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Study online at https://quizlet.com/_hm0tag
Rapidly lower the diastolic pressure to
100 with IV antihypertensive meds, then
A 56 yr-old male is admitted to the ICU
continue to gradually reduce the diastolic
with a blood pressure of 225/135 and
pressure to 85 with oral antihypertensive
complains of a headache and nausea.
meds.
He reports he ran out of blood pressure
meds three days ago, but also appears
The maximum initial decrease should be
to be confused to the date and situation.
no more than 25% reduction from ini-
What is the most appropriate treatment
tial presenting value. Reducing the blood
approach?
pressure too quickly can lead to cerebral
edema or renal failure.
ScvO2 of 72%
A patient has sepsis, receives Lactated Early goal directed therapy for sepsis
ringers 500ml IV bolus. Which finding in- includes early fluid resuscitation at 30
dicate that this intervention is having it's ml/kg to maintain a CVP of 8-12 or 12-15
intended effect? if mechanically ventilated, MAP greater
than 65, ScvO2 greater than 70%, and
urine output greater than 0.5 kg/hr
72 male patient in ICU for 6 days on the
HIT
ventilator for treatment of a COPD ex-
acerbation. He has been receiving VTE
The hallmark sign of HIT is a signifi-
prophylaxis and subcutaneous Heparin
cant decrease in platelet count over a
since admission. Today his platelet count
24 hours period (>50%) within 5-10 days
decreased significantly to 43,000 and
of administering Heparin. The other hall-
was found to have new DVT on his right
mark sign is a new development of DVT
upper extremity. What do you suspect is
despite being on VTE prophylaxis.
the most likely cause of these findings?
is a complication from a blood transfu-
sion reaction, which causes acute lung
TRALI:
injury typically within 6 hours of a blood
transfusion.
Decrease in platelet count over a 24 hr
period.
2 Hallmark signs of HIT:
New development of DVT despite being
on VTE prophylaxis.
Values in Early compensated Hypov-
olemic shock?
, PASS the CCRN! REAL
Study online at https://quizlet.com/_hm0tag
CO 4.0 L/min, HR 135, SV 65, SVR
1700, MAP 65
In hypovolemic states, circulating volume
is depleted therefore preload and con-
tractility are decreased which leads to
a decrease in SV and CO. HR and SV
increase as compensatory measure to
preserve CO, MAP and cerebral perfu-
sion.
Urine output < 200; urine sodium 30;
BUN: Creatinine ratio 15:1; urine specific
gravity 1.010
Post-renal failure values:
BUN: Creatinine ratio is 15:1, but both
the BUN & creatinine are elevated. Urine
sodium is typically 1-40 mEq/L.
Stop Heparin and administer an alterna-
What to do in the event of HIT:
tive direct thrombin inhibitor.
True - there is also no evidence that
Warfarin is contraindicated in HIT? T/F shows protamine, corticosteroids, and
benadryl are effective treatments for HIT
Patients with right ventricular infarctions
become preload dependent. Meds that Morphine, Nitro, Beta blockers and di-
decrease preload should be avoided - uretics.
which meds are these?
Polymorphic ventricular tachycardia aka
Magnesium
Torsades is treated by?
Atria & right ventricle because of the po-
Myocardial contusions generally impact sition of the heart in the chest.
which parts of the heart? and what would
the values be? PAOP 6, PA Pressure 40/24, RA Pres-
sure 16
CVP: 3, CI: 2.5, SVR: 650, SBP: 88
Neurogenic shock signs?
Neuro shock is associated with a loss of
sympathetic tone causing extensive pe-
, PASS the CCRN! REAL
Study online at https://quizlet.com/_hm0tag
ripheral vasodilation. Clinical signs and
symptoms include hypotension, a low
SVR, low CVP and low normal CI
What causes a larger than normal A Mitral stenosis - causes increased left
wave on a PAOP? atrial pressure during atrial contraction.
Elevated PA pressures but have no im-
Pulmonary HTN will result in what?
pact on PAOP.
Neurologic impairment. One of the risks
of infective endocarditis is the bacterial
Infective Endocarditis can cause what strand breaking in the heart and throwing
kind of impairment? bacterial emboli forward into the lungs
from the right side of the heart or to the
brain/body from the left side of the heart.
Neurologic impairment could be a sign? Embolic ischemic stroke.
Post bariatric surgery should avoid what Extended release meds due to absorp-
kind of meds? tion concerns post-operatively
sulfonylurea drug that is used in DI as
Chlorpropamide is a what? an antidiuretic. It is primarily a glucose
lowering agent. (hypoglycemia)
Will a cardiac transplant patient respond No - pacing is the best instrument for
to atropine? symptomatic bradycardia.
Elevated urine osmolality; decreased SIADH - causes retention of water. Urine
serum osmolality; and decreased serum production is minimal and concentrated
sodium is what symptom? & leads to an increased urine osmolality.
What does Neo drug increase? SVR - Peripheral constriction
Treatment for narrow complex, regular
Administer 6mg adenosine rapidly IVP
rhythm?
6 hours - close monitoring is required to
ensure the blood glucose level does not
Half life of metformin?
climb too quickly while dextrose is being
administered.
Most accurate reflection of daily fluid bal- Record a daily weight at the same time
ance? each day.
Study online at https://quizlet.com/_hm0tag
Rapidly lower the diastolic pressure to
100 with IV antihypertensive meds, then
A 56 yr-old male is admitted to the ICU
continue to gradually reduce the diastolic
with a blood pressure of 225/135 and
pressure to 85 with oral antihypertensive
complains of a headache and nausea.
meds.
He reports he ran out of blood pressure
meds three days ago, but also appears
The maximum initial decrease should be
to be confused to the date and situation.
no more than 25% reduction from ini-
What is the most appropriate treatment
tial presenting value. Reducing the blood
approach?
pressure too quickly can lead to cerebral
edema or renal failure.
ScvO2 of 72%
A patient has sepsis, receives Lactated Early goal directed therapy for sepsis
ringers 500ml IV bolus. Which finding in- includes early fluid resuscitation at 30
dicate that this intervention is having it's ml/kg to maintain a CVP of 8-12 or 12-15
intended effect? if mechanically ventilated, MAP greater
than 65, ScvO2 greater than 70%, and
urine output greater than 0.5 kg/hr
72 male patient in ICU for 6 days on the
HIT
ventilator for treatment of a COPD ex-
acerbation. He has been receiving VTE
The hallmark sign of HIT is a signifi-
prophylaxis and subcutaneous Heparin
cant decrease in platelet count over a
since admission. Today his platelet count
24 hours period (>50%) within 5-10 days
decreased significantly to 43,000 and
of administering Heparin. The other hall-
was found to have new DVT on his right
mark sign is a new development of DVT
upper extremity. What do you suspect is
despite being on VTE prophylaxis.
the most likely cause of these findings?
is a complication from a blood transfu-
sion reaction, which causes acute lung
TRALI:
injury typically within 6 hours of a blood
transfusion.
Decrease in platelet count over a 24 hr
period.
2 Hallmark signs of HIT:
New development of DVT despite being
on VTE prophylaxis.
Values in Early compensated Hypov-
olemic shock?
, PASS the CCRN! REAL
Study online at https://quizlet.com/_hm0tag
CO 4.0 L/min, HR 135, SV 65, SVR
1700, MAP 65
In hypovolemic states, circulating volume
is depleted therefore preload and con-
tractility are decreased which leads to
a decrease in SV and CO. HR and SV
increase as compensatory measure to
preserve CO, MAP and cerebral perfu-
sion.
Urine output < 200; urine sodium 30;
BUN: Creatinine ratio 15:1; urine specific
gravity 1.010
Post-renal failure values:
BUN: Creatinine ratio is 15:1, but both
the BUN & creatinine are elevated. Urine
sodium is typically 1-40 mEq/L.
Stop Heparin and administer an alterna-
What to do in the event of HIT:
tive direct thrombin inhibitor.
True - there is also no evidence that
Warfarin is contraindicated in HIT? T/F shows protamine, corticosteroids, and
benadryl are effective treatments for HIT
Patients with right ventricular infarctions
become preload dependent. Meds that Morphine, Nitro, Beta blockers and di-
decrease preload should be avoided - uretics.
which meds are these?
Polymorphic ventricular tachycardia aka
Magnesium
Torsades is treated by?
Atria & right ventricle because of the po-
Myocardial contusions generally impact sition of the heart in the chest.
which parts of the heart? and what would
the values be? PAOP 6, PA Pressure 40/24, RA Pres-
sure 16
CVP: 3, CI: 2.5, SVR: 650, SBP: 88
Neurogenic shock signs?
Neuro shock is associated with a loss of
sympathetic tone causing extensive pe-
, PASS the CCRN! REAL
Study online at https://quizlet.com/_hm0tag
ripheral vasodilation. Clinical signs and
symptoms include hypotension, a low
SVR, low CVP and low normal CI
What causes a larger than normal A Mitral stenosis - causes increased left
wave on a PAOP? atrial pressure during atrial contraction.
Elevated PA pressures but have no im-
Pulmonary HTN will result in what?
pact on PAOP.
Neurologic impairment. One of the risks
of infective endocarditis is the bacterial
Infective Endocarditis can cause what strand breaking in the heart and throwing
kind of impairment? bacterial emboli forward into the lungs
from the right side of the heart or to the
brain/body from the left side of the heart.
Neurologic impairment could be a sign? Embolic ischemic stroke.
Post bariatric surgery should avoid what Extended release meds due to absorp-
kind of meds? tion concerns post-operatively
sulfonylurea drug that is used in DI as
Chlorpropamide is a what? an antidiuretic. It is primarily a glucose
lowering agent. (hypoglycemia)
Will a cardiac transplant patient respond No - pacing is the best instrument for
to atropine? symptomatic bradycardia.
Elevated urine osmolality; decreased SIADH - causes retention of water. Urine
serum osmolality; and decreased serum production is minimal and concentrated
sodium is what symptom? & leads to an increased urine osmolality.
What does Neo drug increase? SVR - Peripheral constriction
Treatment for narrow complex, regular
Administer 6mg adenosine rapidly IVP
rhythm?
6 hours - close monitoring is required to
ensure the blood glucose level does not
Half life of metformin?
climb too quickly while dextrose is being
administered.
Most accurate reflection of daily fluid bal- Record a daily weight at the same time
ance? each day.
