CCRN Practice exam Flashcards
what to watch for post-op valve replacement
clot
what to give for elevated calcium levels
lasix
which procedure is highest risk for heart block post op
MVR
what happens with oxyhgb shift to the right
increased o2 release
urine osmo and sodium levels in intrarenal failure
decreased, filter is clogged
CP with ST elevation that is relieved with NTG
Prinzmetals angina
What to give with multiple units of PRBCs
Plts and FFP
Major complication of epidural hematoma
uncal hernia
what to give for RV infarct
fluids
what to give for diastolic HF
CCB
CSF glucose level in bacterial meningitis
decreased
highest cause of death in CKD patients
infection
what to give wolff-parkinson white with preexcited a-fib
brevi
peritoneal irritation pain is relieved by
lying with knees flexed
complication of vasopressin
myocardial ischemia, watch for ST changes
glucose level in adrenal insufficiency
hypoglycemia
first line drug for hypertensive crisis with EOD or cardiac ischemia
labetolol
Major cause of DKA
infection
DKA fluids to give if BG less than 250
D5 1/2NS
HHS fluid status and osmo levels
severe dehydration, serum osmo greater than 320
calcium levels in pancreatitis
hypocalcemia
what to do if residuals are elevated
give reglan to improve gastric motility
patients with liver failure have an increased risk of
infection
acid/base chemical produced in pancreas
bicarb
SVR formula
((MAP-CVP)/CO)*80
Medications to hold in hypertrophic cardiomyopathy
dig, diuretics, inotropes
ST elevations in VI, V2, V3, V4
anterior
anterior infarct which vessel
LAD
3 major complications of LAD infarct
cardiogenic shock, BBB, ventricular dysrhythmias
ST elevations in II, III, aVF
inferior
inferior infarct which vessel
RCA
ST elevation in I, aVL, V5, V6
lateral
lateral infarct which vessel
circumflex
complication of circumflex infarct
heart block
sympathetic neurotransmitters
epi and norepi
parasympathetic neurotransmitter
acetylcholine
sympathetic receptors
alpha and beta adrenergic
parasympathetic receptors
nicotinic and muscarinic cholinergic
heart sympathetic receptor
beta 1
lungs sympathetic receptor
beta 2
vessels sympathetic receptors
alpha 1 and beta 2
skeletal muscle sympathetic receptor
beta 2
bladder sphincter sympathetic receptor
alpha 1
kidney sympathetic receptor
beta 1
kidney sympathetic response
renin secreted which turns to ADH
liver sympathetic receptors
alpha 1, beta 2
liver sympathetic response
gluconeogenesis
dobutamine mechanism
beta 1 adrenergic receptor agonist- increase contractility
mild beta 2 adrenergic receptor agonist- mild vasodilation, increased perfusion
nitroglycerin properties (3)
venodilator, decreases preload, dilates coronaries
high dose dobuatmine downfalls
can increase HR so significantly that filling time decreases, decreasing CO
where is the fluid located in pulmonary edema
lung intersitium
CXR pulm edema
spider web vessels
labetolol mechanism
alpha and beta blocker
first line BP control for dissection
labetalol and nicardipine
becks triad
muffled heart tones, narrowed pulse pressure, JVD
electrical alternans is a sign of
tamponade
sign of acute aortic dissection
different BPs in each arm
sign of cardiac contusion
PVCs
specific sign of endocarditis (3)
petechiae, oslers nodes, splinter hemorrhage in nail beds
what medications not to give in HTN emergency
diuretics
first line treatment of adrenal crisis
decardon
fibrinogen levels in DIC
decreased
treatment of DIC (2)
vitamin k, heparin
5 symptoms of tumor lysis syndrome
hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia, acidosis
pain characteristics in acute pancreatitis
pain radiates to back
BUN and Cr in pancreatitis
elevated
vasopressin effects GI
constricts splanchic inflow to reduce portal pressure
Kehrs sign
left shoulder pain from irritation to the diaphragm
normal bladder pressure
0-5
abdominal compartment syndrome pressure
greater than 12
dead spave ventilation
alveolus is receiving ventilation but not perfusion (PE)
interpulmonary shunting
alveolus receiving perfusion but not ventilation (atelectasis, PNA)
pH when oxyhbg shifts to the left
alkalosis
volume remaining in lungs after exhale
FRC
nutrition of COPD
high calorie, low carb
CXR COPD
flattened diaphragm, decreased vascular markings, bullae
virchows triad
venous stasis, hypercoagulability, vascular wall damage
positioning for air embolism
tburg and left side to trap air in RV
acidosis causes cerebral
vasodilation
alkalosis causes cerebral
vasoconstriction
normal ICP
0-15
decorticate lesion location
midbrain
decerebrate lesion location
brainstem
gold standard ICP monitoring
ventriculostomy
MAP goal increased ICP
> 80
CPP goal
60-70
ICP goal
<20
Penumbra
viable but not functioning neuronal cells
stroke treat htn if over
SBP 220
stroke treat htn if giving tpa and SBP greater than
180 for first 24 hours
how fast can you lower BP in stroke pts
less than 10%/hr
HOB in stroke pts
flat initially then 45%
stroke guidelines CT within
20 mins
door to needle stroke within
60 mins
todd’s paralysis
post seizure hemiplegia or monoplegia
gcs less then 8,
intubate
loss of motor in upper extremities, intact motor of lower extremities, bladder and bowel intact, loss pain and temperature sensation
central cord syndrome
loss of motor, pain, and temperature sensation. Proprioception and light tough intact
anterior cord syndrome
whiplash, loss of sensory, intact motor, pain, temp, firm touch, and pressure
posterior cord syndrome
how to position OB patients
on left side
temperature with salicylates and cocaine OD
hyperthermia
temperature with barbiturates and opiate OD
hypothermia
Tylenol OD causes
liver failure
Tylenol antidote
mucomyst aka acetylcycteine
cocaine OD symptoms (7)
HTN, CP, ECG changes, headache, stroke, seizures, hyperthermia