Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ZANDER CNOR > Surgical emergencies > Flashcards

Surgical emergencies Flashcards

1
Q

What is the definition of DIC?

A

inappropriate clotting followed by hemorrhaging, from massive amounts of tissue factor circulating systemically

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

What are the 2 causes of DIC?

A
  1. systemic response
  2. release of procoagulant into the blood stream
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 types of systemic responses that cause DIC?

A
  1. trauma - tons of tissue factor touching the vascular system
  2. sepsis
  3. obstetrics - amniotic fluid emboli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is something that excretes procoagulant into the blood stream?

A

boney tumor

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

What are 4 complications of DIC?

A
  1. severe bleeding
  2. stroke
  3. reduced blood flow to organs
  4. overload of liver and kidneys
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 4 treatment options for DIC?

A
  1. correct the cause
  2. treat with FFP AND cryoprecipitates
  3. heparin sometimes used in the beginning
  4. volume/blood replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 2 types of air embolisms?

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

venous air embolisms can happen what?

A

passively, because the CVP can be lower than atmospheric pressure

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

Pressure in the right atrium is less than what?

A

atmospheric pressure

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

Whenever you get a cut or scrape, why does our body not take on air?

A

because our vascular system collapses where the cut is

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

Where is the only place in the body where the vasculature does not collapse?

A

the dura

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

What patients are most at risk for venous emboli? why

A

neuro procedures where the patient is sitting, because you are pulling air down venous sinuses as water table starts to drop

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

What does surgeon do during sitting procedures to prevent venous embolisms?

A

sews them, but if they miss one it can cause venous embolism

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

What are 2 other procedures where patients are at risk for venous air embolism? why?

A

hysteroscopies and TUR. If there is air in the tubing it can press air into the venous sinuses

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

What are 2 ways you can get an arterial air embolism?

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

Can you receive an arterial air embolism passively?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are 6 s/sx of air embolsim?

A
  1. rapid onset pulmonary edema - fluid in between the lungs and vasculature, because that space is usually one cell thick
  2. drop in ETCO2
  3. hypoxia
  4. hypotension
  5. arrhythmias
  6. neurologic damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is your first step in treating a venous air embolsim?

A

1st identify and occlude the sites of air entry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If you are working in the cranial region what are things you can do to treat venous air embolisms?

A

sloppy wet sponges, irrigation syringe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If you are working in bone, what is one thing you can do to treat venous air embolsim?

A

bone wax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does nitrous oxide do to promote venous air embolisms?

A

it increases surface tension of air, making the fizzy little bubbles in venous sinuses one big bubble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do you want to do with nitrous oxide when doing a procedure where venous air embolism is likely or one shows up?

A

discontinue it or don’t use it at all

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

where else do you see nitrous oxide not being used because it can actually make one big bubble in this area?

A

retina procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What kind of position do you put a patient in when they have a venous air embolism?

A

place patient in left lateral position (durant’s maneuver)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does left lateral position or durant’s maneuver allow to you to do?

A

you can do an echo, throw down a right atrial line, and aspirate the air out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What part of anatomy does the left lateral position or durant’s maneuver elevate?

A

right atrium becomes the high point in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What position do you put patients in for an arterial embolism? which makes most sense for what?

A

deep trendelenburg position, which makes most sense for dialysis not for bypass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How can we treat arterial air embolisms for bypass?

A

perfusionist can aspirate the air out, because deep trendelenburg is not really an option

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are medical reasons for compressions in cardiac arrest?

A

MI, arrhythmias, anaphylactic reactions, emboli, vagal stimulation, MH, anesthesia overdose, hypoxia, laryngospasm, aspiration, hypothermia, electrolyte imbalances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is 1 surgical reason for doing compressions in cardiac arrest?

A

hypovolemic shock r/t blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the RN’s first job of cardiac arrest?

A

1st get help in your room

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the RN’s 2nd job of cardiac arrest?

A

get the defibrillator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the RN’s 3rd job of cardiac arrest?

A

DOCUMENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What 3 things are you going to document during cardiac arrest?

A
  1. meds, time and dose
  2. rhythms
  3. time start and stop CPR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

As the RN you should know what during a code?

A

who is running it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

In cardiac emergencies what is your priority treatment?

A

OMI (oxygen, monitors, IV fluid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

If you have inadequate HR/BP in cardiac emergencies what 4 things are you going to do in order?

A
  1. CPR
  2. defibrillator
  3. epinephrine for BP
  4. amiodarone for HR and BP
38
Q

If you have adequate HR/BP in cardiac emergencies what 5 things are you going to do in order?

A
  1. epinephrine
  2. amiodarone
  3. dopamine
  4. ICU monitored bed
  5. cardioversion - slower intervention. After they have trialed a medication and it has failed then this is next resort
39
Q

A premature ventricular contraction (PVC) is a what?

A

a relatively common event where the heartbeat is initiated by the ventricles rather than by the sino atrial node

40
Q

Is there CO in PVC’s?

A

no there is no real cardiac ouput because there is not enough time for ventricles to fill

41
Q

Are PVCs a big deal?

A

no not unless you have a lot in a row, because they are going to lose their BP

42
Q

What is ventricular tachycardia?

A

tachycardia with beats initiated in the ventricles

43
Q

What is ventricular fibrillation?

A

uncoordinated contraction of the ventricles

44
Q

How do we treat v tach and v fib?

A
  1. CPR - FIRST THING YOU DO! IF CPR IS NOT OPEN, DO EARLY DEFIBRILLATION
  2. early defibrillation
  3. epinephrine
  4. amiodarone
45
Q

What is bigeminy?

A

PVC every other beat, the others are QRS

46
Q

What is a couplet of bigeminy?

A

Pair of PVC’s

47
Q

What is trigeminy?

A

every third beat is PVC

48
Q

How is bigeminy treated?

A

adequate HR, but not adequate BP so support BP and put them on a drip overnight. If they do not snap out of it with meds then cardioversion

49
Q

What is a run of bigeminy?

A

Several PVCs in a row.

50
Q

What is another way to describe a run of bigeminy?

A

unsustained v tach

51
Q

What should you do if anesthesia is talking about couplets and runs?

A

definitely need to fix it whether it be a volume or electrolyte issue. WARNING SHOT!

52
Q

What is a supraventricular tachycardia (SVT)?

A

tachycardia caused by an electrical impulse originating above the ventricles

53
Q

Because SVT is not a ventricular arrhythmia, what medication is not going to work?

A

amiodarone

54
Q

What are 3 things that can help break SVT?

A

vagal stim (like bearing down) adenosine, sync cardioversion

55
Q

What are characteristics of adenosine?

A

it has a short half-life, metabolizes very quickly

56
Q

How do you want to give adenosine?

57
Q

What is the one freaky thing about adenosine?

A

it causes a long cardiac pause

58
Q

We only treat what kind of bradycardia? which means?

A

symptomatic, which means they don’t hold a BP

59
Q

What are 3 things we want to do with treating bradycardia?

A
  1. atropine
  2. dopamine drip to maintain good HR and BP
  3. pacer
60
Q

If it is 3rd degree heart block, or complete heart block, what is the only thing that fixes that?

A

surgery to put a pacer in; no medication can be given to fix that long term

61
Q

What 3 things are contraindicated in glaucoma patients?

A
  1. atropine
  2. robinol
  3. succinylcholine
62
Q

What are 5 H causes of pulseless electrical activity?

A
  1. hypovolemia
  2. hypoxia
  3. hydrogen ions (acidosis)
  4. hypoglycemia
  5. hypothermia
63
Q

What are the 6 T causes of pulseless electrical activity?

A
  1. Toxins
  2. Cardiac TAMPONADE
  3. Tension pneumothorax
  4. Thrombosis (MI/PE)
  5. Tachycardia
  6. Trauma
64
Q

What is PEA?

A

a dead patient who’s heart has not figured it out yet. The heart is not moving, but the electrical current is moving through the myocardium

65
Q

How do we treat pulseless electrical activity?

A
  1. CPR
  2. Treat the underlying cause
66
Q

What kind of diagnosis is PEA?

A

a medical diagnosis

67
Q

How would a nurse document PEA?

A

whatever rhythm you see on the monitor followed by the words “NO PULSE”

68
Q

What is normal pH?

69
Q

What is normal pO2?

70
Q

What is normal O2 sat?

A

> or equal to 98

71
Q

What is normal PCO2?

A

35-45 (respiratory)

72
Q

What is normal HCO3?

A

22-26 (metabolic)

73
Q

What is normal base excess?

A

+2 to -2 (buffer to base ratio

74
Q

What does the acronym ROME tell you?

A

respiratory = opposite
metabolic = equal

75
Q

Respiratory acidosis is caused by what?

A

decreased ventilation

76
Q

What do we ultimately treat respiratory acidosis with?

A

ventilation, give reversal agents, oral airway

77
Q

Respiratory alkalosis is caused by what?

A

hyperventilation

78
Q

What do you treat respiratory alkalosis with what?

A

treat with sedation or decreased ventilation

79
Q

Metabolic acidosis is ultimately caused by what?

A

excess production of metabolic acids

80
Q

What 4 things would you see an excess production of metabolic acids?

A
  1. cardiac arrest
  2. sepsis
  3. ketoacidosis
  4. renal failure
81
Q

Treat metabolic acidosis with what?

82
Q

What 4 things cause metabolic alkalosis?

A
  1. acid loss
  2. upper GI loss
  3. diuretics (potassium loss = hydrogen ion loss)
  4. over administration of alkali
83
Q

Treat metabolic alkalosis with what?

A

treat the cause

84
Q

ph is 7.30
pCO2 is 70
HCO3 is 30

A

respiratory acidosis

85
Q

pH 7.48
pCO2 20
HCO3 15

A

respiratory alkalosis, with partial compensation

86
Q

pH 7.25
pCO2 40
HCO3 12

A

uncompensated metabolic acidois

87
Q

pH 7.50
pCO2 45
HCO3 35

A

uncompensated metabolic alkalosis

88
Q

What is the definition of compensation in terms of pH, CO2, HCO3?

A

pH is WNL, CO2 is not WNL, and HCO3 is not WNL

89
Q

What is the definition of partially compensated in terms of pH, CO2, HCO3?

A

pH is NOT WNL, CO2 is NOT WNL, and HCO3 is NOT WNL

90
Q

What is the definition of uncompensated in terms of pH, CO2, HCO3?

A

pH is NOT WNL, CO2 and HCO3 - one is NOT WNL and the other one is WNL

ZANDER CNOR (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions