correct well detailed answers|latest
Child with congenital heart issues presents on assessment as - ANSWER sensitive for
overload (monitor fluid status), BP, HR, nutritional education
Digoxin levels - ANSWER 0.8-2, count # of beats for full minute
What does surfactant do? - ANSWER prevents alveoli from collapsing
What are we assessing on a patient with ARDS? - ANSWER CXR, abgs, O2 levels,
airway, mental status
Txs and diagnostics for ARDS - ANSWER proning, O2 therapy, tube feedings, chest xray
5 key elements of the VAP bundle - ANSWER elevate HOB 30-45 degrees
Daily sedation vacations and assessment of readiness to extubate
Peptic ulcer disease prophylaxis
DVT prophylaxis
Daily oral care with chlorhexidine
Pneumothorax - ANSWER presence of air in pleural space that causes the lung to
collapse
Spontaneous pneumothorax - ANSWER no trauma that precipitated it (for example,
ventilation settings too high causing pressure)
1
,Tension pneumothorax - ANSWER trapped air and increased pressure in lungs
Tension pneumothorax
S/S - ANSWER JVD, diminished/absent lung sounds, tracheal deviation towards the
unaffected side, poor BVM compliance, tachy, asymmetrical expansion,
Common reasons for tension pneumothorax - ANSWER rib fracture (closed trauma),
gun shot
Tension pneumothorax management - ANSWER needle decompression, chest tube,
abgs (checking for hypoxia), CXR, O2
Thoracentesis - ANSWER the surgical puncture of the chest wall with a needle to
obtain fluid from the pleural cavity; position in high fowlers
Chest tubes- is gentle/intermittent bubbling normal or not? - ANSWER normal;
Constant bubbling is not normal and is indicative of an air leak
Tidaling - ANSWER the rise and fall of fluid within a closed-chest drainage system with
inhalation and exhalation
Flail chest - ANSWER fracture of two or more adjacent ribs in two or more places that
allows for free movement of the fractured segment
Sxs of flail chest - ANSWER -hypotension, tachypnea, cyanosis, chest pain
- Pain and Respiratory distress
- Paradoxical chest wall movement
- Crepitus
- Respiratory Failure
2
,Causes of ARDS - ANSWER VAP, sepsis, near-drowning, smoke inhalation
Respiratory distress sxs in babies - ANSWER nasal flaring, grunting, retractions, labored
breathing
What do nurses usually do at the beginning and end of shift for pt with chest tube? -
ANSWER mark the drainage at the beginning and end of shift to monitor output of
lung fluids
Hemorrhagic stroke diagnostics - ANSWER non contrast CT, LP, ECG
Hemorrhagic stroke treatment - ANSWER blood pressure management, ICP
monitoring, and management, neurological status, swallow evals, MRI, CT, cerebral
angiography, lumbar puncture (to rule out meningitis)
Hemorrhagic stroke causes - ANSWER -intracerebral hemorrhage
-subarachnoid hemorrhage
-cerebral aneurysm
-arteriovenous malformation
Ischemic stroke treatment - ANSWER tpa if within 3-4.5 hours and no hemorrhage/risk
of it
Reduce risk: aspirin, clopidogrel, BP control, blood sugar and lipids control, treatment of
conditions that inc risk (e.g. A.fib.)
Sign that patient is aspirating when eating - ANSWER coughing
Complications with hemorrhagic stroke? - ANSWER altered mental status/confusion
(due to vasospasms), seizures (do EEG), hydrocephalus, hyponatremia
3
, Collaboration team for stroke - ANSWER OT, PT, nutrition, speech, patient's family
If giving TPA to patient, what do you monitor before administration? - ANSWER BP
(Hypertension increasing bleeding)
Diet for stroke prevention - ANSWER diet low in fat and cholesterol
ARDS acronym - ANSWER A- atelectasis
R- refractory hypoxemia
D- decreased lung compliance
S- surfactant cells are damaged
Direct injury from ARDS - ANSWER smoke inhalation
Aspiration
Prolonged high concentrations of O2
Embolism
Localized infection
Trauma
Indirect injury from ARDS - ANSWER shock
Sepsis
Major surgery
Drug ingestion
Hematological d/o
Metabolic d/o
4
Child with congenital heart issues presents on assessment as - ANSWER sensitive for
overload (monitor fluid status), BP, HR, nutritional education
Digoxin levels - ANSWER 0.8-2, count # of beats for full minute
What does surfactant do? - ANSWER prevents alveoli from collapsing
What are we assessing on a patient with ARDS? - ANSWER CXR, abgs, O2 levels,
airway, mental status
Txs and diagnostics for ARDS - ANSWER proning, O2 therapy, tube feedings, chest xray
5 key elements of the VAP bundle - ANSWER elevate HOB 30-45 degrees
Daily sedation vacations and assessment of readiness to extubate
Peptic ulcer disease prophylaxis
DVT prophylaxis
Daily oral care with chlorhexidine
Pneumothorax - ANSWER presence of air in pleural space that causes the lung to
collapse
Spontaneous pneumothorax - ANSWER no trauma that precipitated it (for example,
ventilation settings too high causing pressure)
1
,Tension pneumothorax - ANSWER trapped air and increased pressure in lungs
Tension pneumothorax
S/S - ANSWER JVD, diminished/absent lung sounds, tracheal deviation towards the
unaffected side, poor BVM compliance, tachy, asymmetrical expansion,
Common reasons for tension pneumothorax - ANSWER rib fracture (closed trauma),
gun shot
Tension pneumothorax management - ANSWER needle decompression, chest tube,
abgs (checking for hypoxia), CXR, O2
Thoracentesis - ANSWER the surgical puncture of the chest wall with a needle to
obtain fluid from the pleural cavity; position in high fowlers
Chest tubes- is gentle/intermittent bubbling normal or not? - ANSWER normal;
Constant bubbling is not normal and is indicative of an air leak
Tidaling - ANSWER the rise and fall of fluid within a closed-chest drainage system with
inhalation and exhalation
Flail chest - ANSWER fracture of two or more adjacent ribs in two or more places that
allows for free movement of the fractured segment
Sxs of flail chest - ANSWER -hypotension, tachypnea, cyanosis, chest pain
- Pain and Respiratory distress
- Paradoxical chest wall movement
- Crepitus
- Respiratory Failure
2
,Causes of ARDS - ANSWER VAP, sepsis, near-drowning, smoke inhalation
Respiratory distress sxs in babies - ANSWER nasal flaring, grunting, retractions, labored
breathing
What do nurses usually do at the beginning and end of shift for pt with chest tube? -
ANSWER mark the drainage at the beginning and end of shift to monitor output of
lung fluids
Hemorrhagic stroke diagnostics - ANSWER non contrast CT, LP, ECG
Hemorrhagic stroke treatment - ANSWER blood pressure management, ICP
monitoring, and management, neurological status, swallow evals, MRI, CT, cerebral
angiography, lumbar puncture (to rule out meningitis)
Hemorrhagic stroke causes - ANSWER -intracerebral hemorrhage
-subarachnoid hemorrhage
-cerebral aneurysm
-arteriovenous malformation
Ischemic stroke treatment - ANSWER tpa if within 3-4.5 hours and no hemorrhage/risk
of it
Reduce risk: aspirin, clopidogrel, BP control, blood sugar and lipids control, treatment of
conditions that inc risk (e.g. A.fib.)
Sign that patient is aspirating when eating - ANSWER coughing
Complications with hemorrhagic stroke? - ANSWER altered mental status/confusion
(due to vasospasms), seizures (do EEG), hydrocephalus, hyponatremia
3
, Collaboration team for stroke - ANSWER OT, PT, nutrition, speech, patient's family
If giving TPA to patient, what do you monitor before administration? - ANSWER BP
(Hypertension increasing bleeding)
Diet for stroke prevention - ANSWER diet low in fat and cholesterol
ARDS acronym - ANSWER A- atelectasis
R- refractory hypoxemia
D- decreased lung compliance
S- surfactant cells are damaged
Direct injury from ARDS - ANSWER smoke inhalation
Aspiration
Prolonged high concentrations of O2
Embolism
Localized infection
Trauma
Indirect injury from ARDS - ANSWER shock
Sepsis
Major surgery
Drug ingestion
Hematological d/o
Metabolic d/o
4
