NUR 445 Final Exam
What medication is used to decrease ICP? – answer Mannitol
-osmotic diuretic
-reduces ICP by inducing diuresis (creates an osmotic gradient across the blood-brain
barrier [BBB] and increased serum osmolality -> pulls fluid out of brain cells and shifts it
into the intravascular compartment)
What medication would you plan on administering to a patient who is experiencing
bradycardia or heart block? – answer Atropine
-administer over 1 minute
-therapeutic effect desired = increased HR
-rapid administration may be used during cardiac resuscitation (follow with 20 mL saline
flush)
A patient suffering from a hypertensive crisis enters the ED. What medication is used to
treat this emergent situation? – answer Nitroprusside
-arteriole vasodilator
-rapidly lowers BP
-decreases preload and afterload
What is clonidine used for? - answerlowering of BP
Nitroprusside is the preferred agent if BP needs to be lowered quickly
What medication prevents the absorption of ammonia from the GI tract in order to treat
hepatic encephalopathy? - answerLactulose
-expect more frequent bowel movements
-should see clearing of confusion, apathy, and irritation and improved mental status (24-
48 hours after oral administration)
Under what condition would you administer tPA? - answerpatient that is suffering from
an ischemic stroke
What is mutual support? - answerassisting others
providing feedback
advocacy behaviors when patient safety is threatened
What is the difference between formal and informal feedback? - answerFormal should
be retrospective and scheduled in advance
, Informal occurs in real time and includes huddles/debriefs
Explain the phenomenon of alarm fatigue - answerFrequency of alarms becomes
overwhelming, resulting in delayed response to alarms and deliberate alarm
deactivation which may impact patient safety
What is the purpose of palliative care? - answernursing and medical treatments are
combined with control of pain and symptoms
What is the CUS method of advocacy? - answerI am concerned
I am uncomfortable
This is a safety issue
What does DESC stand for? - answerDescribe the situation
Express what you think and feel
Suggest a solution
Consequences if no changes
What is the normal rate of the SA node, AV node, and ventricular rate? - answerSA =
60-100
AV = 40-60
Ventricular = 20-40
What is the normal length of a P wave, QRS complex, and QT interval? - answerP =
0.12-0.20 sec
QRS = ≤ 0.12 sec
QT = 0.32-0.40 sec
What nursing care should be provided to a patient with PACs? - answerNothing unless
symptomatic
beta blocker, CCB
What are the causes of asystole? - answerHs & Ts
Hypovolemia, hypoxemia, hypo/hyperkalemia
Tension pneumo, tamponade, thrombosis
What are treatments for asystole? - answerEpi and CPR/ACLS
-Unable to shock because no electrical activity
How do we treat Vtach? - answerdefibrillation and/or amiodarone
How do we treat Torsades de pointes? - answerMagnesium sulfate and amiodarone
What medication is used to decrease ICP? – answer Mannitol
-osmotic diuretic
-reduces ICP by inducing diuresis (creates an osmotic gradient across the blood-brain
barrier [BBB] and increased serum osmolality -> pulls fluid out of brain cells and shifts it
into the intravascular compartment)
What medication would you plan on administering to a patient who is experiencing
bradycardia or heart block? – answer Atropine
-administer over 1 minute
-therapeutic effect desired = increased HR
-rapid administration may be used during cardiac resuscitation (follow with 20 mL saline
flush)
A patient suffering from a hypertensive crisis enters the ED. What medication is used to
treat this emergent situation? – answer Nitroprusside
-arteriole vasodilator
-rapidly lowers BP
-decreases preload and afterload
What is clonidine used for? - answerlowering of BP
Nitroprusside is the preferred agent if BP needs to be lowered quickly
What medication prevents the absorption of ammonia from the GI tract in order to treat
hepatic encephalopathy? - answerLactulose
-expect more frequent bowel movements
-should see clearing of confusion, apathy, and irritation and improved mental status (24-
48 hours after oral administration)
Under what condition would you administer tPA? - answerpatient that is suffering from
an ischemic stroke
What is mutual support? - answerassisting others
providing feedback
advocacy behaviors when patient safety is threatened
What is the difference between formal and informal feedback? - answerFormal should
be retrospective and scheduled in advance
, Informal occurs in real time and includes huddles/debriefs
Explain the phenomenon of alarm fatigue - answerFrequency of alarms becomes
overwhelming, resulting in delayed response to alarms and deliberate alarm
deactivation which may impact patient safety
What is the purpose of palliative care? - answernursing and medical treatments are
combined with control of pain and symptoms
What is the CUS method of advocacy? - answerI am concerned
I am uncomfortable
This is a safety issue
What does DESC stand for? - answerDescribe the situation
Express what you think and feel
Suggest a solution
Consequences if no changes
What is the normal rate of the SA node, AV node, and ventricular rate? - answerSA =
60-100
AV = 40-60
Ventricular = 20-40
What is the normal length of a P wave, QRS complex, and QT interval? - answerP =
0.12-0.20 sec
QRS = ≤ 0.12 sec
QT = 0.32-0.40 sec
What nursing care should be provided to a patient with PACs? - answerNothing unless
symptomatic
beta blocker, CCB
What are the causes of asystole? - answerHs & Ts
Hypovolemia, hypoxemia, hypo/hyperkalemia
Tension pneumo, tamponade, thrombosis
What are treatments for asystole? - answerEpi and CPR/ACLS
-Unable to shock because no electrical activity
How do we treat Vtach? - answerdefibrillation and/or amiodarone
How do we treat Torsades de pointes? - answerMagnesium sulfate and amiodarone
