AGACNP Board prep Test Study Guide 2024 Graded A

Hypovolemic shock findings of CVP PAOP/PCWP CO/CI SVR Sv02 - CVP- decreased PAOP/PCWP-decreased CO/CI-decreased SVR-increased Sv02-decreased Cardiogenic shock findings of CVP PAOP/PCWP CO/CI SVR Sv02 - CVP- increased PAOP/PCWP- INCREASED (only shock with increased) CO/CI- decreased SVR- increased Sv02- decreased mainstay of initial shock treatment? - volume replacement isotonic IVF Obstructive shock findings of CVP PAOP/PCWP CO/CI SVR Sv02 - CVP- increased PAOP/PCWP- decreased CO/CI-decreased SVR-increased Sv02-decreased Distributive shock findings of CVP PAOP/PCWP CO/CI SVR Sv02 - ALL DECREASED CVP- decreased PAOP/PCWP- decreased CO/CI-decreased SVR-decreased Sv02-decreased Triad of treatment for distributive shock? - #1 epinephrine glucorticoids antihistamine Septic shock findings during HYPERDYNAMIC *warm* shock CVP PAOP/PCWP CO/CI SVR Sv02 - CVP- increased PAOP/PCWP-normal CO/CI-increased SVR-slightly decreased Sv02- increased SEPTIC shock findings of HYPODYNAMIC *cold* shock CVP PAOP/PCWP CO/CI SVR Sv02 - ALL DECREASED CVP- decreased PAOP/PCWP-decreased CO/CI-decreased SVR-decreased Sv02-decreased or increased Normal SVR - 900-1400 dynes/sec/cm5 Normal CI - 2.5-4.2 L/min/m2 Normal PAOP (wedge) pressure - 8-12 mm Hg What shows resuscitation for septic shock? - lactic acid <2 What is the parkland formula? - Fluids for first 24hrs = 4ml x kg x %TBSA 50% over 8hrs 50% over next 16hrs how do you ensure tissue perfusion in burn patient? - maintain urinary output of 0.5ml/kg/hr What is the rule of 9's with burns? - -head and neck 9% -upper limbs 9% each -trunk 36% -genitalia 1% -lower limbs 18% each Patient is NPO due to aspiration risk and presents with need for nutritional support for <6weeks inpatient, what type of tube should you anticipate using? - duodenal tube Patient is NPO and plan for >6weeks of nutritional support (long term) is needed, what type of feeding tube? - enterostomal tube If you cannot use the gut for nutritional support, what is used in <2week nutritional support needed? What is used if >2 week nutritional support is needed? - A. PPN B. TPN Normal WBC? - 5,000-11,000 Normal neutrophils - 56-67% normal eosinophil count? - 1-3% normal lymphocytes - 22-33% Firstline antibiotic for uncomplicated UTI? - sulfamethozazole/trimethoprim (bactrim) 1 tab BID x3 days or Macrobid 100mg BID x5 days Firstline antibiotic for complicated UTI? - Cipro 500mg PO BID or 400mg IV q12hr or Levofloxacin 750mg PO or IV 7-14 days Abx for high risk UTI that is complicated? - -invanz 1g iv daily -zosyn 3.375 iv Q6hr cefepime 2g iv q12hr Normal serum sodium? - 135-145 mEq/L Normal serum osmolality - 275-295 mOsm/kg