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[Show more]oculovestibular reflex assessment - the patient's eyes are held open while ice water is injected 
slowly into the ear canal and the eye response is observed (cold calorics) 
positive: eyes move toward the side of the ice water injection- positive is good) 
Wh brain herniation occurs when ____ - swe...
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Add to cartoculovestibular reflex assessment - the patient's eyes are held open while ice water is injected 
slowly into the ear canal and the eye response is observed (cold calorics) 
positive: eyes move toward the side of the ice water injection- positive is good) 
Wh brain herniation occurs when ____ - swe...
what are 3 treatments for DI? - 1) give ADH (pitressin, DDAVP), use cautiously in those with heart 
disease, may cause coronary artery ischemia 
2) give fluids to replenish intravascular volume 
3) monitor urinary output/specific gravity 
what is the pathophysiology of SIADH? (figure 10-1 pg 204) - ...
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Add to cartwhat are 3 treatments for DI? - 1) give ADH (pitressin, DDAVP), use cautiously in those with heart 
disease, may cause coronary artery ischemia 
2) give fluids to replenish intravascular volume 
3) monitor urinary output/specific gravity 
what is the pathophysiology of SIADH? (figure 10-1 pg 204) - ...
What value reflects right ventricular preload? - CVP or RA pressure 
In hypovolemic shock, does SVR increase or decrease? - increase 
CVP and PAOP are a measure of preload or after load? - preload 
Heart rate x stroke volume =? - cardiac output 
Stroke volume is dependent on what three concepts? - p...
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Add to cartWhat value reflects right ventricular preload? - CVP or RA pressure 
In hypovolemic shock, does SVR increase or decrease? - increase 
CVP and PAOP are a measure of preload or after load? - preload 
Heart rate x stroke volume =? - cardiac output 
Stroke volume is dependent on what three concepts? - p...
Vasopressin in esophageal varices - Reduces portal hypertension (ran at high doses of 0.4-1) 
-Watch with CAD patients!! 
What is the most common cause of acute hepatic failure? - DILI (drug-induced)- most commonly 
by acetaminophen 
Why would you watch for sepsis in a hepatic failure patient? - Bac...
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Add to cartVasopressin in esophageal varices - Reduces portal hypertension (ran at high doses of 0.4-1) 
-Watch with CAD patients!! 
What is the most common cause of acute hepatic failure? - DILI (drug-induced)- most commonly 
by acetaminophen 
Why would you watch for sepsis in a hepatic failure patient? - Bac...
benefits of IABP - increased coronary artery perfusion 
decreased O2 demand 
increased O2 supply 
decreased afterload 
Pt getting IABP. Hour after return from Cath lab, pt has had minimal UOP. What would be most 
appropriate action? 
A. get CXR to verify catheter placement 
B. give fluid bolus 
C. a...
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Add to cartbenefits of IABP - increased coronary artery perfusion 
decreased O2 demand 
increased O2 supply 
decreased afterload 
Pt getting IABP. Hour after return from Cath lab, pt has had minimal UOP. What would be most 
appropriate action? 
A. get CXR to verify catheter placement 
B. give fluid bolus 
C. a...
Side effects of Positive Pressure ventilation - 1. Increased intrathoracic pressure leads to 
decreased venous return to the heart, decreasing stroke volume, and CO 
Two types of ventilators - 1. Negative pressure ventilators- i.e iron lung 
2. Positive pressure ventilators: hospital bedside ventila...
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Add to cartSide effects of Positive Pressure ventilation - 1. Increased intrathoracic pressure leads to 
decreased venous return to the heart, decreasing stroke volume, and CO 
Two types of ventilators - 1. Negative pressure ventilators- i.e iron lung 
2. Positive pressure ventilators: hospital bedside ventila...
What patients should not receive NS for fluid replacement? - Hypernatremic 
Renal failure (R/t risk of hyperchloremic acidosis) 
What are the goals of fluid resuscitation for patients in shock? - MAP >65 
CVP ~6 mmHg 
Urine output 0.5 ml/kg/hr 
Hgb >7 
Symptoms of hypovolemic shock - Decreased...
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Add to cartWhat patients should not receive NS for fluid replacement? - Hypernatremic 
Renal failure (R/t risk of hyperchloremic acidosis) 
What are the goals of fluid resuscitation for patients in shock? - MAP >65 
CVP ~6 mmHg 
Urine output 0.5 ml/kg/hr 
Hgb >7 
Symptoms of hypovolemic shock - Decreased...
Septic Shock Management Step Three - -Antibiotics (first 60 min) 
-Broad Spectrum antibiotics 
-Try to obtain culture first 
-Consider IM administration if 
hard to get IV access 
- Start with Gram Negative spectrum before Gram Positive 
Septic Shock Management Step One - - Recognition and Access: D...
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Add to cartSeptic Shock Management Step Three - -Antibiotics (first 60 min) 
-Broad Spectrum antibiotics 
-Try to obtain culture first 
-Consider IM administration if 
hard to get IV access 
- Start with Gram Negative spectrum before Gram Positive 
Septic Shock Management Step One - - Recognition and Access: D...
Toddler w meningitis. Resistance when the lower legs are extended. She also cries when her legs are 
raised to change her diaper. Documents this as which of the following? 
a. Kernigs sign 
b. Brudinski sign 
c. Nuchal rigidity 
d. Battle sign - A. Kernig sign 
- back pain and resistance to lower le...
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Add to cartToddler w meningitis. Resistance when the lower legs are extended. She also cries when her legs are 
raised to change her diaper. Documents this as which of the following? 
a. Kernigs sign 
b. Brudinski sign 
c. Nuchal rigidity 
d. Battle sign - A. Kernig sign 
- back pain and resistance to lower le...
IV Infiltration: Management - Prevention 
Early identification 
Stop the infusion 
Elevate 
warm or cool compress 
Monitor the site 
Unstageable pressure injury - Full-thickness tissue loss of unknown depth. The base of the wound 
is completely obscured by slough and eschar. 
Pressure Injury: Stage ...
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Add to cartIV Infiltration: Management - Prevention 
Early identification 
Stop the infusion 
Elevate 
warm or cool compress 
Monitor the site 
Unstageable pressure injury - Full-thickness tissue loss of unknown depth. The base of the wound 
is completely obscured by slough and eschar. 
Pressure Injury: Stage ...
Tx to decrease preload - -Diuretics 
-Dilators (nitrates, nitroprusside, morphine) 
Define preload - -Preload is the volume/pressure in the ventricle at the end of DIASTOLE after the 
AV valves close, just prior to ejection 
-As preload increases, SV and CO will increase up to a point 
-Too high of ...
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Add to cartTx to decrease preload - -Diuretics 
-Dilators (nitrates, nitroprusside, morphine) 
Define preload - -Preload is the volume/pressure in the ventricle at the end of DIASTOLE after the 
AV valves close, just prior to ejection 
-As preload increases, SV and CO will increase up to a point 
-Too high of ...
etiology of aneurysms - arteriosclerosis 
HTN 
smoking/obesity 
bacterial infections 
congenital defects 
Trauma 
Marfan's syndrome (connective tissue disorder) 
what other defect can cause systolic murmurs? - ventricular septal defect (heard on the left 
sternal border) 
relievers for Unstable ang...
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Add to cartetiology of aneurysms - arteriosclerosis 
HTN 
smoking/obesity 
bacterial infections 
congenital defects 
Trauma 
Marfan's syndrome (connective tissue disorder) 
what other defect can cause systolic murmurs? - ventricular septal defect (heard on the left 
sternal border) 
relievers for Unstable ang...
Aortic Regurg sx - -Head bobbing with pulse 
-wide pulse pressure > 40 
-water hammer pulse 
Aortic regurgitation causes - -HTN 
rheumatic fever 
endocarditis 
marfan syndrome and VAD 
S3 heard sound - fluid overload 
s4 heart sound - artium contract into noncompliant ventricle 
LV failure. 
A sp...
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Add to cartAortic Regurg sx - -Head bobbing with pulse 
-wide pulse pressure > 40 
-water hammer pulse 
Aortic regurgitation causes - -HTN 
rheumatic fever 
endocarditis 
marfan syndrome and VAD 
S3 heard sound - fluid overload 
s4 heart sound - artium contract into noncompliant ventricle 
LV failure. 
A sp...
Which clinical sign might patients with both systolic and diastolic heart failure have in common? 
a) Peripheral edema 
b) Enlarged heart size on chest radiograph 
c) Lung crackles 
d) Ejection fraction less than 40% - Answer: C 
Both a problem with ejection (systolic failure) and a problem with fil...
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Add to cartWhich clinical sign might patients with both systolic and diastolic heart failure have in common? 
a) Peripheral edema 
b) Enlarged heart size on chest radiograph 
c) Lung crackles 
d) Ejection fraction less than 40% - Answer: C 
Both a problem with ejection (systolic failure) and a problem with fil...
Which of the following is considered to be an absolute contraindication for anticoagulation therapy in 
managing a VTE? 
A. Hypertensive patient 
B. Intracranial hemorrhage 
C. Postoperative patient 
D. Presence of epidural catheter - B 
Intracranial hemorrhage is an absolute contraindication to rec...
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Add to cartWhich of the following is considered to be an absolute contraindication for anticoagulation therapy in 
managing a VTE? 
A. Hypertensive patient 
B. Intracranial hemorrhage 
C. Postoperative patient 
D. Presence of epidural catheter - B 
Intracranial hemorrhage is an absolute contraindication to rec...
You have a pt you are admitting that suffered an assault from which an individual used a metal pipe. You 
assess your patient to have ecchymosis to his left flank. You determine that your pt most likely has which 
of the following? 
a) hypocalcemia 
b) a ruptured spleen 
c) hemorrhagic pancreatitis ...
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Add to cartYou have a pt you are admitting that suffered an assault from which an individual used a metal pipe. You 
assess your patient to have ecchymosis to his left flank. You determine that your pt most likely has which 
of the following? 
a) hypocalcemia 
b) a ruptured spleen 
c) hemorrhagic pancreatitis ...
How does COPD result in atrial fibrillation and predisposition to PEs? - COPD causes pulmonary 
hypertension, right ventricular hypertrophy, and right atrial enlargement. The right atrial enlargement 
causes stretching of the atrial tissue and frequently results in atrial dysrhythmias. 
SA blocks, s...
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Add to cartHow does COPD result in atrial fibrillation and predisposition to PEs? - COPD causes pulmonary 
hypertension, right ventricular hypertrophy, and right atrial enlargement. The right atrial enlargement 
causes stretching of the atrial tissue and frequently results in atrial dysrhythmias. 
SA blocks, s...
One hemodynamic benefit of intra-aortic balloon therapy is: 
A) Balloon inflation prevents right to left shunt 
B) Balloon deflation increases coronary artery perfusion 
C) Balloon inflation optimizes aortic valve performance 
D) Balloon deflation decreases left ventricular afterload - D) Balloon de...
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Add to cartOne hemodynamic benefit of intra-aortic balloon therapy is: 
A) Balloon inflation prevents right to left shunt 
B) Balloon deflation increases coronary artery perfusion 
C) Balloon inflation optimizes aortic valve performance 
D) Balloon deflation decreases left ventricular afterload - D) Balloon de...
A patient develops atrial fibrillation after abdominal surgery. Her blood pressure falls from 110/70 mm 
Hg to 92/68 mm Hg. The hypotension is related to which of the following? 
a. Decrease in ventricular contractility 
b. Hypovolemia 
c. Mural thrombi 
d. Decrease in ventricular filling - Correct ...
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Add to cartA patient develops atrial fibrillation after abdominal surgery. Her blood pressure falls from 110/70 mm 
Hg to 92/68 mm Hg. The hypotension is related to which of the following? 
a. Decrease in ventricular contractility 
b. Hypovolemia 
c. Mural thrombi 
d. Decrease in ventricular filling - Correct ...
Heparin: - Heparin inhibits the conversion of prothrombin into thrombin 
Heparin inactivates circulating thrombin 
Heparin inhibits the conversion of fibrinogen into fibrin 
Causes of Right side heart failure? - Acute RV infarct 
Pulmonary Embolism 
Septal defects 
Pulmonary stenosis/regurgitation 
...
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Add to cartHeparin: - Heparin inhibits the conversion of prothrombin into thrombin 
Heparin inactivates circulating thrombin 
Heparin inhibits the conversion of fibrinogen into fibrin 
Causes of Right side heart failure? - Acute RV infarct 
Pulmonary Embolism 
Septal defects 
Pulmonary stenosis/regurgitation 
...
A patient received Humulin NPH insulin at 7 am. He was nauseated and vomiting at lunchtime and 
cannot tolerate PO. If this patient develops manifestations of hypoglycemia, treatment would include: 
A. 
25 ml of 50% dextrose in water (D50W). 
B. 
glucagon subcutaneously. 
C. 
4 oz of apple juice. 
D...
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Add to cartA patient received Humulin NPH insulin at 7 am. He was nauseated and vomiting at lunchtime and 
cannot tolerate PO. If this patient develops manifestations of hypoglycemia, treatment would include: 
A. 
25 ml of 50% dextrose in water (D50W). 
B. 
glucagon subcutaneously. 
C. 
4 oz of apple juice. 
D...
What is the difference between an anaphylactic and anaphylactoid reaction? - Anaphylactoid 
reaction is clinically indistinguishable from anaphylactic reaction but does not require previous exposure 
to the antigen. Anaphylactoid reaction is not IgE mediated, and direct activation and degranulation ...
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Add to cartWhat is the difference between an anaphylactic and anaphylactoid reaction? - Anaphylactoid 
reaction is clinically indistinguishable from anaphylactic reaction but does not require previous exposure 
to the antigen. Anaphylactoid reaction is not IgE mediated, and direct activation and degranulation ...
Pulmonary artery pressure (PAP) - Systolic 15-30 mmHg 
Diastolic 5-15 mmHg 
Stroke volume (SV) - 50-100 ml/beat 
Symptoms of Systolic heart failure - Decreased stroke volume, decreased ejection fraction, S3 and 
enlarged heart 
Physical signs of DIC - Hypotension, Petechia, Purpura, Bruising, Bleedi...
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Add to cartPulmonary artery pressure (PAP) - Systolic 15-30 mmHg 
Diastolic 5-15 mmHg 
Stroke volume (SV) - 50-100 ml/beat 
Symptoms of Systolic heart failure - Decreased stroke volume, decreased ejection fraction, S3 and 
enlarged heart 
Physical signs of DIC - Hypotension, Petechia, Purpura, Bruising, Bleedi...
What is the Z point technique? - is a method used to estimate ventricular end diastolic pressure. It 
is taken just before the closure of the mitral valve and is especially useful when an A wave does not exist 
on the PAOP tracing such as in atrial fib. 
CDC indications for urinary catheter include:...
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Add to cartWhat is the Z point technique? - is a method used to estimate ventricular end diastolic pressure. It 
is taken just before the closure of the mitral valve and is especially useful when an A wave does not exist 
on the PAOP tracing such as in atrial fib. 
CDC indications for urinary catheter include:...
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