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BCEN STUDY GUIDE PART ONE
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BCEN STUDY GUIDE PART ONE
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BCEN STUDY GUIDE PART ONEA 7 y/o suddenly develops ventricular fibrillation. The child weighs 66 lbs
(30 kg). CPR is started immediately. What is the correct defibrillation
dose for the initial shock?
A. 60 joules
B. 30 joules
✅✅-A) 60 joules
C. 120 joules
D. 90 joules -
The child weighs 30 kg. The initial joule dose is 2 joules per kg. The
correct dose would be 60 joules for the initial shock and increasing to 4
joules per kg. This dose can be increased to a maximum of 10 joules per
kg.
A conscious pulseless patient with a continuous-flow left ventricular
assist decide (LVAD) and a history of end-stage heart failure presents to
the ED because of a "low-flow" alarm. The nurse anticipates performing
which intervention first?
A. Obtain a BP using a Doppler and sphygmomanometer
B. Auscultation over the pump to ascertain if the device is working
✅✅
C. Administer IV fluids
D. Begin chest compressions - -A) Obtain a BP using a Doppler
and sphygmomanometer
The "low-flow" alarm may be because of decrease preload from
hypotension, dehydration, on structure of the inflow or outflow cannula,
or disconnection of percutaneous leads. LVAD patients should have a
MAP 70-80. In a conscious patient, determining the patient's BP will help
guide therapy and troubleshooting. The patient's LVAD coordinator also
be contacted as soon as possible.
, WRONG ANSWER RATIONALES:
B) auscultation of the pump is prudent to determine if the pump is
functioning properly. device failure has been reported as the second
most common cause of death in LVAD patients. signs of pump failure
include absence of power light on the controller, undetectable blood
pressure while using the Doppler, and inability to auscultation the motor.
C) IV fluids only indicated if MAP is low
D) compressions no indicated in conscious patient
A patient being evaluated in the ED is noted to have Janeway lesions,
Roth's spots, and Osler's nodes along with elevated body temperature
and elevated WBC. Patient assessment reveals the presence of several
recent body piercings. The ED. It's suspects the patient has:
A. Endocarditis
B. Pericarditis
✅✅-A) Endocarditis
C. Myocarditis
D. Leukemia -
The patient's symptoms are classic for endocarditis. Janeway lesions
are petechial lesions found on the palms of the hands or soles of the
feet. Osler's nodes are defined as painful fingertip lesions, and Roth's
spots are retinal hemorrhages with the presence of whitish spots in the
center. The patient may experience fevers along with an elevated WBC.
Recent body piercings may be a source of infections leading to
endocarditis. The endocarditis infection may also spread to valve
structures in the heart, resulting in permanent valvular dysfunction.
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