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Rasmussen - MDC III - Final Exam Questions And Answers
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respiratory alkalosis - correct answer ✅high pH, low CO pH: 7.35-7.45 acidic-basic HCO3: 21-28 acidic-basic CO2: 45-35 acidic-basic metabolic acidosis - correct answer ✅low pH, low HCO pH: 7.35-7.45 acidic-basic HCO3: 21-28 acidic-basic CO2: 45-35 acidic-basic respiratory acidosis - correct answer ✅low pH, high CO pH: 7.35-7.45 acidic-basic HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic metabolic alkalosis - correct answer ✅high pH, high HCO pH: 7.35-7.45 acidic-basic HCO3: 21-28 acidic-basic CO2: 45-35 acidic-basic ▪ change in condition make take priority over ABCs (ex: post op bleeding is priority over an O2 Sat% of 90%) ▪ pick the patient that is going to die first - correct answer ✅Priority questions...something to consider CPR, press the code button - correct answer ✅You walk into your patient's room and they don't have a pulse, what are you going to do? bag resuscitation, press the code button - correct answer ✅You walk into your patient's room and they are not breathing but have a pulse, what are you going to do?
▪ they may end up with a blood clot because the blood is pooling in the atria - correct answer ✅What is our priority concern for a patient in atrial fibrillation (a-fib)? control RVR for patient: ▪ give anticoagulants ▪ beta blockers, digoxin, diltiazem ▪ if meds don't work...cardioversion (synchronized shock to re-start the rhythm) ▪ if cardioversion doesn't work...ablation - correct answer ✅Nursing Interventions: A-fib RVR ▪ chest pain ▪ SOB ▪ diaphoresis ▪ N/V ▪ hypertension ▪ tachycardia ▪ jaw pain, anxiety, indigestion (women)
▪ elevated troponin levels ▪ EKG changes - ST elevation - correct answer ✅If you have a patient who comes into the ED and they are having an MI, what are the signs/symptoms? lab values to confirm this? Oxygen - 1st Nitro - given sublingual, 3 doses q 5 min (home), drip (hospital), drops BP (vasodilator) Aspirin - antiplatelet, stops clotting, 325 mg, chew it Morphine - calms the patient down, helps pain - correct answer ✅Treatment: Myocardial Infarction ▪ CPK ▪ troponin ▪ CK-MB ▪ BNP - correct answer ✅Name the cardiac enzymes angioplasty
pericardial effusion - correct answer ✅accumulation of fluid in the pericardial cavity Pericardialcentesis - correct answer ✅Surgical treatment: Pericardial Effusion aneurysm - correct answer ✅a localized weak spot or balloon-like enlargement of the wall of an artery Abdominal Aortic Aneurysm (AAA) - correct answer ✅Which is the most common aneurysm? ▪ epigastric pain ▪ pulsating in the abdomen - do not push on it! - correct answer ✅S/S: Abdominal Aortic Aneurysm (AAA) immediately go to the OR for surgery
▪ pain between the scapulas (straight across the back) - correct answer ✅S/S: Thoracic Aortic Aneurysm monior BP periodically and check the size of it no anticoagulants!!! - correct answer ✅Non-emergent thoracic aortic aneurysm interventions elevated BP 3 times in a six month period - documented by MD - correct answer ✅How do we diagnose hypertension? ▪ lifestyle modifications (diet, exercise) ▪ record values at home - correct answer ✅Patient Education: Hypertension ▪ obesity ▪ drugs ▪ alcohol ▪ age ▪ race (hispanic, african american)
▪ Cholesterol ▪ Smoking ▪ Uncontrolled diabetes ▪ Uncontrolled HTN ▪ Obesity ▪ Diet ▪ Lack of exercise - correct answer ✅Causes of plaque build up arteriosclerosis - correct answer ✅hardening of the arteries, happens with age, normal good cholesterol, want it >60 - correct answer ✅What is HDL? bad cholesterol, want it <150 - correct answer ✅What is LDL?
"sugary cholesterol" - correct answer ✅What are triglycerides? peripheral arterial disease (PAD) - shiny hairless legs peripheral vascular disease (PVD) - correct answer ✅Atherosclerosis and Arteriosclerosis can cause what conditions? ▪ cool hands and feet ▪ bad pedal pulses ▪ leg pain ▪ decreased capillary refill ▪ mottled skin - correct answer ✅S/S: Peripheral Vascular Disease (PVD) lower extremity doppler - correct answer ✅How do you diagnose Peripheral Vascular Disease (PVD)? ▪ anticoagulants
valve regurgitation - correct answer ✅backward flow of blood through a heart valve valve stenosis - correct answer ✅when valves become narrower than normal, impeding the flow of blood. rheumatic fever - correct answer ✅What are some reasons, besides age, patients might end up with mitral stenosis? decreased cardiac output which leads to heart failure - correct answer ✅When we have any damage to our valves, whether it be regurgitation or stenosis, what are we at risk for? ▪ mitral regurgitation: High pitched holosystolic murmur - begins at S1 and continue to S
▪ aortic regurgitation: Blowing, decrescendo diastolic murmur - correct answer ✅Murmur sounds associated with mitral regurgitation vs aortic regurgitation ▪ high pitched holosystolic murmur ▪ JVD ▪ SOB ▪ fatigue ▪ tachycardia - correct answer ✅S/S: Mitral Regurgitation endocarditis - correct answer ✅inflammation of the inner lining of the heart antibiotics - correct answer ✅How do we FIRST treat endocarditis? dental work IV drugs
▪ loop diuretics ▪ potassium sparing diuretics ▪ digoxin ▪ ACE inhibitors ▪ ARBs ▪ calcium channel blockers - correct answer ✅Treatment: Left-Sided Heart Failure ▪ GI effects (anorexia, N/V) ▪ CNS depressant effects (fatigue, weakness, dizziness) ▪ Headache ▪Decreased HR and BP ▪Heart arrhythmia (paradoxical effect) - correct answer ✅Adverse effects of Digoxin ▪ raise the head of the bed ▪ monitor I&O ▪ daily weight
▪ low sodium diet ▪ avoid NSAIDs ▪ fluid restriction ▪ instruct patient to seek help when weight gain > 2 lbs - correct answer ✅Nursing Interventions/Patient Education: Heart Failure ▪ echocardiogram ▪ BNP lab value - correct answer ✅How do we diagnose heart failure? heart transplant - post op our biggest concern is REJECTION - correct answer ✅Treatment: End Stage Heart Failure iron deficiency anemia - correct answer ✅anemia caused by inadequate iron intake, decreased RBC production first: tell them to eat more in their diet! red meat then can try supplements
▪ bleeding gums ▪ bruising ▪ weight loss, decreased appetite - correct answer ✅S/S: Leukemia ▪ chemotherapy ▪ stem cell transplant ▪ bone marrow transplant - correct answer ✅Treatment: Leukemia hemophilia - correct answer ✅A hereditary disease where blood does not coagulate to stop bleeding; S/S: bleeding, bruising, joint pain prolonged aPTT - correct answer ✅How do you diagnose hemophilia? ▪ this condition is life-long ▪ electric razors ▪ soft tooth brushes
▪ don't play sports ▪ bleeding precautions - correct answer ✅Patient Education: Hemophilia sickle cell anemia - correct answer ✅a genetic disorder that causes abnormal hemoglobin, resulting in some red blood cells assuming an abnormal sickle shape pain, they are having infarctions all over their body - correct answer ✅Main symptom of Sickle Cell Anemia ▪ opioids, morphine ▪ IV fluids ▪ transfusions ▪ oxygen ▪ no restrictive clothing ▪ warmth - correct answer ✅Treatment: Sickle Cell Anemia
