NUR 486 Hemodynamic Monitoring Quiz

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Questions and Answers

Which treatment options are considered for elevated potassium levels?

Nitrates

Dialysis (correct)

Calcium gluconate (correct)

Morphine sulfate

What is a critical step to take before suctioning a patient?

Limit suctioning to 5 seconds

Position the patient supine

Administer 100% oxygen (correct)

Increase fluid intake

What are possible symptoms of a myocardial infarction (MI)?

Chest pain radiating to the neck (correct)

Dry cough

Increased appetite

Lower back pain

Which medication is NOT typically used in the management of a myocardial infarction?

Antibiotics Signup and view all the answers

What should be avoided during endotracheal tube (ETT) management?

Suctioning for over 10 seconds Signup and view all the answers

What is the initial treatment for a simple pneumothorax?

Insert a chest tube Signup and view all the answers

Which symptom is commonly associated with rhabdomyolysis following a femur fracture?

Decreased urine output Signup and view all the answers

What is a key component in the management of autonomic dysreflexia?

Identification and removal of the trigger Signup and view all the answers

What average blood loss is expected in a study group following a femur fracture?

1,276 mL Signup and view all the answers

In the Parkland Baxter Formula, how much fluid should be given in the first 8 hours following a burn?

50% of total fluid requirement Signup and view all the answers

Which of the following best describes a tension pneumothorax?

Involves immediate needle decompression followed by chest tube placement Signup and view all the answers

What condition often occurs following prolonged immobilization or compromised circulation?

Compartment syndrome Signup and view all the answers

What physiological change contributes to metabolic acidosis in rhabdomyolysis?

Increased lactic acid levels Signup and view all the answers

What is the formula for calculating Cerebral Perfusion Pressure (CPP)?

CPP = MAP - ICP Signup and view all the answers

Which of the following is a common sedative agent used for intubation?

Ativan (lorazepam) Signup and view all the answers

What is considered greatest control in ventilator settings?

Assist-control ventilation (ACV) Signup and view all the answers

In the context of ABGs, how would you classify metabolic alkalosis?

pH increased, HCO3 increased Signup and view all the answers

Which of the following statements about cerebral vasospasm is true?

It can result from subarachnoid hemorrhage. Signup and view all the answers

What does the Acute Respiratory Acidosis condition reflect in terms of ABG values?

pH < 7.35, PaCO2 > 45 Signup and view all the answers

Which of the following drugs acts as an antidote for benzodiazepine overdose?

Flumazenil (Romazicon) Signup and view all the answers

What is a common effect of hepatic encephalopathy related to rising ammonia levels?

Cerebral edema Signup and view all the answers

Which ventilator mode provides the least control?

Pressure support ventilation (PS) Signup and view all the answers

Which of the following is NOT characteristic of ischemic stroke?

Usually caused by a ruptured blood vessel Signup and view all the answers

Study Notes

Hemodynamic Monitoring

Hemodynamic monitoring is a critical review topic in NUR 486.
Key components of monitoring include CO, CI, SV, SVR, PVR, and SvO2/ScvO2.
Cerebral perfusion pressure (CPP) is crucial for ensuring adequate blood flow to the brain.
CPP is calculated as MAP - ICP.
ICP (intracranial pressure) can be a critical factor in monitoring.
Cerebral vasospasm is a significant concern related to hemodynamic monitoring.
Brain death is a severe outcome associated with hemodynamic monitoring.

Ischemic Stroke vs. Hemorrhagic Stroke

Ischemic strokes and hemorrhagic strokes are separate entities. Understanding their differences is important.
Traumatic brain injury is a separate but related topic, distinct from stroke
Ventilation is a key factor in managing TBI

Ventilator Settings

Positive end-expiratory pressure (PEEP) is a ventilator setting.
Various settings like assist-control ventilation (ACV), synchronized intermittent mandatory ventilation (SIMV), pressure support (PS), and pressure control (PC) are also used.
Continuous positive airway pressure (CPAP) is another ventilator setting type.

Intubation Drugs

Common sedation agents such as benzodiazepines (Ativan, Versed) and propofol (Diprivan) are used.
Flumazenil (Romazicon) is an antidote to benzodiazepines used in this context
Common neuromuscular blocking agents (NMB agents) are also used during intubation.

ABGs (Arterial Blood Gases)

ABGs are important in assessing respiratory and metabolic status.
Key values include pH (7.34-7.45), PaCO2 (35-45), and HCO3 (22-26).
These values indicate normal ranges.
Acid-base imbalances are associated with specific deviations in these ranges.
Acute respiratory acidosis and alkalosis, as well as metabolic acidosis and alkalosis, are examples of possible imbalances, and how ABG data can be used to quickly identify them.

End-Stage COPD, Esophageal Varices, Acute Pancreatitis, Cirrhosis, and Hepatic Encephalopathy

End-stage COPD, esophageal varices, acute pancreatitis, cirrhosis, and hepatic encephalopathy are conditions with specific considerations in patient care.

HHS vs. DKA, Hyperthyroidism, Retroperitoneal Aortic Rupture, and Suctioning

HHS (hyperosmolar hyperglycemic state) and DKA (diabetic ketoacidosis) require different management protocols.
Hyperthyroidism and retroperitoneal aortic rupture are additional conditions that require specialized care, including precise diagnostics.
Suctioning is often used, and guidelines like every 2-4 hours, PRN, pre-oxygenation, max duration of 10 seconds should be followed.

Elevated Potassium Treatment

Treatment for elevated potassium includes calcium gluconate, bicarbonate, insulin, glucose, Kayexalate, and dialysis.

Chronic & Acute Renal Failure and MI (Myocardial Infarction)

Chronic and acute renal failure management varies, and symptoms ranging from no symptoms to sudden cardiac arrest.
Chest pain radiating to other areas, shortness of breath, and feeling unwell are common symptoms.
Delaying history-taking is important if the patient is experiencing significant chest pain and/or distress.

MI (Myocardial Infarction) Diagnostics and Medications

Aspirin, nitrates (SL, IV, topical), morphine sulfate, beta-adrenergic blockers (like propranolol, metoprolol, and atenolol), and calcium channel blockers (like nifedipine) are often used for MI management.

Various Rhythms & Cardiac Cycle

Identifying different cardiac rhythms is a key component of patient assessment. Various types of rhythm abnormalities are possible and the cardiac cycle includes phases like atria contraction and ventricular contraction.

Pneumothorax, Femur Fracture, and Trauma

Pneumothorax (lung collapse) and femur fractures have unique diagnostic and treatment considerations. Additionally, managing trauma using the ABCDEFG approach is essential to assessing and initiating emergency care.

Autonomic Dysreflexia, Spinal Cord Injury, and Trauma

Important conditions requiring specific responses

Bites, Poisoning, Drowning, and Burns

Bites, poisoning, drowning, and burns have different treatment approaches. Understanding initial response is critical.
Fluids and drug therapies, as well as other support systems, are crucial in care in all of these emergencies.

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Description

Explore key concepts in hemodynamic monitoring as outlined in NUR 486. This quiz covers vital parameters such as cardiac output, cerebral perfusion pressure, and the differences between ischemic and hemorrhagic strokes. Understand the importance of monitoring in patient management and the implications of ventilator settings.