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COMPLEX FINAL EXAM GUIDE
- Course
- NR341 Complex Care
- Institution
- Chamberlain College Nursing
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1.Burns = Rapid sequence intubation2.Severe burns gave fl. And transferred to burn unit and later develops fever = infection
3.Bone fractures and burns = intubate before throat swells
4.Long bone fracture = fat/air embolism that can lead to PE (keep immobile/straight)
5.Long bone fracture = immobilize break ASAP for fat embolism prevention
6.Electrocuted burn = cardiac dysrhythmias = telemetry
7.Know parkland formula- one question- 4mL x % of body burned x kg. administer half of the
fluids within the first 8 hours, and the second half over the next 16 hours- deduct any fluid given
in the field from the first 8 hours
8.Rule of 9’s
9.Deep full thickness is 4th degree= and full thickness is 3rd degree
10.Skin graft for deep and full thickness burns- nursing care: do not remove dressing unless ordered
(aseptic technique), little to no movement, moisturize skin daily for 6-12 months, protect with
sunscreen, elastic stockings 4-6 months on lower extremities, will be in pain
11.Black tag- dead
12.Mass casualty = to save a larger amount of people is better = 21 yr old with resp. distress
13.Vomiting 2-3 days = Mallory Weiss tear = bleeding
14.Liver disorder with portal hypertension and esophageal varices = hyperglycemia
15.Cirrhosis get ascites- what is priority? Could have respiratory compromise but a distended
abdomen with SOB is worse complication!
16.Cirrhosis needs what labs? AST, ALT, bilirubin, ammonia, H&H, PT, aPTT, coagulation
17.Gut problem = acute pancreatitis = Cullen sign would be bad
18.Hypertensive crisis = IV push= hydralazine, labetalol = IV drip nitroprusside or nicardipine
19.DI neurogenic is ADH deficiency.
20.Nephrogenic when kidneys aren’t responding to the ADH. Ddavp (desmopressin)
21.SIADH = hold fluids
22.SIADH = hyponatremia, give diuretics
23.HHS- fluids and insulin are treatment
24.HHS caused by infection or uncontrolled type 2 diabetes
25.HHS > 600, type 2, caused by stress, 3 Ps (polyuria, polydipsia, polyphagia), electrolyte
imbalance, dehydration, decreased LOC
26.DKA >300, ketones in urine, metabolic acidosis, fruity breath, Kussmaul respirations, 3 P’s,
decreased LOC
27.DKA = give fluids first then get on insulin drip. NPO
1
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a.HHS: no
28.Pt on insulin drip = BG q1h, when BG at 200 give D5, and check potassium levels- educate that
type 1- DKA needs management
29.Addisonian crisis – IV solu-cortef (cortisol)
30.MAP (systolic + 2 x diastolic/3 )-ICP = Cerebral perfusion pressure norms >70 (KNOW normal
ICP which is 5-15)
31.CPP- 60-100
32.ICP = fever is a priority (Tylenol)
33.Lumbar puncture contraindicated if ICP increased
34.Pt with closed head injury = notice increase in BP (widened pulse pressure), irregular breathing
(Cheyne stokes rapid, deep w/ periods of apnea), bradycardia = Cushing’s triad
35.High temp, light sensitivity, headache = meningitis (droplet) = lumbar puncture another word is
Spinal Tap= stiff neck, fever, headache
36.Signs of ICP = decrease LOC, restless, difficult to arouse, vomiting, pupil change, light
sensitivity
37.Stroke pt. made NPO = can be paralyzed on one side = need speech therapist
38.Ischemic stroke – negative ct. Hemorrhagic stroke- positive CT
39.Pt with MI and you see facial droop = CT for bleed = turn off heparin could be bleeding out
40.2-3 questions on delirium and nursing priorities=look at notes on this
a.Quick onset, quiet, reorient, hallucinations, treat causes: dehydration, stress, drugs,
electrolytes
b.Clocks, calendars, reduce stimuli, light levels
41.CVP increase = R heart failure PAOP increase= L sided heart failure
42.Status epilepticus = long continuous seizures = LORAZEPAM, then anticonvulsants
43.ABG = acid base balances = important for analyzing breathing
44.Ventricular tachycardia- check pulse
a.If pulse cardiovert: amiodarone
b.If no pulse: defib
45.Anaphylactic shock- albuterol and epi
46.CVP right- 2-6- need to be in Trendelenburg when putting in
47.PAOP left- 4-12
48.Phlebostatic axis- midaxillary 4th intercostal
49.ART monitoring- allens test for radial
50.High pressure- kink, biting, excess secretions
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