Certified Emergency Nurse: Accurate Answers To All
Questions
Hypovolemic shock Right Ans - decreased cellular perfusion due to lack of
circulating volume
Cardiogenic shock Right Ans - decreased cellular perfusion secondary to
failure of the central pump
Distributive shock Right Ans - decreased cellular perfusion secondary to
maldistribution of the oxygen to the periphery
Obstructive shock Right Ans - decreased cellular perfusion secondary to
obstruction of blood into or out of the ventricles (pulmonary embolism,
pericardial tamponade, tension pneumothorax)
sympathetic nervous system Right Ans - fight or flight
adrenergic system
s/s: vasoconstriction, glycogenolysis, diaphoresis, increased HR, increased RR,
increased water and sodium reabsorption, bronchodilation
parasympathetic nervous system Right Ans - rest and digest
cholinergic system
s/s: vasodilation, glucogenesis, dry skin, decreased HR, decreased respiratory
rate, bronchoconstriction
beta one receptors Right Ans - -one heart, beta one affects the heart
(contractility, automaticity, heart rate)
beta two receptors Right Ans - -two lungs, beta two mainly affects the lungs
(bronchodilation, respiratory rate)
agonist Right Ans - stimulates a system
antagonist Right Ans - diminishes system response
,hyponatremia Right Ans - (over hydration)
-s/s: symptoms of water retention, swelling, confusion, apathy, sense of
impending doom, muscle cramps
-treatment: water restriction, oral sodium replacement, slow replacement
with hypertonic saline (3-5% saline solution)
-correcting too rapidly can cause central pontine myelinolysis (flaccid
paralysis, dysarthria, dysphagia, hypotension)
hypernatremia Right Ans - (dehydration)
-s/s: altered mental status, fatigue, lethargy, confusion, coma, weakness,
diarrhea
-treatment: correct hypovolemia, treat underlying cause (fever, vomiting,
diabetes insipidus, lower serum sodium levels (slowly replace total body
water deficit)
-sodium and chloride tend to elevate and decrease together
hyperkalemia Right Ans - -s/s:
early: muscular excitability, irritability, nausea, vomiting, diarrhea
late: muscular weakness, fatigue, generalized weakness, distal limb
paresthesia, tetany, respiratory depression, ascending paralysis
cardiovascular: peaked t wave, elongated PR interval, absent p wave,
enlarging QRS complex
treatment:
-stabilize cardiac membrane: calcium chloride or calcium gluconate
-shift potassium into the cells: albuterol, insulin, dextrose
-remove potassium from the cells: hemodialysis, NS and furosemide, ion
exchange resin (kayexalate)
, -common causes: rental failure, cellular death (rhabdomyelosis, tumor lysis
syndrome, crush injury, burns), acidosis
hypokalemia Right Ans - s/s: frequently asymptomatic, weakness,
hyporeflexia, tetany, paralysis to lower extremities, respiratory failure,
prominent U wave on EKG causing a camel hump appearance to the t wave, st
depression
treatment: oral or IV potassium
-hypokalemia and hypomagnesemia often co-exist so correct magnesium with
potassium
hypermagnesemia Right Ans - s/s: neuromuscular depression, decreased
deep tendon reflex, constipation, anorexia, nausea, vomiting, fatigue, diffuse
body aches, bradycardia, hypotension, tall t waves, depressed ST segments
-treatment: reduce serum magnesium (fluids, loop diuretics) reduce ingestion
of magnesium, dialysis
what foods contain magnesium Right Ans - dark leafy greens, nuts, seeds,
fish, beans, whole grains, avocados, yogurt, bananas, dried fruit, dark
chocolate
hypomagnesemia Right Ans - s/s: mild to moderate elevations
(asymptomatic)
-severe elevations cause neuromuscular excitability (muscular cramping,
tetanic contractions, hyperreflexia, perioral or finger paresthesia, positive
chovsteks sign, positive trousseau's sign, seizures, prolonged PR interval,
widened QRS complex
-treatment: mild: oral magnesium supplements
severe: IV magnesium
chvosteks sign Right Ans - twitch in the facial muscles that occurs when
tapping an individuals cheek in front of the ear by the facial nerve
-hypocalcemia
Questions
Hypovolemic shock Right Ans - decreased cellular perfusion due to lack of
circulating volume
Cardiogenic shock Right Ans - decreased cellular perfusion secondary to
failure of the central pump
Distributive shock Right Ans - decreased cellular perfusion secondary to
maldistribution of the oxygen to the periphery
Obstructive shock Right Ans - decreased cellular perfusion secondary to
obstruction of blood into or out of the ventricles (pulmonary embolism,
pericardial tamponade, tension pneumothorax)
sympathetic nervous system Right Ans - fight or flight
adrenergic system
s/s: vasoconstriction, glycogenolysis, diaphoresis, increased HR, increased RR,
increased water and sodium reabsorption, bronchodilation
parasympathetic nervous system Right Ans - rest and digest
cholinergic system
s/s: vasodilation, glucogenesis, dry skin, decreased HR, decreased respiratory
rate, bronchoconstriction
beta one receptors Right Ans - -one heart, beta one affects the heart
(contractility, automaticity, heart rate)
beta two receptors Right Ans - -two lungs, beta two mainly affects the lungs
(bronchodilation, respiratory rate)
agonist Right Ans - stimulates a system
antagonist Right Ans - diminishes system response
,hyponatremia Right Ans - (over hydration)
-s/s: symptoms of water retention, swelling, confusion, apathy, sense of
impending doom, muscle cramps
-treatment: water restriction, oral sodium replacement, slow replacement
with hypertonic saline (3-5% saline solution)
-correcting too rapidly can cause central pontine myelinolysis (flaccid
paralysis, dysarthria, dysphagia, hypotension)
hypernatremia Right Ans - (dehydration)
-s/s: altered mental status, fatigue, lethargy, confusion, coma, weakness,
diarrhea
-treatment: correct hypovolemia, treat underlying cause (fever, vomiting,
diabetes insipidus, lower serum sodium levels (slowly replace total body
water deficit)
-sodium and chloride tend to elevate and decrease together
hyperkalemia Right Ans - -s/s:
early: muscular excitability, irritability, nausea, vomiting, diarrhea
late: muscular weakness, fatigue, generalized weakness, distal limb
paresthesia, tetany, respiratory depression, ascending paralysis
cardiovascular: peaked t wave, elongated PR interval, absent p wave,
enlarging QRS complex
treatment:
-stabilize cardiac membrane: calcium chloride or calcium gluconate
-shift potassium into the cells: albuterol, insulin, dextrose
-remove potassium from the cells: hemodialysis, NS and furosemide, ion
exchange resin (kayexalate)
, -common causes: rental failure, cellular death (rhabdomyelosis, tumor lysis
syndrome, crush injury, burns), acidosis
hypokalemia Right Ans - s/s: frequently asymptomatic, weakness,
hyporeflexia, tetany, paralysis to lower extremities, respiratory failure,
prominent U wave on EKG causing a camel hump appearance to the t wave, st
depression
treatment: oral or IV potassium
-hypokalemia and hypomagnesemia often co-exist so correct magnesium with
potassium
hypermagnesemia Right Ans - s/s: neuromuscular depression, decreased
deep tendon reflex, constipation, anorexia, nausea, vomiting, fatigue, diffuse
body aches, bradycardia, hypotension, tall t waves, depressed ST segments
-treatment: reduce serum magnesium (fluids, loop diuretics) reduce ingestion
of magnesium, dialysis
what foods contain magnesium Right Ans - dark leafy greens, nuts, seeds,
fish, beans, whole grains, avocados, yogurt, bananas, dried fruit, dark
chocolate
hypomagnesemia Right Ans - s/s: mild to moderate elevations
(asymptomatic)
-severe elevations cause neuromuscular excitability (muscular cramping,
tetanic contractions, hyperreflexia, perioral or finger paresthesia, positive
chovsteks sign, positive trousseau's sign, seizures, prolonged PR interval,
widened QRS complex
-treatment: mild: oral magnesium supplements
severe: IV magnesium
chvosteks sign Right Ans - twitch in the facial muscles that occurs when
tapping an individuals cheek in front of the ear by the facial nerve
-hypocalcemia
