CCRN NICOLE KUPCHIK PRACTICE
EXAM 1 NOTES
ST elevation in leads II, III, if is a?
Reciprocal changes will be seen in leads? - ANS -inferior wall MI
I, Val
Initial priority of care for a pt. experiencing sustained tonic clinic seizures? - ANS -
Call for help and safely guide pt. to the floor
A pt. presents with pneumonia and sepsis, received 4 days of ax and fluids,
increasingly SOB, increase in FiO2 requirements, CXR shows bill infiltrates. ABG is
7.20/ 68/102/28. The pt. is developing? - ANS -ARDS = PaO2 </ 300
PaO2/FiO2 = 102/100%(1) = 102
What is a major complication of hen crisis? - ANS -Encephalopathy
What labs should closely be monitored if pt. is given Lisinopril? - ANS -Potassium
by ACE inhibitor - blocks angiotensin II - decreases aldosterone
Pt with acute MI, in cardiogenic shock.
,BP 86/42
HR 110
Cardiac Index 1.7
SVR 1929
What med should be given? - ANS -Dobutamine
by the goal here is to improve contractility and reduce afterload
What should you monitor closely post gastric bypass? - ANS -HR, RR, temp, WBC
and MAP
Best intervention to promote safety of a pt. receiving hemodialysis? - ANS -Direct
visualization of the connection be the machine and the access device
What mode of ventilation is this?
The ventilator is set to deliver 12 breaths/ min at a set volume. The volume of the
remaining 8 breaths varies. - ANS -SIMV - synchronized intermittent mandatory
ventilation
What mode of ventilation is this?
Any additional breathes taken by the pt. are assisted by the ventilator to achieve
the prescribed volume - ANS -CMV - controlled mandatory volume
A 45 yr. old presents w sepsis. You administer 500 boluses of LR. What indicates
that the intervention is having its intended effect? - ANS -ScvO2 - 72%
, A pt. has been receiving VTE prophylaxis with SQ heparin since admission, 6 days
ago. Today, plot count decreased significantly to 43,000 and he was found to have
a new DVT. What was the cause of this? - ANS -HIT - Heparin induced
thrombocytopenia
- drop in plot count
- new DVT
Hemodynamics of R sided heart failure - ANS -Decreased CO/CI
Increased CVP
Decreased/Normal POAP
Increased SVR
Labs to expect w DI - ANS -Increased serum some
Decreased urine some
Increase serum NA
There is a lack of ADH
Hemodynamics of hypovolemic shock - ANS -Decreased CO
Decreased Preload
Increased Afterload
Increased SVR - to increase BP
Increase in HR- to compensate for
EXAM 1 NOTES
ST elevation in leads II, III, if is a?
Reciprocal changes will be seen in leads? - ANS -inferior wall MI
I, Val
Initial priority of care for a pt. experiencing sustained tonic clinic seizures? - ANS -
Call for help and safely guide pt. to the floor
A pt. presents with pneumonia and sepsis, received 4 days of ax and fluids,
increasingly SOB, increase in FiO2 requirements, CXR shows bill infiltrates. ABG is
7.20/ 68/102/28. The pt. is developing? - ANS -ARDS = PaO2 </ 300
PaO2/FiO2 = 102/100%(1) = 102
What is a major complication of hen crisis? - ANS -Encephalopathy
What labs should closely be monitored if pt. is given Lisinopril? - ANS -Potassium
by ACE inhibitor - blocks angiotensin II - decreases aldosterone
Pt with acute MI, in cardiogenic shock.
,BP 86/42
HR 110
Cardiac Index 1.7
SVR 1929
What med should be given? - ANS -Dobutamine
by the goal here is to improve contractility and reduce afterload
What should you monitor closely post gastric bypass? - ANS -HR, RR, temp, WBC
and MAP
Best intervention to promote safety of a pt. receiving hemodialysis? - ANS -Direct
visualization of the connection be the machine and the access device
What mode of ventilation is this?
The ventilator is set to deliver 12 breaths/ min at a set volume. The volume of the
remaining 8 breaths varies. - ANS -SIMV - synchronized intermittent mandatory
ventilation
What mode of ventilation is this?
Any additional breathes taken by the pt. are assisted by the ventilator to achieve
the prescribed volume - ANS -CMV - controlled mandatory volume
A 45 yr. old presents w sepsis. You administer 500 boluses of LR. What indicates
that the intervention is having its intended effect? - ANS -ScvO2 - 72%
, A pt. has been receiving VTE prophylaxis with SQ heparin since admission, 6 days
ago. Today, plot count decreased significantly to 43,000 and he was found to have
a new DVT. What was the cause of this? - ANS -HIT - Heparin induced
thrombocytopenia
- drop in plot count
- new DVT
Hemodynamics of R sided heart failure - ANS -Decreased CO/CI
Increased CVP
Decreased/Normal POAP
Increased SVR
Labs to expect w DI - ANS -Increased serum some
Decreased urine some
Increase serum NA
There is a lack of ADH
Hemodynamics of hypovolemic shock - ANS -Decreased CO
Decreased Preload
Increased Afterload
Increased SVR - to increase BP
Increase in HR- to compensate for
