Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Level 3 > Complex II Exam 1 > Flashcards

Complex II Exam 1 Flashcards

1
Q

What is the purpose of the mitigation phase?

A

planning and identifying potential hazards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the purpose of the preparedness phase?

A

to practice the plan in order to save lives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the purpose of the emergency response phase?

A

implementation and assessment of the plan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the purpose of the recovery phase?

A

assessing damage and returning everything to normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How quickly should you assess and intervene after a trauma?

A

in 60 seconds or less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do you NEED TO KNOW for a trauma patient?

A
  • VS
  • GCS
  • extent of injuries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is reverse triage used?

A

mass casualty (100+ people)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Who should be treated first in reverse triage?

A

the less injured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some examples of airway obstructions?

A
  • food
  • blood
  • tongue
  • teeth
  • vomit
  • foreign objects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the priority intervention if the airway is obstructed?

A
  • get it out/suction
  • anticipate intubation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which airway can only be used if the patient does not have a gag reflex?

A

oropharyngeal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What should you do if a patient is unresponsive WITHOUT trauma to the airway?

A

head tilt/chin lift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When should a jaw thrust be done?

A

if the patient is unresponsive WITH trauma to the airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is a head tilt/chin lift contraindicated?

A

if a CSI is suspected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What should you do if you suspect blunt force trauma?

A

stabilize the spine and log roll

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What should you LOOK for when assessing breathing?

A

symmetrical chest rise and fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should you LISTEN for when assessing breathing?

A

lung sounds in all 5 lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What should you FEEL for when assessing breathing?

A

chest rise and fall and broken ribs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can having 3 broken ribs and a collapsed lung cause?

A

flail chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What should you do if the patient is not breathing or is breathing inadequately?

A

manual ventilation by a bag valve mask with supplemental O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How are rescue breaths given?

A

ambu bag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What pulses should be assessed first when assessing circulation?

A

central (carotid, femoral)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How should bleeding be stopped?

A

direct pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What variables are assessed for circulation?

A
  • HR
  • BP
  • pulses
  • cap refill
  • skin color
  • LOC
  • urine output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How can shock be identified when assessing circulation?

A

increased HR and hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does disability assess?

A
  • LOC with GCS
  • AVPU
  • pupillary response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does AVPU stand for?

A

A: alert
V: responsive to voice
P: responsive to pain
U: unresponsive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the priority when assessing exposure/environment?

A
  • maintaining body heat
  • maintaining privacy and dignity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What does the trauma triad of death include?

A
  • hypothermia
  • acidosis
  • coagulopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What do the use of warm blankets, an increased room temperature, and warmed IV fluids help with?

A

hypothermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the five adjuncts?

A
  • foley catheter
  • full set of labs
  • cardiac monitor
  • NG tube
  • radiology (x-ray, CT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What does AMPLE stand for?

A
  • allergies
  • meds
  • past medical hx/menstrual period
  • last I&O
  • exposures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What does the absence of rectal tone suggest?

A

SCI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is preload, and how is it measured?

A
  • the amount of blood going into the RA
  • CVP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is normal CVP?

A

2-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What does an elevated CVP indicate, and how should it be treated?

A
  • too much fluid
  • diuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What does a decreased CVP indicate, and how should it be treated?

A
  • not enough fluids, need volume
  • give fluids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What does PAWP measure?

A

pressure generated by the left ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is a normal PAWP?

A

6-15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is afterload, and how is it measured?

A
  • pressure the ventricle has to pump to move blood out of the heart
  • PVR (lungs)
  • SVR (body)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is a normal SVR?

A

600-1200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is a normal systolic PA pressure?

A

15-28

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is a normal diastolic PA pressure?

A

5-16

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is a normal SV?

A

50-100 mL/sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How is SV calculated?

A

end diastolic volume - end systolic volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is a normal CO?

A

3-6 L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How is CO calculated?

A

SV x HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is ejection fraction, and what is a normal EF?

A
  • the % of blood ejected with each beat
  • 55-70%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What EF % would indicate acute HF?

A

<40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What does a PA catheter measure?

A
  • RA pressure (CVP)
  • PA pressure (SVR)
  • LV pressure (CO)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What can a HIGH PA pressure cause?

A

pulmonary HTN & edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What medication can you give to a patient with high PA pressure?

A

sildenafil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Which is more accurate: CVP or PAWP?

A

PAWP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the biggest risk when using a PA catheter?

A

clots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Where is an arterial line most commonly placed?

A

radial artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

If you want to get continuous BP readings, frequent ABG’s, or put your patient on vasopressors, what should you put in place?

A

arterial line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What can NOT be given through an arterial line?

A

meds or IVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the biggest risk with an arterial line?

A

cutting off blood flow to the hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is Allen’s test, and what result is ideal?

A
  • occluding arteries in the arm to examine blood flow to the hand
  • POSITIVE RESULT (WANT): color returns quickly when you let go
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Why should the transducer for an arterial line be level with the atrium of the heart?

A

accurate pressure reading
- heart and pressure = same
- transducer and pressure = opposite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is the first major sign you should worry about with shock?

A

hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What drops with non-progressive (compensatory) shock? What increases?

A
  • CO and BP drop
  • HR increases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Does a high CVP or low CVP indicate JVD?

A

HIGH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What DECREASES with hypovolemic shock?

A
  • BP
  • CO
  • CVP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What INCREASES with hypovolemic shock?

A
  • HR
  • SVR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is the PRIORITY intervention for hypovolemic shock?

A

replace fluids (NS or blood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are the only fluids that can be given bolus?

A

LR and NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What do digoxin and dobutamine (positive inotropes) do when used for hypovolemic shock?

A
  • DO NOT treat shock
  • increase contractility
  • slow and strengthen, making pumping more efficient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What vasopressors can be used for hypovolemic shock?

A
  • norephinephrine
  • dopamine
  • epinephrine
  • vasopressin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is the BEST med for hypovolemic shock? Why?

A

norepinephrine because it does not increase HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What has to be present for vasopressors to work?

A

FLUIDS (CVP >2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What should you give if extravasation occurs after administering vasopressors?

A

phentolamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What vasodilators can you give for hypovolemic shock?

A

nitroglycerine and nitroprusside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

In what situation would you transfuse whole blood?

A

if a patient has lost a large amount of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

How quickly after collection does whole blood need to be transfused and why?

A

within 24 hours to avoid deterioration of coagulation factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What type of blood is used to raise Hgb and Hct levels?

A

packed red blood cells

77
Q

What do packed RBC’s restore/maintain?

A

oxygenation and circulating blood volume

78
Q

What type of blood is used to treat active bleeding, coagulation disorders, burns, and shock?

A

fresh frozen plasma

79
Q

What can platelets be used to treat?

A
  • thrombocytopenia
  • aplastic anemia
  • chemo-induced bone marrow suppression
80
Q

What does albumin do?

A

expands blood volume and increases BP

81
Q

When should you check vitals during a blood transfusion?

A

@ 15 mins, 30 mins, 1 hr, immediately after, and 1 hr after

82
Q

How often should you do vital signs for older adults during a blood transfusion?

A

q 15 mins

83
Q

What should you withhold during a blood transfusion for older adults?

A

IVF

84
Q

What meds should you give to older adults after a blood transfusion?

A

diuretics

85
Q

What causes an acute hemolytic reaction?

A

blood type/Rh factor incompatibility

86
Q

What is the onset of an acute hemolytic reaction?

A

immediate or during subsequent transfusions

87
Q

What is the onset of a febrile reaction?

A

within 2 hours

88
Q

What should you give for a febrile reaction and why?

A

antipyretics because an increase in temperature can occur

89
Q

What is the onset of an allergic/anaphylactic reaction?

A

up to 24 hours after

90
Q

What should you do if the patient has an allergic reaction?

A

restart at a slower rate or admin an antihistamine

91
Q

What type of reaction requires epinephrine, oxygen, and possibly CPR?

A

anaphylactic

92
Q

What is the onset of a bacterial reaction?

A

during or several hours after

93
Q

What med should you give for a bacterial reaction?

A

antibiotics

94
Q

How should you position someone having a circulatory overload reaction?

A

upright with feet lower than heart

95
Q

When does a circulatory overload reaction occur?

A

any time during transfusion

96
Q

What problem occurs with the atria?

A

clots

97
Q

What problem occurs with the ventricles?

A

contraction

98
Q

What does the QRS look like if the current originates in the atria?

A

narrow

99
Q

What does the QRS look like if the current originates in the ventricles?

A

wide

100
Q

What meds should you give for sinus tachycardia?

A

adenosine or beta blockers

101
Q

What is the rate of sinus tachycardia?

A

101-160 bpm

102
Q

Is the rhythm regular or irregular in sinus tachycardia?

A

regular

103
Q

What med should you give to a stable patient experiencing SVT?

A

adenosine 6 mg IV slam (can be repeated twice)

104
Q

What should you do for an unstable patient experiencing SVT?

A

synchronized cardioversion (50-100 joules)

105
Q

What is the rate of SVT?

A

> 160 bpm

106
Q

What does SVT look like?

A

narwhals (no p wave, inverted t waves, narrow)

107
Q

How long should a carotid pulse be assessed?

A

5-10 seconds

108
Q

What steps should you take if a patient is in v-tach or v-fib and has no pulse?

A
  • call code
  • start CPR
  • early defibrillation
  • give epi
  • give amiodarone
109
Q

In what rhythm is it important to assess electrolytes (K, Mg, Na)?

A

Torsades de pointes

110
Q

What med should you give for torsades de pointes?

A

magnesium 2 mg IVP

111
Q

What is the rate of v-tach?

A

> 100 bpm (no p wave, wide QRS)

112
Q

What does v-tach look like?

A

tombstones

113
Q

What does torsades look like?

A

voice memo

114
Q

What does v-fib look like?

A

quivering, no p waves

115
Q

What do you document for abnormal heart rhythms?

A
  • pre-procedure rhythm
  • # of defibrillation/cardioversion attempts with the setting, time, and response
  • pt’s condition and LOC (pre and post)
  • post-procedure rhythm
  • skin condition under electrodes
116
Q

What should you NOT do for PEA? What SHOULD you do?

A
  • NO shock
  • YES CPR
117
Q

How can you treat PEA?

A

fluids/blood, amiodarone

118
Q

If a patient has a complete 3rd-degree heart block, what will end up being done?

A

they will get a pacemaker

119
Q

What will the QRS look like with a 3rd-degree heart block?

A

wide with no relationship to the p wave

120
Q

What meds can you give for a-fib?

A
  • amiodarone
  • CCB
  • heparin/enoxaparin, warfarin
121
Q

What can you do for a-fib if the HR increases?

A

synchronized cardioversion

122
Q

What does a-fib put the patient at high risk for?

A

CLOTS
- DVT, PE

123
Q

Does a-fib have a regular or irregular rhythm?

A

irregular with no p wave

124
Q

What meds can you give for a-flutter?

A
  • amiodarone
  • CCB
  • beta blockers
  • digoxin
125
Q

What should you do when a patient with a-flutter is unstable?

A

synchronized cardioversion

126
Q

What is the rate of a-flutter?

A

240-350

127
Q

What does a-flutter look like?

A

saw-tooth, wings (butterfly), mountains

128
Q

What can a peaked t-wave indicate?

A

hyperkalemia

129
Q

How should you treat someone with peaked t-waves?

A
  • obtain BMP
  • D50
  • insulin
  • calcium gluconate
  • diuretics
  • sodium polystyrene sulfonate
130
Q

What can U waves indicate?

A

hypokalemia

131
Q

What does ST elevation suggest?

A

irreversible cardiac injury (finding of acute MI)

132
Q

What is the most common single chamber pacing code?

A

VVI

133
Q

What is the most common dual chamber pacing code?

A

DDD

134
Q

Why should you get a chest x-ray after the insertion of a pacemaker?

A

to assess for lead placement, pneumo/hemothorax, and pleural effusion

135
Q

What should the patient wear after pacemaker insertion to avoid wire dislodgment?

A

a sling

136
Q

When should you watch for bleeding, hematoma formation, and infection?

A

after the insertion of a pacemaker

137
Q

What lab is the earliest marker of acute MI?

A

myoglobin (gone after 24 hrs)

138
Q

What is a normal creatine kinase-MB level? What indicates cardiac muscle damage?

A

0.1-4.9, elevation = damage

139
Q

What is a normal troponin I or T level?

A

0.01-0.03

140
Q

When will you see troponin I elevation? When will you see troponin T elevation?

A

I: 2-4 hours
T: 4-6 hours

141
Q

What artery is used for cardiac catheterization?

A

femoral (most common) or brachial

142
Q

What allergies are important to know for an angiogram?

A

shellfish and iodine

143
Q

What labs should you monitor for an angiogram?

A

BUN and creatinine

144
Q

What do dysrhythmias, hypotension, and increased chest pain indicate with an acute MI?

A

deterioration

145
Q

What does ONAM stand for?

A
  • Oxygen
  • Nitroglycerine
  • Aspirin
  • Morphine
146
Q

How should aspirin be taken?

A

chew only

147
Q

Why would metoprolol be given for an AMI?

A

to decrease afterload and BP

148
Q

Why would anticoagulants be given for an AMI?

A

to keep the clot from worsening

149
Q

Why would thrombolytics be given for an AMI? What is the risk?

A

to break up the clot, but there is a high risk for bleeding

150
Q

What is the point of an angioplasty?

A

to place a stent to keep an artery open

151
Q

How long must the extremity remain straight after an angioplasty?

A

4-6 hours

152
Q

What is the earliest sign of cardiac tamponade?

A

dyspnea

153
Q

What is the latest sign of cardiac tamponade?

A

cardiac arrest (too late)

154
Q

What are cardiac tamponade, hemorrhage at the insertion site, AKI, and restenosis complications of?

A

angioplasty

155
Q

What is restenosis of a vessel?

A

if a blockage comes back after an angioplasty

156
Q

Why can AKI occur after an angioplasty?

A

secondary to the IV contrast dye

157
Q

When would you do a CABG?

A
  • PCI could not open the CA
  • 3 vessel blockage
  • 50% occlusion of the left main CA
158
Q

What type of shock can occur from a CABG?

A

hypovolemic

159
Q

How is cardiac tamponade treated?

A

pericardiocentesis (UNLESS following CABG)

160
Q

What do you do for pericardiocentesis?

A

insert a needle into the pericardial sac and drain blood to relieve pressure on the heart

161
Q

What electrolytes might be depleted after a CABG?

A

K and Mg

162
Q

What characterizes cardiac muscle with cardiomyopathy?

A

enlarged, thick, rigid

163
Q

What does cardiomyopathy lead to?

A

HF

164
Q

What is starling’s law?

A

the cardiac muscle loses the ability to stretch and contract

165
Q

What are family hx, sudden cardiac arrest, endocrine/metabolic diseases, alcoholism, and HTN risk factors for?

A

cardiomyopathy

166
Q

What does LHF affect?

A

lungs

167
Q

What does RHF affect?

A

body

168
Q

What are diagnostic tests done for HF?

A
  • Echo
  • BNP
  • chest x-ray
  • ECG
  • cardiac enzymes
  • ABG’s (respiratory acidosis)
  • electrolytes (decreased - dilution)
169
Q

What med can be given to reduce preload?

A

diuretics

170
Q

What med can be given to reduce afterload?

A

ACE, CCB

171
Q

What med can be given to increase cardiac output?

A

digoxin, dobutamine, dopamine

172
Q

What med can be given to reduce cardiac workload?

A

beta blockers, nitrates, natriuretic

173
Q

What med can you give if acute HF is due to MI?

A

aspirin

174
Q

When do you use cardioversion?

A

with a pulse

175
Q

When do you use defibrillation?

A

without a pulse

176
Q

What increases with cardiogenic shock?

A

HR, CVP, SVR

177
Q

What decreases with cardiogenic shock?

A

BP, CO

178
Q

What is the priority intervention for cardiogenic shock?

A

oxygen

179
Q

What meds can you give for cardiogenic shock?

A

diuretics and morphine

180
Q

What should you avoid giving for cardiogenic shock?

A

fluids

181
Q

What is the systolic BP level in hypertensive crisis?

A

> 180-240

182
Q

What is the diastolic BP level in hypertensive crisis?

A

> 120

183
Q

What med is given for hypertensive crisis?

A

nitroprusside (low dose initially)

184
Q

Who is at the most risk for aortic aneurysm?

A
  • male
  • uncontrolled HTN
  • atherosclerosis
  • old age
185
Q

What might you see with an abdominal aortic aneurysm?

A

bruit

186
Q

What should you NOT do if there is a pulsating abdominal mass?

A

palpate

187
Q

How can you tell if the aneurysm has been dissected?

A

loss of pulses

188
Q

How can aortic aneurysms be treated?

A
  • AAA resection: surgical repair
  • endothelial stent: strengthens the wall
  • thoracic aneurysm repair

Level 3 (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions