Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
110 Cards in this Set
- Front
- Back
|
What is the most dangerous form of PVC's?
|
Multifocal or R on T phenomenon
|
|
|
This represents atrial depolarization on the EKG?
|
P wave
|
|
|
What is cardioversion?
|
-cardioversion is synchronized shock delivered to heart during an elective procedure
|
|
|
What rhythms are cardioverted?
|
-AFib, AFlutter, VTach with pulse, SVT
|
|
|
This rhythm is characterized by chaotic atrial activity with an irregularly irregular rhthym and no discernible P wave on the EKG?
|
-AFib
|
|
|
What is the normal QRS interval?
|
0.04 to 0.12 seconds
|
|
|
Name 2 lethal arrythmias?
|
- Asystole, VFib, Pulselessness V Tach
|
|
|
This rhthym is characterized by increased rate with inspiration and decreased rate with exhalation?
|
- Sinus arrythmias
|
|
|
What age group are affected with sinus arrythmias?
|
- the very young and the very old
|
|
|
This rhythm is characterized by intermittent conduction of the atrial impulse to the ventricle?
|
- 2 degree AV blocks
|
|
|
This rhythm is characterized by independent atrial and ventricular activity?
|
- 3rd degree heart block
|
|
|
What is the treatment for 3rd degree heart blocks?
|
- Pacing
|
|
|
This is the ability of the heart's pacer cells to depolarize spontaneously
|
- Automaticity
|
|
|
This electrolyte imbalance is assessed using Chovstek's and Trousseau's sign?
|
-Hypocalcemia
|
|
|
This initial therapeutic measure is done during the emergent or acute phase of burns?
|
- Fluid replacement
|
|
|
This electrolyte requires close monitoring during the oliguric phase of acute renal failure?
|
- K+
|
|
|
What is the normal value of K+?
|
- 3.5 to 4.5
|
|
|
This quick method used to calculate total body surface area burned?
|
- Rules of Nine
|
|
|
In burns, what could be used to determine 1%?
|
- palm of patient's hand
|
|
|
Name lab tests that is indicative of liver failure?
|
- PTT
-PT -SGOT -Liver enzymes |
|
|
This disorder is characterized by prematurely activated digestive enzymes producing autodigestion of tissue
|
- Pancreatitis
|
|
|
What nursing diagnosis is top priority for pancreatitis?
|
-Fluid deficit
|
|
|
This is a progressive decrease in level of consciousness related to elevated ammonia levels
|
Hepatic Encephalopathy
|
|
|
How is Hepatic encephalopathy treated (to decrease ammonia levels)
|
- Lactulose
|
|
|
This is GI bleeding caused byu portal hypertension secondary to cirrhosis
|
-esophageal varices
|
|
|
This is a surgical incision into a burned area to relieve pressure and restore circulation
|
- escharotomy
|
|
|
What do these labs indicate?
K+: 6.8 Ca+: 6.0 Na+: 124 |
- Acute renal failure
|
|
|
This syndrome is characterized by hypoperfusion of body tissues?
|
Shock
|
|
|
This is overstimulation of the normal coagulation mechanisms?
|
-DIC
|
|
|
What are sources of stress for staff in the ICU?
|
- high technology, high patient acuity, frequent deaths, ethical conflicts, overtime, families
|
|
|
This type of shock is caused by decreased blood volume?
|
- hypovolemic shock
|
|
|
What lab values are indicative of DIC?
|
^ fibrin split products and prolonged PT and PTT
- decreased platelets - decreased fibrinogen |
|
|
This type of shock is characterized by decreased sympathetic tone, resulting in vasodilation, hypotension and hypothermia?
|
- Neurogenic Shock
|
|
|
What is the initial assessments done on all trauma patients?
|
-A,B,C,D,E,F,G,H,I
|
|
|
This assessment parameter is used for patients receiving vasoactive during therapy?
|
- Blood pressure
|
|
|
Which drug is most commonly used as a vasoactive in the ICU?
|
- Dopamine
|
|
|
This is the time following a trauma when quick interventions may improve prognosis?
|
- "The Golden Hour"
|
|
|
This is for shock is characterized by flushed skin, increased cardiac output and hypotension?
|
- Septic Shock
|
|
|
What are 5 drugs used during a code?
|
-Atropine, epinephrine, oxygen, magnesium, amiodarone, lidocaine, vasopressin, dopamine, TPA
|
|
|
What is the first cardiac enzyme to elevate after an MI?
|
-Troponin I
|
|
|
What is the phlebostatic axis?
|
- 4th ICS mid-axillary line
|
|
|
Where does the phlebostatic axis correlate?
|
-at the level of the atria
|
|
|
What is cardiac output?
|
CO=SV x HR
the amount of blood pumped by the heart per minute |
|
|
This type of pacing delivers a stimulus to the heart only when the heart's intrinsic pacemaker fails?
|
-demand pacing( only when it needs to)
|
|
|
This parameter reflects left ventricular preload?
|
- PAWP (wedge pressure)...looks at left ventricular pressure
|
|
|
List 3 complications that can occur from cardiac surgery?
|
-cardiac tamponade
-decreased cardiac output -muffled heart sounds -tension pneumothorax -infection, pneumonia |
|
|
This is stray electrical current which could precipitate lethal arrhythmias in patients with inracardiac lines?
|
- microshocks
|
|
|
What would you do to avoid microshocks from occurring?
|
-wear gloves when handling wires or equipment
|
|
|
This is a temporary circulatory assist device that inflates during diastole and deflates during systole
|
- Intra-aortic balloon pump
(IABP) |
|
|
This device can defibrillate, cardiovert, overdrive pace and demand pace
|
ICP or PCD
|
|
|
This is an abnormal motor response characterized by flexion of the arms in response to a stimulus?
|
-decorticate posturing
|
|
|
When you get decorticate posturing, where is the injury?
|
-in the midbrain
|
|
|
What is Cushing's Triad?
|
-widened pulse pressure, bradycardia, hypertension and bradypnea
|
|
|
What do the Cushing's Triad indicate?
|
-Increased intracranial pressure
|
|
|
The syndrome is an inflammatory peripheral polyneuritis characterized by a rapidly progressive ascending paralysis?
|
- Guillian Barre'
|
|
|
What are the symptoms of autonomic dysreflexia?
|
-HTN, HA, facial flushing, sweating above the level of injury and piloerection
|
|
|
What is the treatment of autonomic dysreflexia?
|
- check for impaction or kinked foley, check for decub or too tight clothing. Treat hypertension and bradycardia
|
|
|
What does CPP reflect?
|
CPP=MAP-ICP
- cerebral perfusion of the brain |
|
|
What are 3 interventions to lower increased intracranial pressure?
|
- HOB at 30, hyperventilate patient, sedate, NMBA, limit stimulation
|
|
|
Spinal cord injuries of C1 thru C4 cannot do what vital function?
|
- Breathe on own
|
|
|
This is an abnormal motor response characterized by flexion of the arms in response to a stimulus?
|
-decorticate posturing
|
|
|
When you get decorticate posturing, where is the injury?
|
-in the midbrain
|
|
|
What is Cushing's Triad?
|
-widened pulse pressure, bradycardia, hypertension and bradypnea
|
|
|
What do the Cushing's Triad indicate?
|
-Increased intracranial pressure
|
|
|
The syndrome is an inflammatory peripheral polyneuritis characterized by a rapidly progressive ascending paralysis?
|
- Guillian Barre'...what do you have to watch for w/ these people....RESPIRATORY ARREST
|
|
|
What are the symptoms of autonomic dysreflexia?
|
-HTN, HA, facial flushing, sweating above the level of injury and piloerection
|
|
|
What is the treatment of autonomic dysreflexia?
|
- check for impaction or kinked foley, check for decub or too tight clothing. Treat hypertension and bradycardia
|
|
|
What does CPP reflect?
|
CPP=MAP-ICP
- cerebral perfusion of the brain |
|
|
What are 3 interventions to lower increased intracranial pressure?
|
- HOB at 30, hyperventilate patient, sedate, NMBA, limit stimulation, NO FLEXION: treat them like mushrooms
|
|
|
Spinal cord injuries of C1 thru C4 cannot do what vital function?
|
- Breathe on own
|
|
|
What are some key assessments that clue the nurse to a basilar skull fracture?
|
- Battle signs, raccoon eyes, otorrhea, rhinorrhea
|
|
|
What is a patient with basilar skull fracture at risk to develop?
|
-meningitis
|
|
|
This is characterized by a brief loss of consciousness, followed by a lucid period, then progressive decrease in level of consciousness
|
- epidural hematoma or bleed (Natasha Richardson)
|
|
|
Wha is the cause of epidural hematoma?
|
-arterial bleed (middle meningeal artery)
|
|
|
This results from pressure on the temporal lobe, producing ipsilateral pupil dilation, decreased pulse pressure and progressive loss of consciousness
|
Uncal herniation due to increased intracranial pressure
|
|
|
This condition is characterized by Beck's Triad?
|
- Cardiac Tamponade
|
|
|
What are the s/sx of Becks' Triad?
|
-muffled or distant heart sounds
-distended neck veins -hypotension |
|
|
This is when 3 or more ribs are fractured in 2 or more places
|
- Flail Chest. What intervention can you do for these patients? Deep breathe and cough.
|
|
|
this is accumulation of air between the parietal and visceral pleura
|
- pneumothorax
|
|
|
What does it mean when the high pressure vent alarms?
|
- biting on the tube, coughing, gagging, needs suctioning
|
|
|
What happens if there is an alarm with low pressure on the vent?
|
- Leak or disconnection
|
|
|
What is the assist control mode of the vent?
|
- spontaneously initiates a breath at preset volume delivered by vent
|
|
|
Analyze the ABG:
pH: 7.36 PaCO2: 60 HCO3: 30 |
- Compensated respiratory acidosis
|
|
|
What is Virchow's Triad?
|
- venous stasis, injury to vascular system and altered coagulopathy
|
|
|
What are we assessing for with Virchow's Triad?
|
- possible pulmonary embolus
|
|
|
This is the inability of the pulmonary system to maintain adequate gas exchange?
|
- Acute respiratory failure
|
|
|
How is the O2 and CO2 reflected with this?
|
-50/50 Club
|
|
|
What are the signs and symptoms of a tension pneumothorax?
|
- dyspnea, chest pain, subcutaneous air, tracheal deviation....and no breath sounds....
|
|
|
What is the treatment for a tension pneumothorax?
|
- Chest tube ASAP
-needle in chest |
|
|
What are the s/sx of ARDS?
|
- Severe respiratory failure with acute hypoxia despite O2 and increased alveolar capilarry permeability.
|
|
|
What drug is used to treat PVC's?
|
Magnesium
|
|
|
On an EKG, what does the QRS represent?
|
-ventricular depolarization
|
|
|
Where is the positive lead placed when using an MCL 1 view?
|
Right sternal border, 4th ICS
|
|
|
What EKG rhythm shows no or an inverted P wave?
|
- Junctional rhythm
|
|
|
What formula is used to calculate fluid resuscitation in burn victims?
|
-4mL/Kg x % BSA burn
-1/2 amount for 1st 8hrs -1/4 amount for 2nd 8 hrs -1/4 amount for 3rd 8 hrs |
|
|
Injury to the muscle may result in myoglobinurea, what organ does this affect?
|
- Kidneys
|
|
|
What are the categories of renal failure?
|
-pre-renal: hypoperfusion
-intra-renal: glomerular -post-renal: obstructions |
|
|
What complication during the oliguric phase of renal failure are we concerned with?
|
Urinary output <100 mL/24 hr
decreased K+, ^ Ca+ |
|
|
What must the MAP be to support adequate perfusion?
|
60 mm/Hg
|
|
|
What is preload?
|
- myocardial muscle stretch (contractility)
|
|
|
What is afterload?
|
-resistance to flow (arterial BP)
|
|
|
What would you anticipate with an elevated CVP?
|
-use of Lasix
|
|
|
What would you anticipate with a decreased CVP?
|
-need fluids
|
|
|
When using thrombolytic therapy, what must you monitor for?
|
-bleeding
|
|
|
What type of vessel is involved during an epidural bleed?
|
-Arterial
|
|
|
What is the most common vessel for an epidural bleed?
|
- Middle Meningeal Artery
|
|
|
What medication is used to treat vasospasms during SAH?
|
Nimotop x 21 days
|
|
|
What are the signs and symptoms of subarachnoid hemorrhage? (SAH)?
|
- severe headache, projectile vomiting, nuchal pain
|
|
|
What type of vessel is involved during a subdural bleed?
|
-Venous
|
|
|
When do signs and symptoms occur for Subdural bleeds?
|
-weeks to months
late sign is change in pupils |
