PBDS Study Guide QUESTIONS AND ANSWERS 100% CORRECT

Patient is experiencing increase HR, decreased B/P, thirst, tachypnea, decrease urine output, pallor, cool clammy skin, anxiety, agitation, absent bowel sounds, and decrease in SPO2, what is going on with this patient? Correct Answer: Hypovolemic shock What will you do for a patient in hypovolemic shock? Correct Answer: Make sure airway is patent, if they're not breathing begin CPR, Place patient in Trendelenburg to promote blood flow to the brain, administer high flow O2 to increase delivery to tissues, establish IV access with 2 large bore catheters for rapid fluid resuscitation, cardiac monitor to assess cardiac rhythm, control any external bleeding with direct pressure, obtain vitals What orders/meds would you anticipate for a person in hypovolemic shock? Correct Answer: O2, cardiac monitor, administration of fluids or volume expanders, blood administration, blood cultures, lactate, WBC, bladder catheter, labs, CT Meds: if hypotension not corrected by fluid resuscitation, dopamine drip or epinephrine could help to vasoconstrict vessels Patient is experiencing inactive bowel sounds, abdominal pain, distinction of abdomen, nausea, and vomiting, what's going on with this patient? Correct Answer: Post-op Ileus What will you do for a patient with post-op Ileus? Correct Answer: Lay patient flat to prevent pressure on stomach, NPO status to prevent further blockage, hold any meds that could worsen patient condition like opiates, and assess or obtain IV access, ask about passing of flatus, assess abdomen, obtain vitals What orders/meds would you anticipate for a patient with post-op Ileus? Correct Answer: NG tube to decompress stomach and relieve vomiting, IV fluids/supplementation for NPO status, enema or cathartic of some kind, abdominal CT/xray What teaching would you have for patients to prevent post-op Ileus? Correct Answer: Early ambulation Patient is in respiratory alkalosis (paCO2 <35 and pH >7.45), has recent weight gain, edema, and activity limits, what is going on with this patient? Correct Answer: Congestive Heart Failure What will you do for a patient with CHF? Correct Answer: Administer O2 to improve oxygen availability, assess heart and lungs to get a baseline, raise HOB to enable patient to breathe easier, obtain IV access for any fluids or medications that will be ordered, telemetry to monitor heart rhythm, pulse oximetry to assess SpO2 status, obtain vitals What orders/meds would you expect for a patient with CHF? Correct Answer: O2, EKG, chest X-ray, ABGs, cardiac monitor, diuretics, potassium, lab/electrolyte values, BUN and creatinine, BNP, cardiac enzymes, fluid restriction if CHF ad