Things to know

Question 1

When given spinal, what is the order the RN should expect function to return?

Answer 1

Chest, abd, lower extremities, perineal. It moves from top to bottom (thoracic to sacral nerves)

Question 2

HELLP

Answer 2

subset of pre-eclampsia
hemolysis: breakdown of RBC
sx: fatigue, dizziness, pale skin, tachycardia, dyspnea, jaundice
elevated liver enzymes leads to pain, change in LOC, N/V
Tx: Deliver Baby

Question 3

When someone needs a translator, who should the RN use for translation?

Answer 3

ONLY a hospital interpreter!

Question 4

Sequence of recovery from spinal anesthesia (not dermatomes)

Answer 4

1. Sense of body location (proprioception)
2. movement
3. touch
4. pain
5. sense of temp
6. autonomic, sympathetic function (fight or flight response)

Question 5

What can happen if T3/above is blocked?

Answer 5

hypotension, bradycardia, asystole, resp distress, apnea

Question 6

DIC treatment and what to monitor for

Answer 6

Platelets FFP(fresh frozen plasma)
hemolytic reaction: severe hypotension, pain at site, anxiety, malaise, increased temp, decr renal fxn, chills, HA, unexplained bleeding at operative site, uriticaria, stridor, pruritus

Question 7

Postdural puncture/spinal HA txs

Answer 7

1) fluids and caffeine
2) blood patch

Question 8

complications of malignant hyperthermia

Answer 8

renal failure d/t hypotension/myoglobinuria, DIC, pulmonary edema, cardiac failure, brain damage

Question 9

What are the ASA guidelines for telling how sick a pt is?

Answer 9

I) normal healthy pt
II) mild systemic disease
III) sev systemic disease
IV) sev systemic disease that a threat to life
V) not expected to survive w/o surgery
VI) dead, organ donor

Question 10

What is the 4-2-1 pediatric rule?

Answer 10

00-10kg –> 4mLkg/h for q kg
11-20 kg–>40mL + 2mL/kg/h for q kg
> 20mk –> 60mL + 1mL/kg/h for q kg

Question 11

How to test the different CN

Answer 11

I) smell
II) sight
III, IV, VI) pupil constriction, occular movments
V) mastication
VII) smiling, 2/3 anterior tongue
VIII) balance, hearing
IX) swallowing
X) gag reflex
XI) shoulders
XII) tongue movement

Question 12

What is the order of the CN

Answer 12

I. olfactory,
2. optic
3. oculomotor
4. trochlear
5. trigeminal
6. abducens
7. facial
8. vestibulocochlear
9. glossopharyngeal
10. vagus
11. spinal accessory
12. hypoglossal

Question 13

Sickle cell crisis can be caused by :

Answer 13

cold, infection, hypoxia, dehydration, stress

Question 14

Addisonian crisis information

Answer 14

prepare w/ giving steroids before, during and after sx d/t RF infection, injury, operation (aka stressors) that can cause acute adrenal insufficiency
s/s: dehydration, N/V, muscular weakness, hypotension, hyponatremia, hyperkalemia, azotemia, shock

Question 15

Thyroid storm information

Answer 15

appears like MH, however a key sign is hypOkalemia
Tx: BB, iodine, vasopressors, IVF, O2, steroids, cooling measures

Question 16

Myasthenic crisis

Answer 16

developed d/t stress causing pain, stress, need airway equipment at bedside

Question 17

thyroidectomy, what to have at bedside

Answer 17

tracheostomy tray

Question 18

When is Etomidate used in place of propofol?

Answer 18

cardiac dysfunction