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PCCN 2024 EXAM | CORRECTLY ANSWERED AND RATED A+
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PCCN 2024 EXAM | CORRECTLY ANSWERED AND RATED A+ PCCN 2024 EXAM | CORRECTLY ANSWERED AND RATED A+ PCCN 2024 EXAM | CORRECTLY ANSWERED AND RATED A+
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PCCN 2024 EXAM | CORRECTLYANSWERED AND RATED A+
What type of WBC "starts the war" or triggers an immune
response? - Correct Answer - monocytes
What is a shift to the left with neutrophils? - Correct Answer - an
increase in immature neutrophils (bands). If bands > 10% start
thinking infection or inflammation
What do basophils become when they leave the vessels and
enter tissues for response? - Correct Answer - mast cells
What are common stress responses? - Correct Answer - pe,
pneumonia, gi bleed
Normal platelet count - Correct Answer - 150,000-400,000
What is reversal agent for heparin? - Correct Answer - protamine
sulfate
What is reversal agent for coumadin? - Correct Answer - vitamin
k or ffp
,What are causes of dic? - Correct Answer - sepsis, blood or
immuno disease, if greater than 4 units prbcs received in 24
hours, solid organ transplant, trauma
What is dic? - Correct Answer - unpredictable clotting, some
progress to bleeding bc used up all of clotting factors, always
secondary diagnosis to something else
What are s/s of dic? - Correct Answer - dusky fingers/toes
(clotting in capillaries), bleeding (gums, oozing of iv sites),
unexplained petechiae/bruising
Lab changes in dic - Correct Answer - -decreased platelets <
100,000
-increased coags (ptt, inr, pt)
-decreased fibrinogen levels (protein precursor to fibrin which is
essential to make the clot)
-increased fsps (things that make the clot)
-increased d dimer
How to treat dic - Correct Answer - treat clotting phase with
heparin
Treat bleeding phase with cyroprecipitate - blood product of
choice for hemorrhage related to dic - gives pt back clotting
factors and fibrinogen
,What is hit? - Correct Answer - heparin induced
thrombocytopenia. Platelets decrease 5-14 days after receiving
heparin. More likely to be caused by low molecular weight heparin
(sq). See unpredictable clotting, more common in venous.
What is hit treatment? - Correct Answer - stop all heparin!
Including heparin flushes. Stop coumadin! Don't want to give
platelets because it will cause more clotting.
What is most common reason patients reject an organ/blood? -
Correct Answer - they develop antibodies
What are s/s of hypoglycemia? - Correct Answer - pale, sweaty,
cool/clammy, shaky, confusion, vision changes (blurred or seeing
spots)
What do cells start to break down when they dont have glucose
for energy? What does this produce? - Correct Answer - proteins
and fats, ketones
What is dka? - Correct Answer - more commonly in type one
diabetics who produce little to no insulin. As glucose in blood
increases, it causes osmotic diuresis and patient excretes large
volumes of urine. Patient may become hypovolemic. Patient will
develop ketoacidosis and lactic acidosis.
What s/s of dka? - Correct Answer - blood sugar 250-800
, Sweet, fruity breath
Postural hypotension
Kusmol respirations (deep + labored) to decrease co2 to attempt
to normalize ph
Nausea/vomiting
What are the hallmarks of dka? - Correct Answer - high blood
sugars
Ketones in urine and blood
Acidosis with low bicarb
What is treatment for dka? - Correct Answer - fluid volume
resusitation and insulin drip
What kills dka patient? - Correct Answer - hypokalemia
When can you stop insulin drip with dka? - Correct Answer -
when no more ketones in urine
What is hhs? - Correct Answer - hyperosmolar hyperglycemic
state. More common in type two diabetics. Relative lack of insulin
that leads to increase glucose production
What kills an hhs patient? - Correct Answer - severe dehydration
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