practice Qs
nerve agent
Sarin; causes SLUDGEM
what is hospice
a program committed to making the end of life as free from pain, anxiety, and have less than 6 months with death accepted
botulism antitoxin may cause
allergies
what can you give for hypothermia pt if they are less than 88F and v fib
amiodarone, warm IV fluids, sodium bicarb
which cream for minor burns
antimicrobial
what of you give to someone suffering from SLUDGEM or sarin
atropine; drys them up and speeds them up
for heat stoke what do you give for sz and shivering
benzo and thorazine
painful, lactrodectism, ptosis (eyelid drooping)
black widow
RED-WHITE-BLUE-SIGN and loxoscesilism
brown recluse
Beck's triad for ? and what is it
cardiac tamponade JVD, muffled heart sounds, hypotension
first line tx for anthrax
cipro x60 d
zone of no saving zone of maybe salvageable zone of viable
coagulation (no) stasis (maybe) hyperemia (yes)
what temp do you cool to what temp do you stop at initially for heat stroke
cool to 102F but no less than 100.4F initially
snake anti venom
crofab
tularemia from ticks meds
"cycline"
plague meds
"mycin"
body temp of heat exhaustion
102F or 38.8C
what temp bath do we want for frostbite warming intervals
104-108F
which burn do you monitor for hemolysis
3rd full thickness
which burn is the tx graft and which one is not eligible for graft
3rd full thickness gets the graft 4th deep necrosis burn does not get graft; amputation
lethal dose 50
50% chance of dying if older than 65 with 30-35%
what do you keep MAP at for spinal shock
85
mild hypothermia moderate hypothermia severe hypothermia
90-97 82-90 82 or less
core temp for hypothermia
95F or less (35C)
body temp of heat stroke
>104F
what temp do you maintain burn pt
>95F
hematocrit female and male
F 36-48 M 41-50
The registered nurse (RN) is delegating tasks to several members of the healthcare team caring for a client with a bacterial infection and elevated temp. Which of the following would be MOST appropriate to delegate to the licensed practical nurse (LPN)? Select all that apply A. You should administer an antipyretic as prescribed B. You should assess the client's condition C. You should change the bed sheets and dress the client every day D. You should administer prescribed antibiotics to the client twice a day E. You should collect data that can be used in the assessment of client's condition
A,D,E
Which action by the Emergency department nurse is priority for a client with heat stroke? A. Assess the airway and breathing B. Administer diazepam to prevent shivering C. Apply ice packs to the groin, axilla, head, and neck D. Ask the client to state their name and DOB
A. Assess the airway and breathing
Which of the following may be assigned to the unlicensed assistive personnel (UAP) to achieve effective outcomes in the care? A. Assisting a client with knee fracture out of bed to chair B. Ear irrigation of a client with hearing loss C. Assessing urinary output of a patient with kidney stones D. Providing IV medication to a client with anaphylaxis
A. Assisting a client with knee fracture out of bed to chair
A client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority? A. Institute fall and safety precautions B. Evaluate coping skills C. Measure abdominal girth daily D. Test stool specimens for blood
A. Institute fall and safety precautions
Please identify who can perform the following tasks? RN, LPN, or UAP A. Measuring pulse and respiratory rate B. Administer IV antibiotics & IV dextrose C. Help the client dress and assist with oral hygiene D. Empty drainage and ambulate the client
A. all B. RN C. all D. all
Which nursing action is priority in the care of a young child with severe diarrhea? A. Measuring daily urine output B. Maintaining fluid and electrolyte imbalance C. Replacing lost calories with high fiber foods D. Promoting perianal skin integrity
B. Maintaining fluid and electrolyte imbalance
What is the priority intervention for a dependent client with peptic ulcer disease that is vomiting bright red blood? A. Apply oxygen B. Place client in side-lying position C. Prepare to administer PRBCs D. Assess the client's pulse and blood pressure
B. Place client in side-lying position
Which task is classified as low priority when planning client care for the day? A. Obtaining ABG on a client in respiratory distress B. Turning and positioning a client after hip replacement surgery C. Teaching self-administration of insulin to a patient before discharge D. Obtaining post-op vitals on a client returning from surgery
B. Turning and positioning a client after hip replacement surgery everything else is important or "teaching" or "post op"
Which of the following would be the LOWEST priority issue in a group of clients? A. Complaints of chest pain after ambulating in hallway B. Decrease level of consciousness after an automobile accident C. Difficulty achieving set mark on incentive spirometry post surgery D. Respiratory depression after narcotic pain med administration
C. Difficulty achieving set mark on incentive spirometry post surgery
Which action by the nurse would be the priority for a male client with a history of schizophrenia who comes to the emergency department accompanied by his spouse A. Writing a plan of care for the mental health team B. Obtaining a copy of his past medical records C. Observing and evaluating his behavior D. Meeting separately with the wife and exploring the reason for the visit
C. Observing and evaluating his behavior
The registered nurse (RN) is evaluating the statement of a student nurse after teaching about delegation. Which statement indicates a need for correction? A. Delegation is sharing a set of functions B. Delegation ensures quality client care outcomes C. Professional aspects of care can also be delegated D. The final accountability of the task remains with the delegator
C. Professional aspects of care can also be delegated
Which goal would be priority for the child with autism spectrum disorder who has frequent episodes of self-biting and head banging who also needs help with feeding and toileting? A. Controlling repetitive behaviors B. Being able to feed independently C. Remaining safe from self-inflicted injury D. Developing control of urinary elimination
C. Remaining safe from self-inflicted injury
for severe muscle injuries, watch for rahbdo by monitoring
CK and lactic acid (<2 norm)
After reviewing the following lab results, which priority action should the nurse take for a client who is taking meds for bipolar disorder, type 2 DM, and PVD? Labs- INR=2.6, Troponin T=negative, Lithium=2.5 mmol/L, Hgb A1c- 8.2% A. Move the crash cart outside the patient's room B. Assess the client's stool for blood C. Perform a stat finger stick to check the blood sugar level D. Implement seizure precautions immediately
D. Implement seizure precautions immediately
The delegator working in a rural setting has the task of managing care for a group of clients. Which crucial first step would the delegator take to develop a productive strategy in delegating tasks to a delegate? A. Assigning the task to the delegate B. Providing feedback to the delegate C. Supervising the task at regular intervals D. Understanding the capabilities of the delegates
D. Understanding the capabilities of the delegates
which fluid for hypoglycemia
D50
huge sign of massive hemothorax
flattened neck veins
what would you give for delerium
haladol
BP with etoh
hyper
what kind of thermia can the patient get if loss of spinal control?
hyper
BP with benzos
hypo
tension pneumothorax s/s (5)
hypotension, tracheal deviation to fx lung, absent breath sounds, JVD, central cyanosis
v fib as hypothermia pt warming up. when can you shock them?
if they are warmer than 88
lavage for all chemical burns EXCEPT
lye and white phosphorus
painful and can cause metabolic acidosis
mafenide acetate (sulfamylon)
Tylenol OD acid base
metabolic acidodsis
Mafenide acetate (Sulfamylon) acid base
metabolic acidosis
resp distress and ? are signs of flail chest
paradoxical movement
tx for cardiac tamponade which aspirates and which relieves pressure
pericardiocentis- aspirates thoracotomy- relieves pressure
for an abdominal injury, what do you do if CT not available
peritoneal lavage and send it to lab
cardiac tamponade restricts
pumping of the heart
what is palliative care
relieve suffering and improve quality of life for pts with serious illnesses
hematuria is most common sign of which trauma
renal
autografts homo/allo xeno/hetero
self dead ppl pig; coverage only no vascular
for chemical debreidment, its enzymatic and interferes with
silver
does not penetrate eschar and have to monitor for hyponatremia and hypokalemia
silver nitrate
direct to wound for days and may cause pseudo eschar
silver sheets
check for sulfa allergy
silver sulfadiazine (silvadene)
which do you give ice for spider or snake bite
spider; no ice for snake
pt can be organ donor only if
they are on a mech vent or brain dead
what is in banana bag for etoh
thiamine, folic acid, multivitamin