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Certified Emergency Nurse-(CEN) | Questions with 100% Correct Verified Answers

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Certified Emergency Nurse-(CEN) | Questions with 100% Correct Verified Answers

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Certified Emergency Nurse-(CEN) |
Questions with 100% Correct Verified
Answers
Obstructive shock - ANSWER cardiac output and tissue perfusion are inadequate because of
resistance to ventricular filling. Causes pericardial tamponade, tension pneumo, pulmonary
embolism



Obstructive shock interventions - ANSWER correct underlying condition, pericardial tamponade,
pericardiocentesis and subsequent surgical repair, tension pneumo-immediate needle
thoracotomy, PE-thrombolytics


CVP - ANSWER 8-12mm Hg



Geriatric considerations - ANSWER tachycardia during shock may be masked by
medications (beta blockers), prone to dehydration, decreased thirst, avoid fluid overload


CO=SV X HR - ANSWER



SNS sympathetic nervous system - ANSWER heart rate is increased by stimulation of the sns,
which occurs from stress, anxiety, acute pain, release of catecholamines, hypotension and
drugs with positive chronotropic effects.



PNS parasympathetic nervous system - ANSWER heart rate decreases by stimulation of the
pns, which can occur with vagus nerve stimulation, cardiac conduction abnormalities and drugs
with negative chronotropic effects.



Stroke volume - ANSWER amount of blood ejected from each ventricle per contraction,
strength of myocardial contraction

,Preload - ANSWER volume of blood that results in pressure or stretch of the ventricles
during diastole.


Afterload - ANSWER The force or resistance against which the heart pumps.



Cushing's triad - ANSWER three classic signs—bradycardia, hypertension, and bradypnea—
seen with pressure on the medulla as a result of increased intracranial pressure.


Chronotropes - ANSWER Drugs that affect HR, at the SA node


Inotropes - ANSWER Drugs that affect contractility, force of contraction of the heart.


Dromotropes - ANSWER drugs that affect automaticity of the heart at the AV node



Vasodilators - ANSWER ACE Inhibitors -pril, decrease preload and afterload by vasodilation
and diuresis. Monitor for dry cough, angioedema or rash.



Angiotensin Receptor Blockers (ARBs) - ANSWER -sartan, vasodilation and decreased
aldosterone levels increasing excretion of sodium and sparing of potassium, indications
include htn, heart failure



Calcium Channel Blockers - ANSWER -dipine, negative inotropic, chronotropic and
dromotropic effects



Beta-blockers - ANSWER -lol, negative inotropic, chronotropic and dromotropic effects.
cardioselective work on beta 1 (heart) and non cardioselective work on beta1 and 2 (lungs)


Vasodilators - ANSWER Nicardipine, Labetalol, Nesiritide, Nitroglycerin, Nitroprusside

, Vasopressor and Inotropic Medications - ANSWER Epinephrine, Dobutamine, Dopamine,
Milrinone, Norepinephrine, Phenylepyhrine,



Nicardipine - ANSWER calcium channel blocker, coronary, peripheral vasodilator, monitor bp,
hr continually



Labetalol - ANSWER slows hr, decreases pvr, co, bp, moderately decreases preload and
afterload. gradually lower bp to avoid cerebral ischemia/infarct, optic nerve infarction,
angina, myocardial ischemia or infarct.


Nitroglycerin - ANSWER coronary artery dilator, peripheral vasodilator.


Epinephrine - ANSWER increases co, hr, svr, relaxes bronchial smooth muscles.



Dobutamine - ANSWER decreases preload and afterload, increases contractility, sv, co but does
not increase oxygen demand.



dopamine - ANSWER lower doses increase contractility, higher doses additionally
increase vasoconstriction



Norepinephrine - ANSWER tissue necrosis with infiltration, increases co, hr, svr, increases
bp, coronary blood flow.


vasopressin - ANSWER increase svr, causes vasoconstriction, water retention, urine contraction


Adenosine - ANSWER svt, wpw, slows sa node and av node conduction, hr, give rapid iv push



Amiodarone - ANSWER unstable vt, vf, svt, decreases av conduction, prolongs action
potential, refractory period.

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