Practice Test Flashcards

(200 cards)

1
Q

ABX associated w/ thromboytopenia

A

Vancomycin

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2
Q

Highest level of evidence

A

Meta-analysis

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3
Q

How long before you can use a new AVF???

A

6-8 weeks

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4
Q

Spinal Injury, low BP: vasopressor vs. fluids?

A

Fluids - ↓ ♥ tone d/t spinal injury/sx = ↓ effectiveness of Pressors

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5
Q

2 ABX that cause idiopathic intracranial HTN

A

Tetracycline and Doxycycline

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6
Q

2 Flu s/s (in contrast to the cold/rhinovirus)

A

resp s/s + fever
(rhinovirus = !fever)

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7
Q

Key s/s necrotizing fasciitis

A

reddish-purple patchy blue gray around site

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8
Q

2 S/S auscultation pleural effusion

A

dullness in lobe
diminished breath sounds

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9
Q

MAP Formula

A

(sbp + 2 * dbp)/3

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10
Q

Cerebral Perfusion Pressure (CCP) WDL and Formula

2 meds for ↑?

A

60 - 80 mmHg
MAP minus ICP

Pressors & -ephrines

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11
Q

Mean Arterial Pressure Formula

A

((2* DBP) + SBP)) / 3

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12
Q

Intracranial Pressure WDL

A

7 - 15 mmHg

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13
Q

HELLP syndrome
qualifier, 4 s/s, only tx

A

> 34 weeks pregnant
-Preeclampsia
-Hemolysis
-Thrombocytopenia
-↑ LFTs

Emergency C-Section

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14
Q

Hyperosmolar hyperglycemic State values
Glucose, Serum Osmolality, Arterial pH, BiCarbonate

A

Glucose > 1000
Serum osmo > 400
Art. ph > 7.27
Bicarbonate > 15 or norm

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15
Q

Bicarbonate (HCO3) WDL

A

22 - 26 mEq/L

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16
Q

Hyperosmolar hyperglycemic State - Initial, secondary, tertiary TX

A

Isotonic solution (NSS 0.9%)
K repletion
Insulin Bolus

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17
Q

Hypo, Iso, Hypertonic IVF Examples

A

Hypo = 0.45% NaCl
Iso = NSS 0.9% NaCl
Hyper = 3% NaCl

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18
Q

TX for onset visual disturbance in context of spinal dx

A

Vasopressors to ↑ BP

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19
Q

Pastoral Care
Social Work
Psychiatrist
is for…

A

Pastoral = Coping Strats
Social = ↓ resilience, body image, financial difficulties
Psych = ↓ coping

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20
Q

Acetyl Salicylic Acid is AKA

A

ASPIRIN dumbass

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21
Q

S/P Brain Sx Med choice to TX vasospasm

A

Ca chnl Blocker (ipidines)

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22
Q

Compartment syndrome 2 pulse characteristics & TX

A

Firm, faint pulses
TX: position extremity @ level ♥

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23
Q

In darker pts, bruising s/s may also be…

A

Stage 1

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24
Q

Post-Intensive Care Syndrome (PICs) 4 S/S and TX

A

Anxiety
Depression
↓ Memory
Weakness

physical therapy

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25
Pt not compliant with care?
↑ sense of control, inquire of reasoning
26
Effect on EKG: Hypercalcemia
shortened QT interval
27
Ca+ WDL
4.6 - 5.3 mg/dL
28
K, Ca, and Glucose levels in: Pancreatitis
Hypokalemia Hypocalcemia Hyperglycemia
29
Pharmacotherapy & Counciling
↑ effectiveness together
30
Sodium Nitroprusside FX & key Adverse FX to monitor for
↓ BP Monitor A/VBGs for Cyanide Toxicity
31
Old people can't metabolize this as well as they used to
Glucose
32
LDL and HDL WDLs
LDL < 100 HDL > 60
33
WDL for... Systemic Vascular Resistance (SVR) Cardiac Output
800 and 1200 dynes/sec/cm-5 4 - 8 L / min
34
Diabetic Ketoacidosis what IVF after < 250mg/dL Glucose?
D5% NS 0.45% or D5%NSS to give fluids/prevent hypoglycemia
35
FX of Diabetes Insipidus (▲ in what hormone r/in 4 ▲ to...) volume lytes serum osmo urine osmo
**↓ Antidiuretic Hormone r/in...** ↓ volume r/in ↑ lytes (concentrated) ↑ serum osmolality (concentrated) ↓ urine osmolality (diluted)
36
Compensated (Early) Hypovolemic Shock on SV/CO and afterload vs. Non-Compensated
↑ SV/CO ↓ afterload then... ↓ SV/CO ↑ afterload
37
FX of Post-Renal Failure BUN/Cr and Urine Na+ (& Urine Na WDL)
Post = after kidneys ↑ BUN/Cr Urine Na = 1 - 40 mEq Urine Na WDL = 40 - 220 mEq
38
WDLS for... Urine Output Urine Na+ BUN / Cr Creatinine ♂ vs ♀ Urine Specific Gravity
> 30 mL/hr around 20 mEq/L 6 - 20 mg/dL 0.7 - 1.3 ♂ / 0.5 - 1.1 mg/dL ♀ 1.005 - 1.030
39
BUN/Cr Ratio Formula
BUN / Cr
40
Adverse FX of Hypervolume Resuscitation
Metabolic Acidosis d/t HCO3 lost in urination
41
A/VBG WDLs & ↑ ↓ meaning pH CO2 HCO3
Acid ← pH 7.35 - 7.45 → **Alk** **Alk** ← CO2 35 - 45 → Acidosis Acid ← HCO3 22 - 26 → **Alk**
42
A/VBG Thought Tree
ph WDL? = un v. compensated acid ← ph 7.40 → **alk** Match between CO2 (resp) v HCO (meta) matches pH. Poss to be both~!
43
FX of myocardia contusions (trauma), side and ▲ to... CO R side L side
Likely R side ↓ CO ↓ R side preload ↓ L side afterload
44
EtoH Withdrawal Tremors common start/last times
start 24 hrs last 1-2 weels
45
4 FX EtoH Withdrawal
Hypothermia (if long time) Hypomagnesmia 2ndary ↑ HR ↑ BP
46
Side/Pressure FX of... Mitral Stenosis Pulmonary HTN Tricuspid regurg Patent Foramen Ovale
↑ L Atrial Pressure ↑ Pulmonary Pressure (no fx on ♥) ↑ R Atrial preload + pressure ↓ L Atrial preload + pressure
47
Poss s/s Bacterial Endocarditis on Neuro
AMS when bacterial emboli moves to brain r/in ischemic stroke
48
SAFEST way to verify TF placement
Abdominal Radiograph (Abd XR)
49
Bariatric FX on ER meds
not indicated b/c ↓ absorption esp. s/p sx
50
Bariatrics and Fentanyl
Fent is lipophilic, lasts longer may consider switching if r/in ↓ resp. drive
51
When Kidneys ↑ erythropoietin and fx
When sense ↓ O2 to ↑ RBC count, also r/in ↑ Renin which ↓ BP & ↑ Na/H2O reabsorption
52
Purpose of Targeted Temperature Management (s/p CODE) and desired degress C
Neurologic Protection 32 - 36 C if ROSC w/o purposeful commands
53
S/P ♥ transplant. Pacing vs. Chemical Tx
d/t denervation ↓ efficacy meds opt of external pacing
54
SIADH meaning and 3 FX to... Urine Osmo Serum Osmo Serum Na
Syndrome of Inappropriate Antidiuretic Hormone ↑ urine osmolality ↓ serum osmolality ↓ Na
55
WDL Serum Osmo & Urine Osmo
275 - 295 mmol/kg 50 - 1200 mmol/kg
56
FX SIADH on Serum Na Urine Na Initial & 2nd TX
Serum Na ↓ Urine Na ↑ Fluid Restriction then Diuretics
57
Tegretol and Desmopressin (DDVAP) with Diabetes
counters diabetic neuropathy counters urine production
58
Osmolality Definition
Concentration ↑ = more concentration vise versa
59
Key TX of sepsis, metabolic acidosis
Hydration, LR
60
3 S/S Aortic Dissection and what NOT to TX with?
sudden chest/back pain ↑ BP diastolic murmur to sternal border DO NOT use thrombolytics
61
3 Key S/S Liver Injury
RUQ Pain Hypotension Bleeding
62
FIRST TX for GI Hemorrhage and 2 key FX
Octreotide outside ↓ acidity, ↓ blood flow to help w/ clotting
63
TX for Sinus Tach if stable / unstable
Stable = 6mg adenosive IVP fast Unstable = Sync Cardioversion
64
Best way to record fluid volume
Daily Wt
65
Best way to facilitate learning/clinical inquiry to RNs
Identify and direct towards resources
66
Hemodialysis vs. Continuous Renal Replacement Therapy
CRRT for unstable, urgent, requiring norepinephrine HD is stable
67
3 FX Cardiac Tamponade KEY DX
Wide mediastinum (full ♥) on CXR Narrow Pulse Pressure (full/can't jeject) Hypotension (poor CO) ECHO
68
If pt is confused...
SAFETY FIRST
69
Meds to ↓ Preload
Venous Dilator
70
Best way to r/o ♥ issues
Cardiac Markers (blood labs)
71
4 FX of Hypokalemia on EKG
↓ conduction longer repolarizaiton Bradycardia flattened T & U waves
72
2 FX of Hyperkalemia on EKG
Peaked T widened QRS
73
Hyperosmolar Hyperglycemic Non-Ketotic Syndrome primary FX and initial, 2nd, 3rd TX
LARGE fluid deficit TX with isotonic solution then K repletion then insulin bolus
74
Hyperosmolar Hyperglycemic FX on... Glucose Mental Status Volume Na Other Lytes
↑ Glucose (> 1000) AMS ↓ volume ↑ Na ↓ Other Lytes
75
Diabetic Ketoacidosis FX on... Serum Osmolality Ketones Breathing
↓ Serum Osmo ↑ Ketones Shallow
76
Diabetic Ketoacidosis INITIAL TX?
Fluid Resuscitation
77
INITIAL tx to hospital induced delirium
↓ sensory overload
78
Leads Positioning I, aVR, V1, V4 II, aVL, V2, V5 III, aVF, V3, V6
L Ao S A I L S L I I A L Lateral, Anterior, Inferior, Septal, Lateral
79
Leads for... Left Coronary Aorta R Coronary Artery Left Anterior Decending
I, aVL, V5-6 aVR II, III, aVF V1 - 4
80
FX Pulsus Paradoxus on BP
↓ 10 SBP during inspiration b/c ↑ pressure on ♥ and pulm
81
2 Potential complications of Pressors
HTN and ischemia but overconstriction vessels
82
COPD Goal PaO2 and SaO2
PaO2 > 60% SaO2 > 90%
83
If pt has HTN, don't forget to educate about...?!
STROKE
84
Withdrawal Repression Regression Sublimation
def mechanism to separate from others to avoid response forgetting painful thoughts back to earlier emotional level development diverting energy from bad impulse to acceptable
85
If Chest Tube has... no fluctuations? bubbling? no bubbling?
poss kink/occlusion air in chest disconnection
86
Stroke goal BP
< 185/110
87
TX Hypoglycemia w/ S/S vs No S/S
D50 and recheck FSBS in 30min, notify MD Opt for PO
88
SvCO2 WDL and what it means if ↓
65 - 75% demand > supply
89
WDL INR PT PTT
0.8 - 1 (2-3 if on wafarin) 3 - 9 25 - 47
90
3 Counters to Warfarin in addition to K 1 Counter to Heparin and ↑ PTT
FFP Activated ProThrombin PO Phytonadione if INR > 10 and no risk of bleed Protamine
91
Chest Blossoming Contusions are common in & r/in
Trauma, r/in ARDS
92
When to hold Mannitol
↑ Serum Osmo
93
Key S/S for... Kehr's Sign Brudzinki's Sign Grey-Turner's Cullen's Sign Chovstek
splenic injury r/in pain L shoulder neck rigidity r/t meningitis flank bruising periumbilical bruising/swelling r/t peritoneal bleeding facial twitching r/t lyte imba
94
What is Hemolytic-Uremic Syndrome & 3 s/s
Renal failure r/t Ecoli toxins Renal failure, Thrombocytopenia, and Hemolytic Anemia
95
Common EKG complicaton of Ibutilide and reccommended action if seen.
Prolonged QT Discontinuation
96
2 Key goals of TX of Abdominal Aortic Aneurism
↓ Pain and BP
97
Key S/S Autonomic Hyperreflexia and 5 Causes
SUDDEN ↑ BP Injuries to T6 Bladder obstruction Constipation Pressure Ulcers Pain
98
Quick fix to ↓ BP w/ Ascites
Turn on L side
99
Disseminated Intravascular Coagulation Expected ▲ to... Fibrinogen Fibrin Split Products Platelets D-Dimer
↓ Fibrinogen ↑ Split Products ↓ Platelets ↑ D-Dimer
100
WDL... Fibrinogen Split Products Platelets D-Dimer
200 - 400 mg/dL < 10 ug/mL 150k - 450k uL < 500 ng/mL
101
FX Alkalosis . vs Acidosis on Oxyhemoglobin Dissociation Curve
Alk: ↑ affinity between Hgb & O2 r/in LEFT SHIFT Acid: Hyperthermia and ↑ DPG r/in RIGHT SHIFT
102
In context of ↓ Sats% Which takes priority??? Volume or O2 Replacement
Volume
103
Diastolic Pulmonary Gradient WDL and meaning if !WDL
< 7 mmHg Pulmonary HTN
104
Effect of Long term Lorazepam r/in ↑ of "THIS" r/in Metabolic Acidosis
Propylene Glycol
105
Regurg in Mitral Valve r/in what ▲ chamber and pressure
↑ Diastolic Pressure in chamber **before valve** in this case L Atria
106
♥ Anatomy and Blood Flow
Vena Cava → R Atrium Tricuspid Valve R Ventricle → Pulmonary Valve Pulmary Artery Lungs Pulmonary Vein L Atrium → Mitral Valve L Ventricle → Aortic Valve Aorta → rest of body
107
Ultra Filtration vs. Convention
Movement of water w/ pressure gradient vs. Ultra filtration + countercurrent pressure gradient
108
Grade Level to Speak to Pts Education
4th Grade
109
Per CDC, 6 Qualifiers for an Indwelling Foley Catheter
Recent Sx Immobility Perianal/Sacral Wounds Retention/Obstruction Strict I/Os End of Life Care
110
111
What do Juxtaglomerular Cells in the Kidney Produce?
Renin
112
Adverse FX of anti-rejection (transplant) meds, name and 5 s/s
Secondary Adrenal Insufficiency Fatigue Nausea Abd Pain ↑ HR ↓ BP
113
3 S/S Transplant Rejection
Flu like Fever, ↓ Urine
114
What is Myxedema Coma and 2 S/S Can be caused by (2)
Hypothyroidism r/in ↓ BP and ↓ HR Antidepressants and/or infection
115
Cause for Broken ♥/Takostubo and 2 S/S
Physical/Emotional Stress Chest pain and SoB
116
GI Bleed Initial, 2nd, 3rd TX
Volume Replacement Coagulopathy Pressors
117
Key trait about replacing RBCs w/ PRBCS
PRBCS do not have platelets, in context bleed may need platelets
118
Key TX for Stable Narrow Complex Tachy
Amio gtt 150mg / 10min
119
% Hematomas are Epidural vs. Arterial or r/t Linear Skull Fractures
25% Epidural 85% Artieral / Linear Skull Fractures
120
INITIAL/FIRST thing to do in URGENT situation
Notify the Provider
121
Per AHA, TX of Brady Atropine vs. Transcutaneous Pacing
Atropine > Transcutaneous Pacing
122
Key Med TX for Pulmonary HTN with PE vs. Long term
PE = Heparin Long term = Warfarin
123
S/P Subarachnoid Hemorrhage repair... if Neuro/visual disturbances occur KEY TX (and example) Why no Hypotonics?
Vasopressors (Nimopidine) to maintain BP Spasms can occur with HypoTN Will ↑ volume and cerebral edema
124
Nimodipine Type of Med and FX on CPP
CaChnl Antagonist ↑ CPP
125
Proper action with pt with poor prognosis, discomfort but fam concerned/continuing care??? What if can't decide, no POA or AD???
Educate on benefits of Palliative Facilitate fam focuses on pt's wishes vs their own.
126
Director makes mistake and ▲ policy r/in problems??? What do first?
Address affected first, don't try to have a meeting - dumbass lol.
127
FX of prepping for Bone Marrow Transplant
Admin of Cytotoxic Drugs r/in ↓ WBC
128
Did the pt OD?
POISON CONTROL
129
Cause of Autonomic Dysreflexia 5 S/S Key TX
Lesions above C-5 BP ↑ 20 - 30 mmHg, Tachy OR bradycardia Flushing HA Constipation Diurese
130
Acute Hepato Renal Syndrome 2 Identifiers
Liver HX and Creat > 2.5 mg/dL
131
Best intervention against Pressure Injury
Movement
132
Best Mentoring Practice
Coach w/ materials
133
Pancreatitis FX on... K Ca Glucose O2%
↓ K ↓ Ca ↑ Glucose ↓ O2%
134
WDL Lytes... Na K Ca Cl Mg Phos
135 - 145 3.5 - 4.5 2 - 2.5 95 - 105 1.6 - 2.6 2.5 - 4.5
135
Key identifer on Vent (Pressure support) of Ventilator Dysynchrony
Spontaneous Tidal Volume
136
Key DX for GI bleed + Liver issues?
Upper EGD to look for varices/hemorrhage
137
FX of... ↓ ventricular contractility vs. stiff ventricles
↓ systolic vs ↓ diastolic function
138
Black person with DTI looking wound? It's probably/actually a...
Stage I
139
Alveolar-Arterial Gradient
Diff in O2 pressure in Alveoli vs. Artery
140
WDL for... PaO2 / FiO2 Ratio PaOP
400 - 500 mmHg 6 - 12 mmHg
141
If no defined protocol for project...
Consult a specialist
142
Black ppl ↑ r/o
CAD
143
LDL & HDL WDL
< 100 mg/dL > 60 mg/dL
144
Ischemic Stroke GOLD Standard TX
IV Nicardipine
145
Sad RN about work?
DO NOT encourage inservice, variance reports... any work! Validate feelings and Debrief only
146
Best way to implement policy change
Involve more people
147
Pt can't pay for all meds?
Prescribeo only essentials
148
Aspiration Priority? O2 vs. Suctioning
O2 > Suctioning
149
2 Key S/S Early-Onset Dementia
Disruption of sleep-wale cycle Wandering/agitation @ PM
150
Pt position to fix Pacer not capturing?
Lateral Decubitus Position ON THEIR SIDE...
151
FX on ↓ Glucose on... BP, HR, RR
all 3 ↑ initially
152
If EKG shows ST - T ▲s in context of infection... it's likely "THIS" and what DX to anticipate?
Myocarditis Endocardial Bx
153
EKG: How to Check for extension of MI?
Look at most distal lead
154
Pt c/o pain and on tons of meds?
Just ask for the dose from MD, max coddle.
155
# S Staff has ethical issues with assignment?
▲ assignment, max coddle.
156
FX of Hypercalcemia on EKG
Shortened QT
157
Idiopathic Cardiomyopathy 2 Key S/S 2 Key TX 1 Contraindication
↑ anxiety and S3-S4 sounds High Fowlers + ACE Inhibs NO CPAP, will ↑ anxiety
158
WDL... Central Venous Pressure vs. on Impella Mechanical Circulatory Support
2 - 6 mmHg 12 - 14 mmHg
159
Goal Impella Mechanical Circulatory Support CVP, CI, MAP what to do if ↓
12 - 14 mmHg 2L/min/m2 70 - 80 if ↓ address volume status
160
INITAL TX with hypovolemia with KEY EXCEPTION and alt. 3 TX
NSS Unless hemorrhage, then TX with FIRST SX REPAIR, then consider pressors and/or Coagulants
161
Acute Mesenteric Ischemia 2 Key S/S and KEY DX to verify
Sudden severe abd pain Tender, soft, non-distended abd Verify with STAT CT
162
Glasgow Coma Scale Scores (3-15) 13 - 15 9 - 12 < 8
mild moderate severe TBI if < 8 you dead boi notify organ procurement lol
163
Thyroid Storm vs. Graves Disease TSH WDL
Storm = undetectable TSH Graves = ↑↑↑ TSH 0.4 - 4.0 mIU/L
164
Thyroid Storm 3 S/S
AMS, Fever, GI s/s
165
Grave's Disease 3 S/S
↑ anxiety, ↑ appetite, weight loss
166
Seizure with Lyte Imba? First, 2nd TX 1 Contraindication
TX imba first then anti-epileptics DON'T Diurese
167
S/S Asthma, infection, & Accessory Muscle Usage. What do?!
EMERGENCY: PREPARE FOR INTUBATION~!
168
How to stimulate Clinical Inquiry in RN?
Promote work/research, don't just answer it for em' EVEN IF A SHIT TON OF WORK MAKE EM DO IT
169
Vent Setting WDLs Rate Tidal Vol PEEP
12 - 16 / min around 500 mL 5 - 15 cmH2O
170
5 EASIEST evidence-based non-cert needing therapies an RN can use 2 which need certs?
Guided Imagery Aromatherapy (but no in ICU) Massage Music Therapy Distraction Acupuncture and Therapeutic Touch
171
If super low temp, pref? Passive Rewarming vs. Warmed IVF
Passive Warming > Warmed IVF
172
3 Lab ▲s Microcytic/Hypochromic Anemia Specify Type of Anemia Key S/S
↓ RBC, MCV, MCH Iron Deficiency Anemia Pica (wanting to eat ice chips)
173
WDLs for... RBC MCV MCH
4.7 - 6 mil/microL 80 - 100 fL 27 - 33 pg
174
Plasma-Lyte is...? ... and for?
IV Nutrition for lyte + protein replacement
175
↑ ICP (d/t metabolic or trauma) FX on... Pupils Mental status SVR Pulse Pressure Name for it all combined???
Pinpoint ↓ LoC ↑ SVR Widened Cushing's Triad
176
Seizure differences... Tonic-Clonic Myoclonic Focal Status Epilepticus
2 Phases - Rigidity (Tonic) then Rhythmic Jerking (Clonic) Sudden, brief to face & extremities Sensory & awareness ▲ Just Clonic
177
Controlled vs. Uncontrolled AFIB
HR controlled < 100 < uncontrolled
178
1st Degree ♥ Block
R far from P, 1st degree
179
2nd degree Type I (Wenkebach)
Longer, longer, longer drop (P to R) - Wenkebach~!
180
2nd degree Type II (Mobitz)
some P's don't get through (Mobitz II)
181
3rd degree ♥ block
P's & Q's don't agree
182
What ist most dangerous + ischemic stroke
Fever
183
Anion Gap is determined with these 4 Labs
Na, K, Cl, HCO3
184
Sepsis FX on R Atrial Preload
↓ b/c global vasodilation
185
3 key s/s anxiety
nausea diarrhea SoB
185
ACE inhibiters SFX r/in ↑ what Lyte?
Hyperkalemia
186
Abd Sx ↑ r/o
Atelectasis which ↑ temp
187
Pref mode Nutrition for Pancreatitis pt
Jejunal to ↓ pancreatic stimulation
188
Pancreas function of A, B, D, cells
A = glucagon B = insulin D = somatostatin
189
Meaning of split S1, S3, S4 ♥ sounds
split S1 = BBB or PVC S3 = fluid overload S4 = ventricular hypertrophy, atria pushes hard to overcome and vibrations make S4
190
tPA for Stroke is contraindicated for...?
Bleeding complications/Sx w/in 3 months
190
Hypercapnia means...
↑↑ CO2 in the blood
191
Neprogenic Diabetes Insipidus means...
Kdineys are NOT responding to ADH (Vasopressin)
192
FX Cardiogenic shock means and FX on... preload Vasculature 3 Common s/s
↓ ability to pump blood ↑ pre ↑ SVR cool, pale, moist skin
193
Gold standard for TX MI
Percutaneous Coronary Intervention (PCI)
194
Sounds of... Aortic Stenosis Aortic Regur Mitral Strenosis Mitral Regurg
systolic S2, rales high pitched diastolic murmur apical diastolic murmur holosystolic split S2 murmmur
195
What initiates Renin Cascade?
↓ renal perfusion pressure
196
HIT ↑ chances of which kind of stroke?
Ischemic
197
Cerebral injury and affected side
SAME SIDE
198