CRNA Prep Guide for Exams

Symptoms of diastolic heart failure ️️ Decreased stroke volume, normal ejection fraction, S4, normal heart size DIC labs ️️ Decreased platelets Increased PT/INR Increased aPTT Decreased fibrinogen Increased FSP Increased D-Dimer Kehr's sign ️️ Acute pain in the tip of the shoulder when a person is lying down and the legs are elevated - splenic rupture Tension pneumo ️️ Tracheal deviation and PMI move away from affected side High peak inspiratory pressure (if vented) Hypotension CPP ️️ MAP-ICP. Normal 60-100 mmHg SS of basilar skull fracture ️️ Racoon eyes, battle sign (black and blue across mastoid (behind ear)), otorrhea (CSF from ears: perform halo test), rhinorrhea (csf from nose: check sugar), lose cranial nerve one (cant smell) bolt placement ️️ subarachoid space and dura mater, becomes less and less reliable over time and can be influenced by external things Etomidate dose ️️ 0.2-0.3 mg/kg Etomidate ️️ used for brief periods of sedation for intubation, dose if 0.3mg/kg IVP, peak= I min, duration of action= 4 to 10 minutes Coumadin ️️ Anticoagulant, most commonly given orally, watch INR levels, antidote: Vitamin K Mannitol ️️ 025g/kg given IV blus 24-6 hrs, used to treat ICP, monitor serum osmolality to prevent dehydration and hypernatremia. Heparin gtt ️️ anticoagulant, prevent thrombin, monitor APPT levels Clonidine ️️ Antihypertensive, centrally acting analgesic, stimulate both alpha and beta adrenergic receptors in the brain to decrease sympathetic outflow from the CNS to decrease BP, HR, renal vascular resistance, and PVR, dose: 0.1-0.2mg Coumadin ️️ Anticoagulant, most commonly given orally, watch INR levels, antidote: Vitamin K Esmolol ️️ a short-acting cardioselective adrenergic receptor blocker used for HTN crisis and SVT, adverse reactions include seizures and bronchospasm Epinephrine receptors ️️ alpha 1, alpha 2, beta 1, beta 2