GP

A reliable tool for measuring tissue perfusion when there is metabolic acidosis and ongoing hemorrhage is:

Base deficit/excess

Which type of sedation is contraindicated for the patient with increased lipids?

Propofol

You are caring for a patient with hypovolemic shock. After insertion of a PA catheter, you have the following information: BP 80/68 mmHg CVP 2 mm Hg PA 20/7 mmHg PCWP 4 mmHg CI=2.1 L/min/m2 PVR 250 dynes/sec/cm5 SVR 1700 dynes/sec/cm-5>Based on the above information, you know the PRIORITY treatment is to:

limit output, increase input

Cardiac Tamponade is defined as:

A serious condition that occurs when extra fluid or blood builds up in the space between the heart and the pericardium (the sac around the heart). The extra fluid causes pressure on the heart, which keeps it from pumping enough blood to the rest the body.

In order to achieve the Triple H therapy (hypervolemic, hypertensive, and hemodilution) used for subarachnoid hemorrhage management, the following usually are required:

IV Fluid and nimodipine

a persistent air leak after chest tube placement may indicate

an esophageal rupture

A hypertensive patient is started on nitroprusside (Nipride), and his O2 sat decreases to 90%. ABG's are drawn and show a PaO2 of 60 mmHg and a 02 sat of 90%. What is the mechanism for this change?

antihypertensives lower the threshold for adverse reactions to nipride caused by cyanide toxicity

Your patient is on a ventilator. The low volume alarm sounds. This may be due to:

biting the tube

Which of the following rhythms is an appropriate indication for transcutaneous cardiac pacing?

bradycardia unresponsive to drug therapy. 3rd degree heart block. Mobitz type II second-degree heart block when haemodynamically unstable or operation planned. overdrive pacing. asystole.

Persistent metabolic acidosis in a trauma patient may indicate

continued bleeding

Whenever there is an increase in the carbon dioxide levels, the pH will:

decrease

An increase in PCO2:

decreases ph and prompts compensation via HCO3 increase

Signs and symptoms of Cardiac Tamponade include distant heart sounds, Decreased B/P, and _____________.

distended neck veins

For a positive outcome in shock resuscitation, all three of these conditions require equal attention and balance:

hemodynamic instability, respiratory failure, clear airway

The signs and symptoms of autonomic dysreflexia include:

hypertension, bradycardia, pallor, and flushing

The two leading cellular components that result in acute tubular necrosis from rhabdomyolysis due to a crush injury are:

myoglobin and potassium

IMMEDIATE treatment for tension pneumothorax would be:

needle decompression above the 3rd rib, mid-clavicular line

A 58 yr old patient was admitted to the trauma service after a motor vehicle crash. Three days after admission, the patient develops deep vein thrombosis, and develops a cough with slight hemoptysis and complains of shortness of breath and sharp pain under his right shoulder blade. A pulmonary embolus is suspected and a ventilation/perfusion scan of the lungs is ordered. The ventilation/perfusion scan of a client with pulmonary embolism who has no other pulmonary disease demonstrates:

reduction in perfusion and ventilation related to the PE location

The abdominal organ MOST susceptible to injury in blunt trauma is the:

spleen

A 32 year old male sustained a crush injury to his left leg. The leg was caught between two pieces of heavy machinery for approximately 3 hours. The management of crush injury is:

stop bleeding, limit movement, PH balancing, albuterol, dialysis vent fluid support

What would you do if you walked into your patient's room and the PA waveform of the pulmonary artery catheter is flat?

troubleshoot the catheter(flush)

In the temporal lobe of the brain which area is responsible for our ability to understand spoken word:

wernickes

Patient has been admitted status post MVC. The patient's urine output has increased from 125 mL to 1,000 mL over the past two hours. Which of the following is the MOST important assessment to make at this time?

Blood Sugar, then cat scan of the head

What is the general acceptable amount of output (mL's of urine) per hour in an adult?

50/hr

When administering Adenosine in an adult patient for treatment of PSVT, how would you administer the medication?

6mg IVP, followed by 12 mg IVP Q2mins

Indications for use of an external cardiac pacemaker include:

transcutaneous pacing should only be applied in situations that include systolic blood pressure less than 90, heart rate less than 40, or if an arrhythmia is compromising organ perfusion. Atrioventricular Nodal dysfunction Bradycardic patients hypothermia Third-degree heart block

A patient with a mandible fracture will likely complain of:

malocclusion and paresthesia of the lower lip and chin

Your patient with a plaster cast on his left leg after sustaining a left femoral fracture 24 hours ago is developing compartment syndrome. His toes are cool, swollen, with faint pulses with Doppler. He c/o's that his leg hurts extremely bad, the "worse pain" he has felt since breaking it. You gave him the max dose of Morphine 8 mg IV about 30 minutes ago without any relief. What action would you take?

Elevate the leg to promote venous drainage

The Cardiovascular consequences of Neurogenic shock include:

Hypotension, Bradycardia, and hypothermia

The MOST accurate definition of the shock state is:

Inadequate perfusion to meet end organ oxygenation requirements

When a patient presents with an inferior wall MI, what other area of the heart is also at risk for a MI?

LVentricle

Ventricular tachycardia is MOST often caused by:

Myocardial Ischemia

A client had a right-sided craniotomy due to a subdural hematoma. What neurological findings are consistent with this injury?

Signs of ICP, Brain Damage, Loss of consiousness, aphasia, ataxia, tinnitus, weakness

Trauma Triad of death

hypothermia, acidosis, coagulopathy

The cardiovascular changes associated with normal pregnancy are:

Increased HR and Blood Volume, Decreased SVR

Since your patient is taking nitroglycerin with Verapamil, the nurse should observe for:

orthostatic hypotension

Effective neuromuscular blockade is achieved when:

2/4

For a 135 pound woman to be log rolled due to cervical precautions, how many trained individuals need to be present?

4

Due to normal changes of pregnancy, the pregnant woman has

Estrogen mediates this rise in cardiac output by increasing the pre-load and stroke volume, mainly via a higher overall blood volume (which increases by 40-50%) The heart rate increases, but generally not above 100 beats/ minute. Total systematic vascular resistance decreases by 20% secondary to the vasodilatory effect of progesterone. functional residual capacity decreases by 10-25%, expiratory reserve volume 15-20%, and residual volume decreased by 20-25%, and the total lung capacity decrease. In addition, an increase in the respiratory capacity by 5-10%, respiratory rate by 1-2 breaths more than normal, and an increase in the tidal volume 30-50%. We will find an increase in oxygen consumption by 30% and the metabolic rate by 15% in pregnant women, but they still have a lower oxygen reservoir due to the lower rate of functional residual capacity FRC, and are more prone to hypoxic, hyperventilation and dyspnea are common in pregnancy. In addition these changes there is an increase in PaO2 to facilitate the transfer of oxygen from mother to fetus and lower PaCo2 to facilitate the transfers of carbon dioxide from fetus to mother[

what is an early sign of tension pneumothorax?

Respiratory distress

When is ICP monitoring necessary?

TBI, ICH, SAH, Hydrocephalus, Malignant Infarction, cerebral edema, CNS infections, hepatic encephalopathy

When the kidneys increase the excretion of bicarbonate, the pH will:

increase

The MOST common complication of PEEP may be:

pulmonary barotrauma