Rasmussen - MDC III - Final Exam with Answers 75 Qs - 5 SATA, 3 Dose Calc, 2 ABGs

Rasmussen - MDC III - Final Exam with Answers 75 Qs - 5 SATA, 3 Dose Calc, 2 ABGs respiratory alkalosis - ️️ - high pH, low CO2 pH: 7.35-7.45 acidic-basic HCO3: 21-28 acidic-basic CO2: 45-35 acidic-basic metabolic acidosis - ️️ - low pH, low HCO3 pH: 7.35-7.45 acidic-basic HCO3: 21-28 acidic-basic CO2: 45-35 acidic-basic respiratory acidosis - ️️ - low pH, high CO2 pH: 7.35-7.45 acidic-basic HCO3: 21-28 acidic-basic CO2: 45-35 acidic-basic metabolic alkalosis - ️️ - high pH, high HCO3 pH: 7.35-7.45 acidic-basic HCO3: 21-28 acidic-basic CO2: 45-35 acidic-basic ▪ change in condition make take priority over ABCs (ex: post op bleeding is priority over an O2 Sat% of 90%) ▪ pick the patient that is going to die first - ️️ - Priority questions...something to consider CPR, press the code button - ️️ - You walk into your patient's room and they *don't have a pulse*, what are you going to do? bag resuscitation, press the code button - ️️ - You walk into your patient's room and they are *not breathing but have a pulse*, what are you going to do? ▪ unconscious, pulseless ▪ shock them with the AED! - ️️ - If you walk into a room with a patient that is in *ventricular fibrillation (v fib)* ▪ How will they present? ▪ What must we do to get them out of that state? ▪ make them bear down (valsalva maneuver) ▪ make them cough (vagal maneuver) - ️️ - If you walk into a room and a patient is alert and oriented, speaking to you, has a pulse, but their cardiac monitor shows they are in *ventricular tachycardia* ▪ What are you going to do? Supraventricular Tachycardia (SVT) - ️️ - Which cardiac rhythm requires the patient to take *adenosine*? ▪ they may end up with a *blood clot* because the blood is pooling in the atria - ️️ - What is our priority concern for a patient in *atrial fibrillation (a-fib)*? *control RVR for patient:* ▪ give anticoagulants ▪ beta blockers, digoxin, diltiazem ▪ if meds don't work...cardioversion (synchronized shock to re-start the rhythm) ▪ if cardioversion doesn't work...ablation - ️️ - Nursing Interventions: *A-fib RVR* ▪ chest pain ▪ SOB ▪ diaphoresis ▪ N/V ▪ hypertension ▪ tachycardia ▪ jaw pain, anxiety, indigestion (women) ▪ elevated troponin levels ▪ EKG changes - ST elevation - ️️ - If you have a patient who comes into the ED and they are having an MI, what are the signs/symptoms? lab values to confirm this? *Oxygen* - 1st *Nitro* - given sublingual, 3 doses q 5 min (home), drip (hospital), drops BP (vasodilator) *Aspirin* - antiplatelet, stops clotting, 325 mg, chew it *Morphine* - calms the patient down, helps pain - ️️ - Treatment: *Myocardial Infarction* ▪ CPK ▪ troponin ▪ CK-MB ▪ BNP - ️️ - Name the cardiac enzymes angioplasty stent the artery angiogram remove clots cardiac catheterization - ️️ - Procedures: *Myocardial Infarction (MI)* CABG (Coronary Artery Bypass Graft) - ️️ - Procedure: Patient has an MI and extreme plaque build up pericarditis - ️️ - inflammation of the membrane surrounding the heart heart can't expand and contract properly (*cardiac tamponade*) - ️️ - When you have pericarditis what are you at risk for? pleural friction rub - ️️ - What sounds will you hear in a patient with pericarditis? pericardial effusion - ️️ - accumulation of fluid in the pericardial cavity Pericardialcentesis - ️️ - Surgical treatment: *Pericardial Effusion* aneurysm - ️️ - a localized weak spot or balloon-like enlargement of the wall of an artery Abdominal Aortic Aneurysm (AAA) - ️️ - Which is the most common aneurysm? ▪ epigastric pain ▪ pulsating in the abdomen - do not push on it! - ️️ - S/S: *Abdominal Aortic Aneurysm (AAA)* immediately go to the OR for surgery ▪ pain between the scapulas (straight across the back) - ️️ - S/S: *Thoracic Aortic Aneurysm* monior BP periodically and check the size of it no anticoagulants!!! - ️️ - Non-emergent thoracic aortic aneurysm interventions elevated BP 3 times in a six month period - documented by MD - ️️ - How do we diagnose hypertension? ▪ lifestyle modifications (diet, ex