BKAT 9R ANSWERS AND QUESTIONS SURE A+
✔✔Describe drug adjustments to be made for patients in renal failure - ✔✔Decrease the
dose or increase the during between doses (not cleared as well through the kidneys)
✔✔Renal diet restrictions - ✔✔Restrict Na, K, and protein.
✔✔Normal UOP - ✔✔30 ml/hr
✔✔Complications with acute renal failure - ✔✔Increased K, increased fluid, HTN
✔✔CAUTI prevention - ✔✔Hand washing, aseptic insertion technique, frequent
pericare, no dependent loops, no kinked tubing
✔✔How to verify NG tube placement - ✔✔CXR
✔✔Assess for GI bleed - ✔✔Coffee ground emesis or drainage
✔✔Aspiration precautions - ✔✔HOB > 30, frequent handwashing, assess feeding tube,
assess for residuals, swallow study, ETT cuff at appropriate levels
✔✔GI suction - ✔✔Low intermittent. 120-140 mm Hg.
✔✔Describe digoxin toxicity - ✔✔Confusion, Irregular pulse, Loss of appetite, Nausea,
vomiting, diarrhea, Palpitations, Vision changes (blind spots, blurred vision, changes in
how colors look, or seeing spots), Decreased consciousness, Decreased urine output,
Difficulty breathing when lying down, Excessive nighttime urination
✔✔Heparin reversal agent - ✔✔Protamine
✔✔When to use Amiodarone and dosage - ✔✔For VT with pulse (150 mg) or pulseless
Vfib (300 mg)
✔✔Drug to use for asystole - ✔✔Epinepherine
, ✔✔Drug for bradycardia - ✔✔Atropine
✔✔What to do if a transfusion reaction starts? - ✔✔STOP the blood
✔✔What to do if a patient develops hypovolemic shock? - ✔✔FLUIDS first
(crystalloid/collliod). Keep MAP > 60 mmHg. Then support oxygenation. Vasopressors
are fluid replacement is optimal.
✔✔Treatment of cardiogenic shock - ✔✔Vasodilators & inotrops (nitro, dobutamine,
milrinone) to optimize hemodynamics. Cardizem to stop afib. Remove obstruction.
Surgery/stent/bypass.
✔✔Treatment of septic shock - ✔✔Fluids (crystalloid), antibiotics, follow lactate, get
blood cultures before starting abx. Keep MAP > 65 & CVP 8-12 - can use pressors,
✔✔Best vasopressors for septic shock - ✔✔Neorepinephrine, Epinepherine,
Vasopressin
✔✔What do we see in a patient with shock (or with activation of SNS)? - ✔✔1)
Vasoconsriction, increased HR/SBP, increased RR, dilated coronary arteries d/t Epi &
Norepi
2) Increased ACTH, cortisol, and blood glucose d/t adrenals
3) Na & H2O retention with decreased urinary output d/t RAAS activation
✔✔What to see with lidocaine toxicity in the heart? - ✔✔Ventricular irritability
✔✔Complications of long bone fractures - ✔✔Fat emboli, air emboli (PE)
✔✔Chest trauma complications - ✔✔Pneumothorax
✔✔Initial treatment for burn patients - ✔✔Follow ABCs - secure an airway, intubate
early if there are signs of obstruction, watch for smoke inhalation, then LOTS of fluids
✔✔Nursing concerns with rewarming - ✔✔Watch for hyperkalemia (causing
arrhythmias), hypoglycemia, and hypotension (secondary to vasodilation). Go slow! Do
not allow shivering. Monitor electrolytes & glucose frequently.
✔✔Normal cardiac index (CI) - ✔✔2.5-4.0
✔✔Normal stroke volume (SV) - ✔✔60-100
✔✔Normal stroke volume index (SVI) - ✔✔33-47
✔✔Describe drug adjustments to be made for patients in renal failure - ✔✔Decrease the
dose or increase the during between doses (not cleared as well through the kidneys)
✔✔Renal diet restrictions - ✔✔Restrict Na, K, and protein.
✔✔Normal UOP - ✔✔30 ml/hr
✔✔Complications with acute renal failure - ✔✔Increased K, increased fluid, HTN
✔✔CAUTI prevention - ✔✔Hand washing, aseptic insertion technique, frequent
pericare, no dependent loops, no kinked tubing
✔✔How to verify NG tube placement - ✔✔CXR
✔✔Assess for GI bleed - ✔✔Coffee ground emesis or drainage
✔✔Aspiration precautions - ✔✔HOB > 30, frequent handwashing, assess feeding tube,
assess for residuals, swallow study, ETT cuff at appropriate levels
✔✔GI suction - ✔✔Low intermittent. 120-140 mm Hg.
✔✔Describe digoxin toxicity - ✔✔Confusion, Irregular pulse, Loss of appetite, Nausea,
vomiting, diarrhea, Palpitations, Vision changes (blind spots, blurred vision, changes in
how colors look, or seeing spots), Decreased consciousness, Decreased urine output,
Difficulty breathing when lying down, Excessive nighttime urination
✔✔Heparin reversal agent - ✔✔Protamine
✔✔When to use Amiodarone and dosage - ✔✔For VT with pulse (150 mg) or pulseless
Vfib (300 mg)
✔✔Drug to use for asystole - ✔✔Epinepherine
, ✔✔Drug for bradycardia - ✔✔Atropine
✔✔What to do if a transfusion reaction starts? - ✔✔STOP the blood
✔✔What to do if a patient develops hypovolemic shock? - ✔✔FLUIDS first
(crystalloid/collliod). Keep MAP > 60 mmHg. Then support oxygenation. Vasopressors
are fluid replacement is optimal.
✔✔Treatment of cardiogenic shock - ✔✔Vasodilators & inotrops (nitro, dobutamine,
milrinone) to optimize hemodynamics. Cardizem to stop afib. Remove obstruction.
Surgery/stent/bypass.
✔✔Treatment of septic shock - ✔✔Fluids (crystalloid), antibiotics, follow lactate, get
blood cultures before starting abx. Keep MAP > 65 & CVP 8-12 - can use pressors,
✔✔Best vasopressors for septic shock - ✔✔Neorepinephrine, Epinepherine,
Vasopressin
✔✔What do we see in a patient with shock (or with activation of SNS)? - ✔✔1)
Vasoconsriction, increased HR/SBP, increased RR, dilated coronary arteries d/t Epi &
Norepi
2) Increased ACTH, cortisol, and blood glucose d/t adrenals
3) Na & H2O retention with decreased urinary output d/t RAAS activation
✔✔What to see with lidocaine toxicity in the heart? - ✔✔Ventricular irritability
✔✔Complications of long bone fractures - ✔✔Fat emboli, air emboli (PE)
✔✔Chest trauma complications - ✔✔Pneumothorax
✔✔Initial treatment for burn patients - ✔✔Follow ABCs - secure an airway, intubate
early if there are signs of obstruction, watch for smoke inhalation, then LOTS of fluids
✔✔Nursing concerns with rewarming - ✔✔Watch for hyperkalemia (causing
arrhythmias), hypoglycemia, and hypotension (secondary to vasodilation). Go slow! Do
not allow shivering. Monitor electrolytes & glucose frequently.
✔✔Normal cardiac index (CI) - ✔✔2.5-4.0
✔✔Normal stroke volume (SV) - ✔✔60-100
✔✔Normal stroke volume index (SVI) - ✔✔33-47
