Critical Care BKAT

Initial Measures For TX of Angina - answer-Morphine, oxygen, nitrogen, aspirin Pt. Is depressed in the first few days after having an MI, most appropriate nursing action is: - answer-Encourage the Pt. to ventilate feelings and concerns Pt. Is a couple days post MI and is getting out of bed for the first time and his HR increases from 80's to 90's. The nurse should do what? - answer-Check his VS Major therapeutic goal in the Tx of cardiogenic shock is? - answer-Increase the cardiac output Elevated cardiac enzymes occur in all of the following EXCEPT: - answer-CHF *will occur in trauma, CABG, and pericarditis What is the classic EKG change in a MI: - answer-ST segment elevation After an arterial catheter is removed direst pressure should be applied for how long? - answer-5-10 minutes A CVP reading directly measures pressure where? - answer-Right Atrium You can use an arterial line for all the following except: - answer-Administration of drugs Causes of ST elevation include: - answer-MI, pericarditis, left bundle branch block, left ventricular hypertrophy, hyperkalemia Causes of ST depression Include: - answer-Hypothermia, hypokalemia, tachycardia What is the normal pulmonary capillary wedge pressure? - answer-4-12 mmHg Normal pulmonary artery pressure is? - answer-11-20 Elevated central venous pressure show: - answer-Right sided heart failure Pulmonary capillary wedge pressure shows pressure where? - answer-Left ventricle Monitor is showing the correct pattern for a pulmonary capillary wedge pressure, you can do all of the following except? - answer-Flush the line If the pulmonary capillary wedge pressure is elevated it can be an indication of? - answer-Left ventricular failure The wave in the cardiac cycle that shows atrial depolarization is? - answer-P-Wave P-R interval - answer-0.12-0.20 seconds QRS Complex longer that 0.12 may indicate? - answer-Bundle branch block What is the purpose of enclosing a pacemaker generator in a rubber glove is? - answer-To prevent electrical interference with the pacemaker In which part of the cardiac cycle would a strong ventricular stimulus be dangerous - answer-T-wave What is the initial drug Tx for ventricular tachycardia? - answer-Lidocaine 50-100MG Why is A-Flutter so dangerous? - answer-It can cause the ventricular rate to increase Is the nurse sees V-Fib they should first - answer-Establish unresponsiveness A drug that can be given in complete heart block is? - answer-Atropine A Pt. Has atrial flutter with a ventricular response into the 150's what could be done? - answer-Cardioversion, verapamil or digoxin What is the correct setting to defibrillate? - answer-200-300 joules Signs and symptoms of cardiac tampon are include all except? - answer-Bradycardia You have a patient that has no pulse, apneic and the monitor is showing asystole. What drug is given initially? - answer-Epinephrine To avoid sepsis when dealing with a central venous catheter the most important thing you can do is? - answer-Use aseptic care when dealing with the catheter You get a Pt. back with a chest tube system in place following thoracic surgery. What would be considered an excessive amount of fluid over the next few hours? - answer-150 When setting up to suction a Pt. You should adjust the negative pressure to what? - answer--120 mmHg Chest physical therapy on a post-op Pt. with a chest tube in the left side you listen to the breath sounds and you note they are decreased on the right. What would this indicate? - answer-Atelectasis Chest percussion and postural drainage would be contraindicated in what condition? - answer-Pulmonary hemorrhage Caring for a pt. on a ventilator and you hear a low volume alarm it indicates? - answer-Tube disconnection Assessing endotracheal tube position the most appropriate action a nurse can do is? - answer-Listen bilaterally to breath sounds Your pt. has an endotracheal tube in place and you ask him if he's going ok this morning and he responds in an audible voice "yes". You should? - answer-You should first check the function on the cuff A high pressure alarm in a ventilator can be triggered by all the following except: - answer-Leaky cuff Pt. comes in from a motor vehicle accident with a closed chest trauma and has a deviated trachea. What is the most common reason? - answer-Tension pneumothorax Pt. Is three days post-op with a fractured left femur and suddenly gets SOB. What is most likely the reason? - answer-Fat embolism Pt. Is admitted with sever burns, what is the most important thing to treat? - answer-Fluid replacement One of the most dangerous side effects in rewarding a hypothermia pt. is? - answer-Decrease in cardiac output You have a Pt. that is on a hypothermia blanket. What should you do? - answer-Observe frequently to ensure there is no tissue injury Pt. is admitted with a cervical spine injury. The most important thing is? - answer-Immobilize the head Pt. with a cervical spine injury. What is the most important observation you can do is with which body system? - answer-Respiratory Earliest sign of increase intracranial pressure usually involves changes in? - answer-LOC Increased intracranial pressure is characterized by all except? - answer-Decrease in pulse pressure A drug used to decrease intracranial pressure? - answer-Mannitol Positive babinski reflex is? - answer-Abnormal Caring for a pt in the acute period of a stroke included all except? - answer-Increasing sensory input I'm doing hourly neuro checks, you do all except? - answer-Check urine output Diabetic ketoacidosis signs and symptoms: - answer-Fruity breathe, rapid deep breathing, dry warm skin Impending insulin shock should be suspected when a diabetic patient complains of? - answer-Weakness, diaphoresis and headache In treating a patient with diabetic ketoacidosis in a coma you could do all the following except? - answer-Giving dextrose 50% IV You have a diabetic pt on a regular insulin sliding scale and he is complaining of being nervous and feeling faint. Your nursing action should be all the following except? - answer-Give PRN regular insulin Pt. who is acutely I'll with diabetes will usually need? - answer-A higher dose of insulin Physiologic response to stress