Midterm T7

Question 1

Tell tale sign for Type 1 Diabetes in children

a. dizziness
b. blurred vision
c. frequent urination
d. nausea?

Answer 1

c. frequent urination

Question 2

Priority intervention for a child who had a seizure 4 weeks ago and has a history of something neurological?

a. call provider
b. 360 check
c. comfort mom
d. something else

Answer 2

b. 360 check bc of seizure precautions?

Question 3

What scale do you use for someone who is sedated with propofol?

Answer 3

Richmond Agitation-Sedation Scale (RASS)

Question 4

Continous bubbling in the water chamber of a chest tube

Answer 4

bubbles can indicate a leak

Question 5

After giving skittles to a kid for low blood glucose, what do you give?

a. crackers and cheese
b. water
c. saturated and unsaturated fats

Answer 5

a. crackers and cheese

Question 6

dosing for a bolus for peds

Answer 6

20ml/kg

Question 7

You perform the faces scale for a peds patient that is post laparoscopic appendectomy, they show an 8/10, what do you do?

a. morphine
b. Tylenol
c. albuterol sulfate
c. something else

Answer 7

a. morphine

Question 8

What drug do you give first for pulseless v tach?

Answer 8

epi then amiodarone (anti-arrythmic)

Question 9

Sorting question for what is indicated vs contraindicated for someone with a seizure

Answer 9

indicated: turn on side, suction, decrease stimulation, suction, oxygen

contraindicated: BP cuff, rubbing back to stop sezire, placing the patient in high fowlers, one more

Question 10

What will help ensure an accurate reading of BP with an arterial line?

Answer 10

Maintaining the device stopcock at the phlebostatic axis will help ensure a proper reading

Question 11

PICC line is not flushing SATA

Answer 11

b. Check for kinked or clamped line
c. Call provider if still not flushing
d. Change dressing
e. Another one i think

Question 12

what part of the rhythm is ventricular depolarization

Answer 12

QRS complex represents ventricular depolarization

Question 13

Restraints SATA

Answer 13

a. Report how many times they go to the bathroom
b. Monitor circulation
c. Readiness for discontinuation
d. Check IV lines
e. Maybe something else

Question 14

What is the first thing you do if someone needs CPR?

Answer 14

compressions immediately, then get the pads on and then meds

Question 15

What pain assessment tool do we use in the critical care setting?

Answer 15

CPOT (Critical Care Pain Observation Tool)

Question 16

What pain assessment tool do we use for sedation?

Answer 16

RASS

Question 17

For AFIB, when do you use medication vs cardioversion?

Answer 17

Stable = medications
Unstable = cardioversion

Blood pressure is the determining factor of stabilitiy

Question 18

If you have a patient in AFIB and their blood pressure still looks good, which medication are you going to give?

Answer 18

amniodarone

Question 19

If you have VFIB and VTACH without a pulse, what do you do?

Answer 19

first thing is chest compressions, then defibrilliation, then meds

Question 20

wyd for asystole

Answer 20

epi and compressions, DONT SHOCK

Question 21

wyd for a STEMI

Answer 21

MONA: morphine, oxygen, nitro, asprin

(not in that order, nitro and asprin first and morphine last)

Question 22

How many nitros can you give and how often?

Answer 22

you can give nitro 3 times every 5 minutes, for a total over 15 minutes

before each dose, retake bp and rate pain

Question 23

what does STEMI stand for?

Answer 23

ST elevated myocardial infarction

Question 24

When would we do vagal maneuvers vs medication?

Answer 24

vagal maneuvers when they are stable, if blood pressure is trending down then we would give medication

Question 25

How do you give adenosine?

Answer 25

stopcock method, tell patient they are going to feel funny for a second (bc it stops the heart)

Question 26

Examples of vagal maneuvers

Answer 26

ice on face, blow in straw, take rectal temp for peds

Question 27

SVT med

Answer 27

adenosine

Question 28

What causes high ventilator alarms?

Answer 28

biting on the tube, resistance, occlusion from secretions

Question 29

What causes low ventilator alarms?

Answer 29

leaks, deflated cuff, extubation

Question 30

Where is the best position for an arterial line to get the most accurate measurement of blood pressure?

Answer 30

phlebostatic axis, 4th intercostal space midaxillary line

Question 31

what is important to maintain with central lines?

Answer 31

sterility and patency

Question 32

What is the most common and preferred sedation drug?

Answer 32

propofol

Question 33

What is the preferred number for RASS scoring (generally)?

Answer 33

0 to -2

Question 34

What is the #1 thing a nurse must be assessing with restraint use?

Answer 34

circulation and skin integrity

Question 35

seizures nursing interventions

Answer 35

-turn on side
-dont put anything in their mouth
-time it
-pad rails
-loosen or remove tight clothing
-minimize stimulation
-call for help
-02
-make sure suction is working
-lorazepam or benzos

Question 36

what is the first drug we give in the cardiac arrest algorithm?

Answer 36

epi

Question 37

when is epi given?

Answer 37

for asystole and cardiac arrest

Question 38

hypoglycemia chief complaints

Answer 38

cold, clammy, shaking, dizzy, tachycardia, anxiety, hungry, irritable

CHILDREN = “i have a bad headache”!!!

Question 39

How do you treat hypoglycemia if they’re awake?

Answer 39

15 grams of fast-acting carbs (juice, dextrose) then complex carbs to maintain glucose and recheck sugar

Question 40

what do you give for RSV?

Answer 40

RSV is VIRAL not bacterial, you do not give antibiotic treatment

-supportive treatment: suction, oxygen, fluids

Question 41

asthma treatment

Answer 41

bronchodilators (albuterol), no antibiotics

Question 42

What is the first thing we do when a patient has trouble breathing?

Answer 42

sit them up

if its RSV or pt has congestion then suction before sitting up

Question 43

What fluid for dehydration do we use for peds?

Answer 43

0.9% NS

Question 44

Prevention of infection in the hospital setting

Answer 44

-hand hygiene
-scrub the hub
-foley care
-following precautions
-wear PPE appropriately
-don and doff appropriately

Question 45

patient comes in with symptoms of a heart attack- radiating arm pain, abd pain, etc) and you do MONA and they still have chest pain that is not resolving. What do they most likely have?

Answer 45

STEMI

Question 46

SATA interventions for RSV and bronchiolitis

Answer 46

a. encourage feeding Q4H?
b. suction
c. cluster care to allow for rest

NOT ANTIBIOTICS

Question 47

What would you tell a 12 year old who is asking why they nee d to count carbs

Answer 47

edu on long term effects of poor glucose control

Question 48

propofol MOA

Answer 48

inhibits GABA A receptors and causes rapid sedation

sedation med

Question 49

epinephrine MOA

Answer 49

acts on alpha-1 receptors and induces increased vascular smooth muscle contraction, pupillary dilator muscle contraction, and intestinal spinster muscle contraction

neurotransmitter/hormone (adrenaline)

Question 50

insulin MOA

Answer 50

promotes glycogen synthesis (glycogenesis) and inhibits gluconogenesis

Question 51

amniodarone MOA

Answer 51

blocks potassium ion channels (prolonging repolarization), sodium ion channels, and alpha and beta adrenergic receptors

antiarrythmic

Question 52

dopamine MOA

Answer 52

increases heart rate and cardiac contractility

catecholamine neurotransmitter/hormone

Question 53

heparin MOA

Answer 53

binds to and activates antithrombin III

antithrombotic, decreases clotting ability of blood

Question 54

nitroglycerin MOA

Answer 54

nitroglycerin converts to nitric oxide (NO) which converts guanosine triphosphate to guanosine

treats angina/chest pain

Question 55

albuterol MOA

Answer 55

acts on B2-adrenergic receptors, inducing bronchial smooth muscle relaxation

bronchodilator

Question 56

keppra (levetiracetam) MOA

Answer 56

antiepileptic/anticonvulsant

Question 57

potassium MOA

Answer 57

treats and prevents low potassium levels, treats high blood pressure, and prevents stroke

electrolyte

Question 58

adenosine MOA

Answer 58

slows conduction time through the AV node and can restore normal sinus rhythm in patients with SVT

Question 59

What do you do for SVT if the patient is stable with a good blood pressure?

What do you do if they are stable but their blood pressure is trending downwards?

What do you do if they are unstable?

Answer 59

stable w good bp: vagal maneuver

stable w decreasing bp: adensoine

unstable: cardiovert

Question 60

What is the difference between cardiovert and a defibrilator?

Answer 60

cardiovert uses less joules

Question 61

what is in a trach kit emergency kit?

Answer 61

2 trachs (1 normal size and a smaller size) + pulse + suction

Question 62

What is the first thing you do after suction?

Answer 62

re-assess

Question 63

never ____ through an art line

Answer 63

push meds

only draw blood and flush with normal saline

Question 64

How long do you have to clean a CL for? a peripheral line?

Answer 64

-30 seconds for a CL and 15 for a peripheral

Question 65

Why would a child get an enteral/g-tube?

Answer 65

bc they have failure to thrive

Question 66

palliative care vs hospice care

Answer 66

palliative = treatment of chronic condition and maintain quality of life

hospice = terminal illness and pain management

Question 67

insulin target glucose scale question

Answer 67

0.1 kg

Question 67

Many people live with chronic conditions, what type of care do they need?

Answer 67

palliative