NUR 2755 Multidimensional Care IV MDC 4 Rasmussen Il! Il! Il! Il! Il! Il! Il! Il! Il!
Exam 14 2025/26 Il! Il! Il!
Il!
respiratory alkalosis - high pH, low CO2 Il! Il! Il! Il! Il! Il! Il!
Il!
Il!
pH: 7.35-7.45 acidic-basic HCO3:
Il! Il! Il!
21-28 acidic-basic
Il! Il! Il!
CO2: 45-35 acidic-basic Il! Il! Il!
Il!
metabolic acidosis - low pH, low HCO3 Il! Il! Il! Il! Il! Il! Il!
Il!
pH: 7.35-7.45 acidic-basic HCO3:
Il! Il! Il!
21-28 acidic-basic
Il! Il! Il!
CO2: 45-35 acidic-basic Il! Il! Il!
Il!
respiratory acidosis - low pH, high CO2 Il! Il! Il! Il! Il! Il! Il!
Il!
pH: 7.35-7.45 acidic-basic HCO3:
Il! Il! Il!
21-28 acidic-basic
Il! Il! Il!
CO2: 45-35 acidic-basic Il! Il! Il!
Il!
metabolic alkalosis - high pH, high HCO3 Il! Il! Il! Il! Il! Il! Il!
Il!
pH: 7.35-7.45 acidic-basic HCO3:
Il! Il! Il!
21-28 acidic-basic
Il! Il! Il!
CO2: 45-35 acidic-basic Il! Il! Il!
Il!
▪ change in condition make take priority over ABCs (ex: post op bleeding is priority over an O2
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
Sat% of 90%) Il! Il!
▪ pick the patient that is going to die first - Priority questions...something to consider
Il!
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
CPR, press the code button - You walk into your patient's room and they *don't have a pulse*,
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
what are you going to do?
Il!
Il! Il! Il! Il! Il!
bag resuscitation, press the code button - You walk into your patient's room and they are *not
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
breathing but have a pulse*, what are you going to do?
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Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
▪ unconscious, pulseless
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▪ shock them with the AED! - If you walk into a room with a patient that is in *ventricular
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
fibrillation (v fib)*
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Il!
Il! Il! Il!
▪ How will they present?
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Il! Il! Il! Il!
▪ What must we do to get them out of that state?
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▪ make them bear down (valsalva maneuver)
Il! Il! Il! Il! Il! Il! Il!
▪ make them cough (vagal maneuver) - If you walk into a room and a patient is alert and oriented,
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
speaking to you, has a pulse, but their cardiac monitor shows they are in *ventricular tachycardia*
Il!
Il!
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
▪ What are you going to do?
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Il!
Supraventricular Tachycardia (SVT) - Which cardiac rhythm requires the patient to take Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
*adenosine*?
Il!
▪ they may end up with a *blood clot* because the blood is pooling in the atria - What is our
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
, Il!
priority concern for a patient in *atrial fibrillation (a-fib)*?
Il!
Il! Il! Il! Il! Il! Il! Il! Il!
Il!
*control RVR for patient:* Il! Il! Il!
▪ give anticoagulants
Il!
Il! Il!
▪ beta blockers, digoxin, diltiazem
Il!
Il! Il! Il! Il!
▪ if meds don't work...cardioversion (synchronized shock to re-start the rhythm)
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
▪ if cardioversion doesn't work...ablation - Nursing Interventions: *A-fib RVR*
Il!
Il! Il! Il! Il! Il! Il! Il! Il! Il!
▪ chest pain
Il! Il! Il!
▪ SOB Il! Il!
▪ diaphoresis ▪
Il! Il!
N/V ▪
Il! Il!
hypertension
Il! Il!
▪ tachycardia
Il! Il!
▪ jaw pain, anxiety, indigestion (women)
Il! Il! Il! Il! Il! Il!
▪ elevated troponin levels
Il! Il! Il! Il!
▪ EKG changes - ST elevation - If you have a patient who comes into the ED and they are having
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
an MI, what are the signs/symptoms? lab values to confirm this?
Il!
Il!
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
*Oxygen* - 1st Il! Il! Il!
*Nitro* - given sublingual, 3 doses q 5 min (home), drip (hospital), drops BP (vasodilator)
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
*Aspirin* - antiplatelet, stops clotting, 325 mg, chew it Il! Il! Il! Il! Il! Il! Il! Il! Il!
*Morphine* - calms the patient down, helps pain - Treatment: *Myocardial Infarction* Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
▪ CPK
Il!
Il!
▪ troponin
Il!
Il!
Il!
▪ CK-MB Il!
▪ BNP - Name the cardiac enzymes
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angioplasty stent Il!
the artery
Il! Il!
angiogram
Il!
remove clots
Il! Il! Il!
cardiac catheterization - Procedures: *Myocardial Infarction (MI)*
Il! Il! Il! Il! Il! Il! Il!
CABG (Coronary Artery Bypass Graft) - Procedure: Patient has an MI and extreme plaque build
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
up
Il!
pericarditis - inflammation of the membrane surrounding the heart Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
heart can't expand and contract properly (*cardiac tamponade*) - When you have pericarditis
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
what are you at risk for?
Il!
Il! Il! Il! Il! Il!
pleural friction rub - What sounds will you hear in a patient with pericarditis?
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
pericardial effusion - accumulation of fluid in the pericardial cavity Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
Pericardialcentesis - Surgical treatment: *Pericardial Effusion* Il! Il! Il! Il! Il! Il!
Il!
aneurysm - a localized weak spot or balloon-like enlargement of the wall of an artery
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
Abdominal Aortic Aneurysm (AAA) - Which is the most common aneurysm? Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
Exam 14 2025/26 Il! Il! Il!
Il!
respiratory alkalosis - high pH, low CO2 Il! Il! Il! Il! Il! Il! Il!
Il!
Il!
pH: 7.35-7.45 acidic-basic HCO3:
Il! Il! Il!
21-28 acidic-basic
Il! Il! Il!
CO2: 45-35 acidic-basic Il! Il! Il!
Il!
metabolic acidosis - low pH, low HCO3 Il! Il! Il! Il! Il! Il! Il!
Il!
pH: 7.35-7.45 acidic-basic HCO3:
Il! Il! Il!
21-28 acidic-basic
Il! Il! Il!
CO2: 45-35 acidic-basic Il! Il! Il!
Il!
respiratory acidosis - low pH, high CO2 Il! Il! Il! Il! Il! Il! Il!
Il!
pH: 7.35-7.45 acidic-basic HCO3:
Il! Il! Il!
21-28 acidic-basic
Il! Il! Il!
CO2: 45-35 acidic-basic Il! Il! Il!
Il!
metabolic alkalosis - high pH, high HCO3 Il! Il! Il! Il! Il! Il! Il!
Il!
pH: 7.35-7.45 acidic-basic HCO3:
Il! Il! Il!
21-28 acidic-basic
Il! Il! Il!
CO2: 45-35 acidic-basic Il! Il! Il!
Il!
▪ change in condition make take priority over ABCs (ex: post op bleeding is priority over an O2
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
Sat% of 90%) Il! Il!
▪ pick the patient that is going to die first - Priority questions...something to consider
Il!
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
CPR, press the code button - You walk into your patient's room and they *don't have a pulse*,
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
what are you going to do?
Il!
Il! Il! Il! Il! Il!
bag resuscitation, press the code button - You walk into your patient's room and they are *not
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
breathing but have a pulse*, what are you going to do?
Il!
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
▪ unconscious, pulseless
Il! Il! Il!
▪ shock them with the AED! - If you walk into a room with a patient that is in *ventricular
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
fibrillation (v fib)*
Il!
Il!
Il! Il! Il!
▪ How will they present?
Il!
Il! Il! Il! Il!
▪ What must we do to get them out of that state?
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
▪ make them bear down (valsalva maneuver)
Il! Il! Il! Il! Il! Il! Il!
▪ make them cough (vagal maneuver) - If you walk into a room and a patient is alert and oriented,
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
speaking to you, has a pulse, but their cardiac monitor shows they are in *ventricular tachycardia*
Il!
Il!
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
▪ What are you going to do?
Il! Il! Il! Il! Il! Il! Il!
Il!
Supraventricular Tachycardia (SVT) - Which cardiac rhythm requires the patient to take Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
*adenosine*?
Il!
▪ they may end up with a *blood clot* because the blood is pooling in the atria - What is our
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
, Il!
priority concern for a patient in *atrial fibrillation (a-fib)*?
Il!
Il! Il! Il! Il! Il! Il! Il! Il!
Il!
*control RVR for patient:* Il! Il! Il!
▪ give anticoagulants
Il!
Il! Il!
▪ beta blockers, digoxin, diltiazem
Il!
Il! Il! Il! Il!
▪ if meds don't work...cardioversion (synchronized shock to re-start the rhythm)
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
▪ if cardioversion doesn't work...ablation - Nursing Interventions: *A-fib RVR*
Il!
Il! Il! Il! Il! Il! Il! Il! Il! Il!
▪ chest pain
Il! Il! Il!
▪ SOB Il! Il!
▪ diaphoresis ▪
Il! Il!
N/V ▪
Il! Il!
hypertension
Il! Il!
▪ tachycardia
Il! Il!
▪ jaw pain, anxiety, indigestion (women)
Il! Il! Il! Il! Il! Il!
▪ elevated troponin levels
Il! Il! Il! Il!
▪ EKG changes - ST elevation - If you have a patient who comes into the ED and they are having
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
an MI, what are the signs/symptoms? lab values to confirm this?
Il!
Il!
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
*Oxygen* - 1st Il! Il! Il!
*Nitro* - given sublingual, 3 doses q 5 min (home), drip (hospital), drops BP (vasodilator)
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
*Aspirin* - antiplatelet, stops clotting, 325 mg, chew it Il! Il! Il! Il! Il! Il! Il! Il! Il!
*Morphine* - calms the patient down, helps pain - Treatment: *Myocardial Infarction* Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
▪ CPK
Il!
Il!
▪ troponin
Il!
Il!
Il!
▪ CK-MB Il!
▪ BNP - Name the cardiac enzymes
Il!
Il! Il! Il! Il! Il! Il!
angioplasty stent Il!
the artery
Il! Il!
angiogram
Il!
remove clots
Il! Il! Il!
cardiac catheterization - Procedures: *Myocardial Infarction (MI)*
Il! Il! Il! Il! Il! Il! Il!
CABG (Coronary Artery Bypass Graft) - Procedure: Patient has an MI and extreme plaque build
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
up
Il!
pericarditis - inflammation of the membrane surrounding the heart Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
heart can't expand and contract properly (*cardiac tamponade*) - When you have pericarditis
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
what are you at risk for?
Il!
Il! Il! Il! Il! Il!
pleural friction rub - What sounds will you hear in a patient with pericarditis?
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
pericardial effusion - accumulation of fluid in the pericardial cavity Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
Pericardialcentesis - Surgical treatment: *Pericardial Effusion* Il! Il! Il! Il! Il! Il!
Il!
aneurysm - a localized weak spot or balloon-like enlargement of the wall of an artery
Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
Abdominal Aortic Aneurysm (AAA) - Which is the most common aneurysm? Il! Il! Il! Il! Il! Il! Il! Il! Il! Il! Il!
Il!
