ANCC Adult Gerontology Acute Care
Study online at https://quizlet.com/_82skbv
1. Cardiac Index 2-4
2. SVR/Afterload 800-1200
3. MAP mean CVx80/CO
4. PA pressure 15-30
5. Wedge PCWP 6-12
pressure
6. Hypovolemic Preload CVP decreased, SVR afterload increased, CI decreased, Oxygen delivery
Shock Decreased, Venous Oxygen saturation increased
Parameters
7. Types of hypov- Hemorrhage, burns, pancreatitis
olemic shock
8. Cardiogenic CVP preload increased, SVR afterload increased, CI decreased, oxygen delivery
shock decreased, SV02 decreased
parameters
9. Types of cardio- Post mi, malignant dysrhythmia, acute myocarditis
genic shock
10. Obstructive Preload either, SVR increased, CI decreased, oxygen delivery decreased, SV02
shock decreased
parameters
11. Types of obstruc- Tension pneumo, cardiac tamponade, PE
tive shock
12. Preload CVP decreased, afterload SVR decreased, CI increased, SV02 decreased,
oxygen delivery increased
, ANCC Adult Gerontology Acute Care
Study online at https://quizlet.com/_82skbv
Distributive
shock
parameters
13. Types of distribu- Septic shock, anaphylaxis, neurogenic shock
tive shock
14. CVP Preload 2-8
15. Cardiac Output 4-8
16. MAP 70-90
17. Fractional Excre- Prerenal state of kidney dysfunction (i.e. dehydration)
tion of NA <1%
18. Fractional Excre- ATN (acute tubular necrosis)
tion of NA >2%
19. CPP equation MAP-ICP
20. SIADH Hyposmo- serum sodium low, serum osmo low <280, urine osmo high >100, no dehydration,
lar hyponatrem- tx restrict fluids
ia "inappropriate if neuro symptoms give 3%NS
water retention"
21. DI Hyperosmo- Serum sodium high, serum osmo high >290, urine osmo low <100, urine spec
lar hypernatrem- grave 1.005 (urine is like water), urine sodium >20, dehydration, if serum Na >150
ia dry give D5W to replace ½ volume deficit in 12-24 hours, avoid rapid lowering of Na,
DDAVP for acute situations
22. Serum Osmo 280
23. Urine Osmo 300-800
, ANCC Adult Gerontology Acute Care
Study online at https://quizlet.com/_82skbv
24. Sodium ~140
25. Total cholesterol <200
26. Triglycerides <150
27. HDL >40
28. LDL <100
29. Management of 02, sitting up, morphine 2-4mg, Lasix 40, another Lasix 40 if needed
pulm edema
30. Left heart failure LUNGS, dyspnea at rest, rales, wheezing, generally healthy except acute event, S3,
murmur of mitral regurg
31. Right heart fail- JVD, hepatomegaly, peripheral edema
ure
32. MR ASS Mitral regurg, aortic stenosis, systolic murmurs
33. MS ARD Mitral Stenosis, aortic regurg, diastolic
34. Mitral murmur 5th ICS, apex
locations
35. Aortic murmur 2nd or 3rd ICS, base
locations
36. S1 AV valves closed, SL open
37. S2 SL closed, AV open
38. Cardiac blood SVC,RA, tricuspid, RV, pulmonic valve, pulmonary artery, lungs, pulmonary veins,
flow LA, mitral, LV, Aortic valve, aorta, body
, ANCC Adult Gerontology Acute Care
Study online at https://quizlet.com/_82skbv
39. Cushing's Moon face, buffalo hump, hypertension, HYPERglycemia, HYPERnatremia, HY-
POkalemia, tx depends on cause (stop meds, tumor)
40. Addison's Remember: SEX, SALT, and SUGAR
ADRENOcorti- Deficient cortisol, androgens, and aldosterone, hyperpigmentation in buccal mu-
coid deficiency cosa, tanning, HYPOtension, scant hair, HYPOglycemia, HYPOnatremia, HYPER-
kalemia, cosyntropin is the rule out for addison's, manage: referral, glucorticoid,
hydrocortisone, fludrocortisone inpatient: hydrocortisone and fluids
41. HYPERthy- TSH LOW, T3 High, Grave's Disease, bulgy eyes, weight loss, fine thin hair, smooth
roidism/Grave's skin, a fib
Specialist referral, propranolol, methimazole, PTU, lugol's
42. Thyroid crisis PTU or Methimazole with adjunct within 1 hour Lugol's propranolol, hydrocorti-
sone
No ASA
43. Hypothyroidism (TSH assay most sensitive test) TSH ELEVATED, T4 LOW
hasimototo's most common, LOW AND SLOW, cold intolerance, weight fain, brittle
nails, brady, hypoactive BS, Levothyroxine 50-100mcg
44. Myxedema Coma AIRWAY, fluid replacement PRN, levothyroxine 400mcgIVx1
45. Subacute thy- Treated symptomatically with propanonlol
roiditis
46. Pheocromocy- Labile hypertension, TSH normal, postural hypotension, plama-free
toma metanephrines to rule out, CT to confirm, surgical removal, postop: hypotension,
adrenal insufficiency, hemorrhage
urine catecholamines, alpha blockers phentolamine
47. DKA -intracellular dehydration, kussmaul, hyperglycemia >250, ketonemia, hyper-
kalemia
Study online at https://quizlet.com/_82skbv
1. Cardiac Index 2-4
2. SVR/Afterload 800-1200
3. MAP mean CVx80/CO
4. PA pressure 15-30
5. Wedge PCWP 6-12
pressure
6. Hypovolemic Preload CVP decreased, SVR afterload increased, CI decreased, Oxygen delivery
Shock Decreased, Venous Oxygen saturation increased
Parameters
7. Types of hypov- Hemorrhage, burns, pancreatitis
olemic shock
8. Cardiogenic CVP preload increased, SVR afterload increased, CI decreased, oxygen delivery
shock decreased, SV02 decreased
parameters
9. Types of cardio- Post mi, malignant dysrhythmia, acute myocarditis
genic shock
10. Obstructive Preload either, SVR increased, CI decreased, oxygen delivery decreased, SV02
shock decreased
parameters
11. Types of obstruc- Tension pneumo, cardiac tamponade, PE
tive shock
12. Preload CVP decreased, afterload SVR decreased, CI increased, SV02 decreased,
oxygen delivery increased
, ANCC Adult Gerontology Acute Care
Study online at https://quizlet.com/_82skbv
Distributive
shock
parameters
13. Types of distribu- Septic shock, anaphylaxis, neurogenic shock
tive shock
14. CVP Preload 2-8
15. Cardiac Output 4-8
16. MAP 70-90
17. Fractional Excre- Prerenal state of kidney dysfunction (i.e. dehydration)
tion of NA <1%
18. Fractional Excre- ATN (acute tubular necrosis)
tion of NA >2%
19. CPP equation MAP-ICP
20. SIADH Hyposmo- serum sodium low, serum osmo low <280, urine osmo high >100, no dehydration,
lar hyponatrem- tx restrict fluids
ia "inappropriate if neuro symptoms give 3%NS
water retention"
21. DI Hyperosmo- Serum sodium high, serum osmo high >290, urine osmo low <100, urine spec
lar hypernatrem- grave 1.005 (urine is like water), urine sodium >20, dehydration, if serum Na >150
ia dry give D5W to replace ½ volume deficit in 12-24 hours, avoid rapid lowering of Na,
DDAVP for acute situations
22. Serum Osmo 280
23. Urine Osmo 300-800
, ANCC Adult Gerontology Acute Care
Study online at https://quizlet.com/_82skbv
24. Sodium ~140
25. Total cholesterol <200
26. Triglycerides <150
27. HDL >40
28. LDL <100
29. Management of 02, sitting up, morphine 2-4mg, Lasix 40, another Lasix 40 if needed
pulm edema
30. Left heart failure LUNGS, dyspnea at rest, rales, wheezing, generally healthy except acute event, S3,
murmur of mitral regurg
31. Right heart fail- JVD, hepatomegaly, peripheral edema
ure
32. MR ASS Mitral regurg, aortic stenosis, systolic murmurs
33. MS ARD Mitral Stenosis, aortic regurg, diastolic
34. Mitral murmur 5th ICS, apex
locations
35. Aortic murmur 2nd or 3rd ICS, base
locations
36. S1 AV valves closed, SL open
37. S2 SL closed, AV open
38. Cardiac blood SVC,RA, tricuspid, RV, pulmonic valve, pulmonary artery, lungs, pulmonary veins,
flow LA, mitral, LV, Aortic valve, aorta, body
, ANCC Adult Gerontology Acute Care
Study online at https://quizlet.com/_82skbv
39. Cushing's Moon face, buffalo hump, hypertension, HYPERglycemia, HYPERnatremia, HY-
POkalemia, tx depends on cause (stop meds, tumor)
40. Addison's Remember: SEX, SALT, and SUGAR
ADRENOcorti- Deficient cortisol, androgens, and aldosterone, hyperpigmentation in buccal mu-
coid deficiency cosa, tanning, HYPOtension, scant hair, HYPOglycemia, HYPOnatremia, HYPER-
kalemia, cosyntropin is the rule out for addison's, manage: referral, glucorticoid,
hydrocortisone, fludrocortisone inpatient: hydrocortisone and fluids
41. HYPERthy- TSH LOW, T3 High, Grave's Disease, bulgy eyes, weight loss, fine thin hair, smooth
roidism/Grave's skin, a fib
Specialist referral, propranolol, methimazole, PTU, lugol's
42. Thyroid crisis PTU or Methimazole with adjunct within 1 hour Lugol's propranolol, hydrocorti-
sone
No ASA
43. Hypothyroidism (TSH assay most sensitive test) TSH ELEVATED, T4 LOW
hasimototo's most common, LOW AND SLOW, cold intolerance, weight fain, brittle
nails, brady, hypoactive BS, Levothyroxine 50-100mcg
44. Myxedema Coma AIRWAY, fluid replacement PRN, levothyroxine 400mcgIVx1
45. Subacute thy- Treated symptomatically with propanonlol
roiditis
46. Pheocromocy- Labile hypertension, TSH normal, postural hypotension, plama-free
toma metanephrines to rule out, CT to confirm, surgical removal, postop: hypotension,
adrenal insufficiency, hemorrhage
urine catecholamines, alpha blockers phentolamine
47. DKA -intracellular dehydration, kussmaul, hyperglycemia >250, ketonemia, hyper-
kalemia
