-sided EKG lead placement:

Right-sided EKG lead placement:

Posterior EKG lead placement:

A

V1 & V2: b/l sternal borders 4th ICS

V3: b/t V2 & V4

V4: 5th ICS MCL

V5: 5th ICS b/t V4 & V6

V6: 5th ICS MAL

V4R: 5th ICS right MCL

V5R: 5th ICS b/t V4R & V6R

V6R: 5th ICS right MAL

V7: posterior axillary line, same plane as V5 & V6

V8: tip of scapula, same plane as V7

V9: left of vertebral column, same plane as V8

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10
Q

Anterior MI affected artery

A

Left anterior descending - may cause left ventricular failure

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11
Q

Lateral MI affected artery

A

Circumflex

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12
Q

Posterior MI affected artery

A

Right coronary artery
S&S: bradycardia, heart blocks
Need posterior EKG (leads V7, V8, V9)

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13
Q

Inferior EKG affected artery

A

Right coronary artery
S&S: heart blocks

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14
Q

Right ventricular EKG affected artery

A

Right coronary artery
Possible right ventricular failure
Common with inferior MI
Need right-sided EKG if suspected

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15
Q

4 symptoms of right sided HF

4 symptoms of left sided HF

A

Right = extremity swelling, ascites, hepatomegaly, JVD

Left = pulm edema, orthopnea, dyspnea, rales/crackles

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16
Q

Hs (6) & Ts (6)

A

-Hypovolemia
-Hypoxia
-Hypo/hyperkalemia
-Hypothermia
-Hydrogen ions (acidosis)
-Hypoglycemia

-Thrombus (MI/PE)
-Tension PTX
-Tamponade (cardiac)
-Tablets (OD)
-Toxins
-Trauma

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17
Q

flexion in upper extremities pulling to the core, damage to the core of the brain = above brain stem

A

Decorticate Posturing

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18
Q

extension of the upper extremities, damage is lower in the brain in the midbrain and brain stem

A

Decerebrate Posturing

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19
Q

3 symptoms of cushings response seen with increased ICP?

A

-widened pulse pressure
-bradycardia
-bradypnea

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20
Q

One episode of decreased BP can be catastrophic in head injury pts. Maintain systolic BP above what?

A

100

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21
Q

What 3 CN are responsible for EOM?

A

III (oculomotor)
IV (trochlear)
VI (abducens)

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22
Q

What cranial nerve is responsible for the majority of parasympathetic activity? What will stimulation of this CN cause?

A

X vagus

Bradycardia and hypotension

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23
Q

What CN is responsible for constriction of the pupil?

A

III oculomotor

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24
Q

How many branches does CN VII have? What 2 things is it responsible for?

A

5 branches; facial movement and sensation

25
Q

What should we not do to an infant to open the airway?

A

Hyperextend the neck

26
Q

Name 7 S&S of respiratory distress in an infant

A

-nasal flaring
-grunting
-head bobbing
-retractions
-stridor
-tachycardia
-tachypnea

27
Q

What can diarrhea in an infant cause?

A

Metabolic Acidosis

28
Q

What med do we treat esophageal varicies with?

A

Octreotide (sandostatin)

29
Q

What is the sequence of an abdominal assessment?

A

1- inspect
2- auscultate
3- percuss
4- palpate

30
Q

Focused Assessment with Sonography for Trauma (FAST) is not considered positive for bleeding unless how many mLs are identified?

A

200mL

31
Q

A FAST exam can product false negatives for what 2 things?

A

Hollow organs
Retroperitoneal injuries

32
Q

What does the os look like for a threatened abortion? An inevitable abortion?

A

Threatened = closed os

Inevitable = open os

33
Q

What bpm are normal fetal heart tones?

A

120-160

34
Q

What drugs clear from the body quickly so specimens must be collected early?

A

date rape

35
Q

What will morning after pills also need a prescription for?

A

antiemetic

36
Q

Apgar score:
Appearance (color)

A

0 = blue/pale
1 = acrocyanotic (bluish discoloration in extremities)
2 = completely pink

37
Q

Apgar score:
Pulse (HR)

A

0 = absent
1 = <100bpm
2 = >100bpm

38
Q

Apgar score:
Grimace (reflexes)

A

0 = no response
1 = grimace
2 = cry or active withdrawal

39
Q

Apgar score:
Activity (muscle tone)

A

0 = limp
1 = some flexion
2 = active motion

40
Q

Apgar score:
Respirations

A

0 = absent
1 = weak cry, hypoventilation
2 = good, crying

41
Q

What complications of an eating disorder should we look for in the ER? (6)

A

-electrolyte disorders
-cardiac dysrhythmias
-esophageal rupture
-Mallory-Weiss tears
-pneumomediastinum
-cardiomegaly

42
Q

What is the treatment for an anticholinergic OD (TCAs)?

Cholinergic OD (insecticides/sarin gas)?

A

Sodium Bicarb

Atropine

43
Q

Hypovolemic shock can occur as a result of acute blood loss and what other things?

A

relative loss of volume in situations such as burns, ascites, other cases of 3rd spacing

44
Q

Suture removal times:

Face ?
Scalp ?
Hands/Feet ?
Joints ?
Extremities ?

A

Face = 3-5 days
Scalp = 7-10 days
Hands/Feet = 7-10 days
Joints = 14 days
Extremities = 10-14 days

45
Q

What 2 maxillofacial problems can become airway issues?

A

Ludwigs angina
PTA

46
Q

What is a normal IOP? What is it measured with?

A

10-21
tonometer

47
Q

What EKG change is seen with hypothermia?

A

J-wave (small positive deflection b/t QRS and ST segments)

48
Q

What kind of bites can cause DIC?

A

Brown recluse spider

49
Q

Lyme disease can have what 5 long term effects?

A

-meningitis
-AV blocks
-cardiomyopathies
-encephalopathies
-psych problems

50
Q

Is there a vaccine for Hep C?

What can Hep C progress to?

A

No vaccine

Can progress to cancer or cirrhosis

51
Q

What should we avoid using when handling bullets?

A

Metal forceps - can change markings on the side of the bullet

52
Q

What terms should be avoided when describing bullet wounds?

A

extrance/exit

53
Q

What kind of bags must be used for evidence handling?

A

Paper

54
Q

What should be avoided in GSW victims? What can we place over the hands to protect possible evicence?

A

Washing hands

Paper bags

55
Q

Ethical principle of nursing: personal freedom/providing education so patients can make their own informed decisions

A

Autonomy

56
Q

Ethical principle of nursing: good actions are for the benefit of the patient and prevention of harm

A

beneficence

57
Q

Ethical principle of nursing: doing no harm/avoiding harmful actions

A

nonmaleficience

58
Q

Ethical principle of nursing: caring for all individuals the same/fairness

A

justice

CEN2 (12 decks)

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