Miscelaneous Flashcards

1
Q

What are the normal ranges for the following lab values:

1) platelets
2) INR
3) aPTT
4) Fibrinogen

A

1) Platelets - 150,000 to 450,000
2) INR - 0.6 to 1.7
3) aPTT - 25 to 35 seconds
4) Fibrinogen - 200 to 300 mg/dL

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

Briefly describe the pathophysiology of DKA.

A

DKA occurs when the body breaks down fat at fast rate. The liver processes the fat into ketones which causes the blood to be acidic.

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

How are critical levels of Hyperkalemia treated?

A

Critically high levels of potassium is treated with IV Regular insulin (10 units), Dexteose 50%, and IV Calcium Gluconate.

The insulin helps to shift potassium into the cell, dextrose prevents hypoglycemia and the calcium gluconate prevents dysrhytmias caused by the high potassium level.

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

How do you differentiate stable and unstable angina?

A

Chest pain at rest is present in unstable angina but not in stable angina.

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

Describe Wolfe-Parkinson White Syndrome. What is the treatment? Which meds should be avoided?

A

Syndrome in which a person has an extra pathway between the heart’s upper and lower chambers causing a rapid heartbeat.
Treatment involves Procainamide or electrical cardioversion.

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

What is the first line medication used for hypertension in patients with a stroke? Why?

A

Lane talon - because it’s titratable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which nursing actions are taken to ensure an accurate ICP reading?

A

The transducer should be leveled with the Tracy’s.

The head of the bed should be at 30 degrees.

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

How soon should a non-contrast CT be preserved upon arrival or recognition of a patient having a stroke?

A

Within 10 mins

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

Why is gradual rewarming in a hypothermic patient important and at what rate should it be done?

A

Gradual warming should be achieved at about 0.5 degrees Celsius per hour increase because rapid warming can lead to electrolyte abnormalities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the cause of anemia of chronic inflammation (aka anemia of chronic illness) commonly seen in adults and critically ill patients?

A

Increased levels of inflammatory cytokines due to comorbid illness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the main diagnostic marker for ARDS?

A

A PaO2/FiO2 ratio of less than 300 mmHg.

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

What is the Pituitary Gland? What are some conditions caused by problems with this gland?

A

Small gland at the base of the brain that controls hormones. Problems include Cushings, acromegaly, diabetes insipidus, etc.

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

How do you treat Anaphylactic shock?

A

Epinephrine to reduce the body’s allergic response .
Oxygen
IV antihistamines and cortisone to reduce inflammation
Albuterol to relieve breathing symptoms

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

How do you treat neurogenic shock?

A

Pressers

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

What are the two types of Neuromuscular blocking agents used during general anesthesia?

A

1) NDNMB - Non-depolarizing neuromuscular blocker.

2) DNMB - Depolarizing neuromuscular blockers

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

What’s the difference between NDNMBs and DNMBs? Give examples of each.

A

1) NDNMBs are non-competitive Ach receptor antagonists. They block receptor sites so acetylcholine can’t bind and prevent muscle contraction. (Rocuronium).
2) DNMBs are competitive Ach receptor agonists. They bind receptor sites and cause muscle contraction but cannot be broken down by acetylcholinesterase so depolarization is not possible (Succinylcholine).

17
Q

How are NDNMBs and DNMBs reverses?

A

NDNMBs - reversed with acetylcholinesterase inhibitors such as Neostigmine suggameddix.

DNMBs- reversed with ?

18
Q

What is malignant hypothermia and which drug is used to treat it?

A

Anesthesia causes severe muscle contractions and increase in body temperature.
Dantrolene - Muscle relaxant

19
Q

What are the concerns when giving anesthesia to patients with Myasthenia Graves?

A

These patients are sensitive to NDNMBs and resistant to DNMBs such as succinylcholine.

20
Q

What are the 3 types of sympathetic/adrenergic receptors?

A

1) Alpha - Located in the arteries (constricts arteries)
2) Beta1 - Located in the heart (Increases HR and contractility)
3) Beta2 - Located in the bronchioles of the lungs and the arteries of the skeletal muscles (dilates bronchioles and dilates arteries in skeletal muscles).

21
Q

Which arteries lack Alpha receptors and why?

A

The blood vessels in the in the skeletal muscles because they need to stay open to utilize the increased blood being pumped to the heart. Fight or flight - you need leg muscles working to run or fight.

22
Q

What are the 2 types of parasympathetic/cholinergic receptors?

A

1) Muscarinic - Stimukation If these receptors cause increased HR, decreased contractility, decreased diameter of bronchioles.
2) Nicotinic - involved only in muscle contraction (Succinylchol-
ine blocks nicotinc receptors).

23
Q

What are the 4 Phases of Anesthesia?

A

1) Induction - Period between administration of anesthesia until loss of consciousness.
2) Excitement - From loss of consciousness and includes excited or delirious activity (muscle spasms, vomiting, irregular breathing, etc).
3) Surgical Anesthesia - Skeletal muscles relax, respiratory depression, eye movements stop.
4) Overdose - To much Anesthesia is given causing brain stem or medullary depression.