Med Surg 2 Study

mattisensept's version from 2018-04-05 02:45

Section 1

Question Answer
Help with cardiac output beta angergonist, try to increase the cardiac output
In the ICU--> patient that extubated, all over the bed, can't hold a conversation, what is going on?delirium
BURN ICU--> what would be the best thing to do for the patient that has burns to the lower extremities?pain management give the pain IV
Promoted to charge nurse, telemetry floor, one of the CNAs has come to you and wants to have clarification on what they are allowed to take and assess on a patient?they can do tasks, concerned with VS, tell tech to tell you the specifics of what you need to know
In the CCU --> Cardiac cath left femoral artery 2 hours after, pedal pulse is not as strong, what is going on and what do you need to do?assess the temperature and color, look at the site (could be bleeding on the inside), feel a knot (put pressure, get co-worker to call someone, this patient has a hematoma, you have to to occlude the hematoma)
CCU patient w/MI, developed L ventricular failure, what assessment might you find?Lungs will have crackles because of pulmonary edema
BURN patient, has wounds debredimented, priority?assess for S/S of infection
In ER gun shot wound, bleeding, what would be inappropriate?furosemide, you do not want a diuretic, do not want losing anything else
what would indicate right sided heart failure?needing new pair of shoes because the heart cannot pull the blood back to the heart and LE get bigger
BURN unit, admitted 4 hours ago and given fluids, what would be an indication that he has enough30ml/hour
ER, patient comes in that has face and chest wounds form a house fire, do first?listen to the lungs

Section 2

Question Answer
ICU has a right arterial line, checking every hour and now it is cooler? what do you do?Assess for a pulse, no pulse, call for help, most likely... take out arterial line & hold pressure and call MD
what has to be hooked up to the arterial line patient transducer, fluid and pressure bag
Patient with DIC, noticed bleeding around gums and IV site, pink tinged urine, what assessment should you do hourly?check for distention in the belly and see if they are bleeding intra abdominally. tape measures to make the spots and checking every hour
New RN to the unit, mechanically ventilated patient what would tell the charge nurse you do not know what you are doing?you have the HOB at 10
mechanically ventilated patients need...suction turned up, secure bite block using adhesive tape, ask for assistance to turn patient to prone, places the patient every 2 hours on their right left of back w/assistance, nurse preforms oral care every 2 hours, HOB 30
Low RR, low 02, lethargic and hard to arouseanticipate that he will be intubated, then positive pressure ventilator, you want to push the pressure down into the lungs
When is a burn patient no longer @ risk for infectionwhen the wounds are closed
what do you call the stretch of the ventricle @ the end of diastole?pre load
BURN--> firefighter gets smoke inhalation, has hypoxia that developed 48 hours after and has to be intubated, what's going on?He has ARDS
Patient with ARDS, oxygen does not exchange at the alveoli, what is happening?instead of O2 being exchanges in the alveoli, there is not fluid in that space so the patient is not getting the O2 that they need
Patient is intubated, on 02 ventilator, high pressure alarms keep going off, causes?biting tubes, secretions are thick, king in the line d/t moving
what are some things that cause low pressure alarms?disconnect, patient could have dislodges the tube, could be delated, low pressure alarm goes off

Section 3

Question Answer
someone has been struggling to breath, not intubated and sedated, king of sleepy, you'll seedecreased cardiac output
commonly see after intubation?patient has a drop in BP & HR, the heart has gotten lazier, usually give fluids to correct
patient with MI, how do you know they have cardiogenic shock?decreased CO, decreased urinary output, decreased BP, can be tachy or brady
ER, pt. come in and has not been feeling well, low BP, HIGH HR & BG. what is going on?Sepsis, frist intervention is IV access
ICU, patient put on ventilator, becomes restless and seems agitated, what should you do?Assess for 02 levels, first thing to see if they are getting enough oxygen
What do you need to make sure for a BURN patient, so they can get better?Nutrition!
Intubated a patient in the ER, what is the most important thing first?listen to breath sounds, they can get a pneumothorax
PH 7.51 Respiratory alkalosis
what happens when someone has had carbon monoxide poisoning?carboxy hemoglobin

Section 4

Question Answer
Central venous cath, noon assessment, site is red & tender & increased temp Assess, should have another IV, discontinue the other one, call physician, will send tip to lab
BURN patient that has top layer of skin removed and you have blisteringsecond degree
burn is very red, skin intactfirst
skin and tissue missing on burnthird
what kind of fluids do you most likely give to a burn patient?crystalloids
awake but slow, slurred and wet, get clothes off and put blanket warmers on them
Definition for ARDS hypoxia despite increase 02 supplementation
BURN patient is ready to go home, what do you need to make sure is in placeemotional support system
patient is restless and agitated in bed, we check ET TUBE was at 22, now 25listen to breath sounds, possibly call RT
When do they do a trache instread of an endotracheal tube?what its long term or massive trauma to the mouth
Pneumonia, PH--> 7.31, bicarb 26, PA02--> 52put him on 2 L nasal cannula and titrate as needed