EMERGE/CRITICAL Flashcards
The nurse is monitoring a child with burns during treatment for burn shock. The nurse understands that which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation? A/ Skin turgor B/ Neurological assessment C/ Level of edema at burn site D/ Quality of Peripheral pulses
B/ Neuro assessment
Sensorium is an accurate guide to determine the adequacy of fluid resuscitation. The injury itself should not affect their neurological status, whereas the other options could.
The nurse begins CPR on a 5 year old unresponsive patient. When the emergency response team arrives, the child continues to have no respiratory effort but has a heart rate of 50 with cyanotic legs. What should the team do next?
A/ Discontinue compressions, but continue respirations with bag valve mask
B/ Establish IV line with large bore IV while preparing the defibrillator
C/ Begin 2 person CPR at a ratio of 2 breaths to 15 compressions
D/ begin 2 person CPR at a ratio of 2 breaths to 30 compressions
C/ 2:15 ratio CPR
CPR is continued on a child with a heart rate of 60 and signs of poor perfusion. Rescuers should use a 15:2 approach for a child.
Breaths without respirations is only indicated in respiratory distress with no cardiac symptoms.
The AED should be used ASAP, but until then the first action taken should be to continue compressions at a 15:2 ratio
30:2 ratio is for adults.
A nurse walks into the room just as a 10-month-old places an object in their mouth and begins to choke. After opening the infants mouth, what should the nurse do next to clear the airway?
A/ Use blind finger sweep
B/ Deliver back slaps and chest thrusts
C/ Apply 4 sub-diaphragmatic abdominal thrusts
D/ Attempt to visualize the object
B/ Back slaps and chest thrusts
This should dislodge the object
Blind finger sweeps are contraindicated under 1 year of age as it could dislodge the object further.
Sub-diaphragmatic abdominal thrusts can damage internal organs of the abdomen at this age
If you couldn’t see the object when opening their mouth, you are wasting time looking for it.. get to business and slap the child.
A patient presents in the ER with the diagnosis of Hypoglycemia. The nurse should expect to find all the following signs and symptoms Except: A/ Nausea B/ Confusion C/ Slurred Speech D/ Blurred Vision E/ Sweating F/ Tremors G/ Tingling around the mouth
D/ Blurred Vision
This is an expected sign of HYPERglycemia, not hypoglycemia
Which of the following is not a sign and symptom of hyperglycemia? SELECT ALL THAT APPLY
A/ Nausea B/ Polydipsia C/ Polyuria D/ Tremors E/ Syncope F/ Blurred Vision
A/ Nausea
D/ Tremors
These are symptoms of HYPOglycemia, All others are symptoms and signs of hyperglycemia.
What is diabetic Ketoacidosis (DKA)? What signs and symptoms are associated with DKA?
Complication of diabetes when severe insulin deficiency occurs. The patient will show signs of hyperglycemia and…
Kussmaul’s Respirations (Deep and laboured)
Acetone breath (Fruity smell)
Increasing lethargy and decreasing level of consciousness
DKA is a life-threatening condition and requires immediate medical attention
A patient is rushed to the ER by EMS, diagnosis is believed to be DKA. The experienced nurse on the floor steps into action knowing that he will need to do all of thew following EXCEPT:
A/ Start IV and begin Normal Saline bolus
B/ Provide Novo-rapid Insulin through IV
C/ Assess neurological vitals routinely
D/ Monitor Potassium levels closely.
B/ Provide Novo-Rapid Insulin per IV.
Novo-Rapid Insulin is a fast acting Insulin and cannot be given IV route. The client would receive a normal acting insulin via IV route.
Saline bolus would be done to restore circulating blood volume and protect against cerebral, coronary, or renal hyper-perfusion.
Neuro status should be routinely checked as their LOC can deteriorate in this condition.
Potassium should be monitored because Insulin binds to free floating Potassium and transports them from the ECF into the cells leading to Hypokalemia. This is why Insulin IV drip may be used to treat a non-diabetic person with Hyperkalemia.
Which complication of anaphylactic shock in an adolescent client is most important for the nurse to detect early? A/ Urticaria B/ Tachycardia C/ Restlessness D/ Laryngeal edema
D/ Laryngeal edema
Could lead to severe upper respiratory obstruction and could be life threatening.
A client is scheduled to have an aldosterone-secreting adenoma and asks the nurse what would happen if the surgery was not performed. On what should the nurse base their response?
A/ If not removed, the tumour would cause Kidney damage
B/ Surgery will prevent metastasis
C/ Radiation therapy could be as productive if the tumour is small
D/ Chemotherapy is as reliable as surgery for the treatment of your tumour.
A/ If not removed, the tumour would cause Kidney damage
Renal and cardiac complication would occur is hypertension caused by the secretion of aldosterone were not arrested. It is a benign tumour, so metastasis is not possible. Neither radiation or chemo are indicated in this type of tumour.
