Peds was fun but we are definately ready to get 7 over with. How is it so far??

Shock it to me!!

1. DIC often results in complications initially associated c which of the following organs?

a. brain

b. kidney

c. lung

d. stomach

2. Which conditions is not caused by DIC?

a. organ tissue damage

b. depletion of circulating clotting factors

c. thrombus formation in the large vessels

d. activation of the clotting dissolving process

3. A 19yo pt admitted c heat stroke begins to show signs of DIC. Which lab finding is most consistent c DIC?

a. low platelet count

b. elevated fibrinogen levels

c. low levels of fibring degradation product

d. reduced PT time

4. Vasopressors may be indicated in which type of shock?
a. neurogenic
b. hypovolemic
c. respiratory
d. metabolic

5. For every unit of blood lost in trauma, how much crystalloid must be infused?
a. twice as much
b. equal amount
c. half as much
d. three times the amount

6. Which drug is a parasympathetic antagonist?
a. lidocaine
b. atropine
c. digoxin
d. dopamine

7. A heat exhaustion patient is suffering from what type of shock?
a. cardiogenic
b. neurogenic
c. hypovolemic
d. metabolic

ARDS and ABGs

1. which intervention would be most likely to prevent ARDS?
a. Teach cigarette smoking cessation
b. Maintaining adequate serum K levels
c. Monitoring pts for signs of hypercapnia
d. Replacing fluids, adequately during hypovolemic states

2. Which ND would be a priority for a pt c ARDS?
a. Ineffective breathing pattern
b. Pain
c. Ineffective health maintenance
d. Risk for infxn

3. Early sign of ARDS in a pt at risk?
a. Elevated CO2 level
b. Hypoxia not responsive to O2
c. Metabolic acidosis
d. Severe, unexplained lyte imbalance

4. pH 7.52, PaO2-50, PaCO2-28, HCO3-24
a. hypoxemia
b. hypoventilation
c. hyperventilation
d. o2 toxicity

5. Same condition as above, which conclusion accurate?
a. Pt severely hypoxic
b. O2 low but poses no risk for pt
c. Pt’s paO2 c/in normal range
d. Pt requires O2 c very low O2

6. same condition, possible cause?
a. COPD
b. DKA c kussmaul’s
c. MI
d. PEmbolus

7. which intervention should the nurse anticipate in a pt c ARDS?
a. Tracheostomy
b. Intermittent positive pressure breathing
c. Mechanical vent
d. Insertion of a chest tube

8. Which condition can put a pt at risk for ARDS?
a. Septic shock
b. COPD
c. Asthma
d. HF

9. which assessment would be most appropriate for determining correct placement of ETT in a mech vent pt?
a. assess skin color
b. monitor RR
c. verify amount of cuff inflation
d. auscultate lung sounds bilaterally

10. which nursing intervention would promote effective airway clearance in a pt c ARD?
a. Administer O2 q 2hrs
b. Turn pt q 4hrs
c. Admin sedatives
d. Sxning if cough ineffective

11. which is a complication associated c mechanical ventilation?
a. GI hemorrhage
b. Immunosuppression
c. Increased CO
d. P Emboli

12. The nurse would anticipate which of the following ABG results in a pt experiencing a prolonged, severe asthma attack?
a. low PaCO2, high PaO2, low pH
b. High paco2, low pao2, low pH
c. High paco2, high pao2, high pH
d. Low paco2, low pao2, high pH

13. A pt’s ABG values are as follows:
pH 7.31, paO2-80, PaCO2-65, HCO3-36
Which s/sx would the nurse expect?
a. cyanosis
b. flushed skin
c. irritability
d. anxiety

Answers in the comments section.

Brush up on Acid-Base imbalance

Acid - Base Quiz

Memorial for one of our own

One of our fellow SJDC nursing students passed away on September 5th in a motor vehicle accident. Melissa was a nursing 4 student from Tracy. Her obituary is below. Donations can be made to Tracy federal credit union, acct #22363.

Melissa Granados
05/23/1981 — 09/05/2008
Services will be Friday for lifelong Tracy resident Melissa Granados, 27, who died Sept. 5 in a car accident that also led to the death of her 5-year-old son, Ayden Weaver. Ms. Granados was born in Tracy and lived here her entire life. She was a nursing student at San Joaquin Delta College and had received a scholarship to study nursing from the National Trucking Association’s San Joaquin County chapter. She was also involved in breast cancer awareness activities, in remembrance of her mother, Darlene, who died of the disease in 2002. Ms. Granados was also an avid San Francisco Giants and 49ers fan and enjoyed playing basketball and soccer. Ms. Granados is survived by her father, Donald Granados, of Tracy; sisters, Tricia Rittger and Staci Granados, both of Los Osos; and many aunts, uncles, nieces and nephews. She was preceded in death by her mother, Darlene Granados; and grandmother, Connie Basruto. Friday’s services, which will include a service for Ayden, will begin at 1 p.m. at Fry Memorial Chapel, 550 S. Central Ave. Burial will be private. Donations in Ms. Granados’ name may be sent to the Ayden Weaver and Melissa Granados Memorial Fund, Tracy Federal Credit Union, account No. 22363.
Published on 09/10/2008

Heart Dz Quiz

1. Which condition most commonly results in CAD?

a. atherosclerosis

b. DM

c. MI
d. Renal failure

2. Atherosclerosis impedes coronary artery blood flow by:

a. plaques obstruct vein

b. plaques obstruct artery

c. Blood clots form outside vessel wall

d. Hardened vessels dilate to allow blood to flow thru.

3. Which serum cholesterol level increases risk of CAD?

a. 100mg/dl

b. 150

c. 175

d. 200

4. which is done first for a pt exhibiting s/sx of CAD?

a. decrease anxiety

b. enhance myocardial O2ation

c. Admin sublingual NTG

d. Educate pt about sx

5. Landmark for obtaining apical pulse

a. left 5th intercostal space, midaxillary line

b. left 5th intercostal space, midclavicular line

c. left 2nd intercostal space, midclavicular line

d. left 7th intercostal space, midclavicular line

6. which blood test is most indicative of cardiac damage?

a. lactate dehydrogenase

b. CBC

c. Troponin I

d. Creatine kinase

7. Primary reason for administering Morphine to MI pt?

a. sedate

b. decrease chest pain

c. decrease anxiety

d. decrease O2 demand on heart

8. Most commonly responsible for MI?

a. aneurysm

b. HF

c. coronary artery thrombosis

d. renal failure

9. Which Dx tool used to most commonly deterine location of myocardial damage?

a. cardiac cath

b. cardiac enzymes

c. echo

d. ECG

10. First intervention for pt experiencing MI?
a. morphine

b. O2

c. sublingual NTG
d. obtain ECG

11. Most common complication of MI?

a. cardiogenic shock

b. HF

c. arrhythmias

d. pericarditis

12. which sx might a R sided HF pt exhibit?

a. adequate UO

b. polyuria

c. oliguria

d. polydipsia

13. Dyspnea, cough, expectoration, weakness, and edema are classic s/sx of:

a. pericarditis

b. htn

c. MI

d. HF

14. after undergoing cardiac cath, pt has a puddle of blood under his buttocks. which step should you take first?

a. call for help

b. obtain VS

c. Ask the pt to "lift up"

d. apply gloves and assess the groin

15. which type of pain characteristic of angina?

a. knifelike

b. sharp

c. shooting

d. tightness

16. drug of choice for angina pectoris?

a. aspirin

b. lasix

c. NTG

d. nifedipine

17. predominant cause of angina?

a. increased preload

b. decreased afterload

c. coronary arty spasm

d. inadequate O2 supply to the myocardium

18. which dx test used most often to dx angina?

a. CXR

b. echo

c. cardiac cath

d. 12 lead EKG

19. Primary tx goal for angina?

a. reversal of ischemia

b. reversal of infarction

c. redxn of stress and anxiety

d. redxn of associated risk factors

20. Earliest sign of Cardiogenic shock

a. tachycardia

b. decreased UO

c. presence of 4th heart sound

d. ALOC

CV questions

1. which of the following is a compenstory response to decreased CO?
a. decreased BP
b. ALOC
c. dec. BP & diuresis
d. inc. BP and fluid volume

2. which is used to describe the amount of stretch on the myocardium at the end of diastole?
a. afterload
b. cardiac index
c. CO
d. preload

3. one hour after administering IV lasix to a pt c HF, a short burst of Vtach appears on the monitor. which lyte imbalance should the nurse suspect?
a. hypoCa
b. HyperMg
c. hypoK
c. hyperNa

4. to reduce risk of coronary artery spasms, whicy type of med is the physicial most likely to prescribe?
a. Beta blocker
b. ACE inhibitor
c. inotropic vasodilator
d. Ca channel blocker

5. pt c HF is receivfing lasix 40mg IV. the MD orders 40 mEq KCl in 100mL D5W, to infuse over 4 hr. the pt's serum K level is 3.0. at which infusion rate should the nurse set the pump?
a. 25mL/hr
b. 10
c. 100
d. 50

6. a pt being tx'd 4 Vtach, why should teaching include eating foods such as bananas?
a. bananas high in carbs
b. high in K
c. low in Na
d. high in fiber

7. BP 126/80, MAP is

Also, links to test bank questions
med I
med II
med III
med IV
med V

Swan Ganz Insertion and Waveform

This shows actual insertion of a Swan Ganz and what the waveforms look like. I don't know about you guys, but I am always pleasantly surprised when I learn something and it is actually like real life!!

Swan Ganz Insertion and Waveform

You really only need to watch 3:20-5:30 of this video.

Oh, by the way. . . it is in Spanish, which is interesting, and you kind of feel like you should be on E as you listen to it (you will know what I am talking about when you watch it).

Also, this man made a good analogy for hemodynamics.

Understanding Hemodynamics

N7 Hemodynamic Basics

Hey guys, check out this Nursing CEU site. Quick easy read with mini quizzes

HEMODYNAMIC BASICS

Take the test in the comment section.

You can also check out Nurse Bob's Hemodynamic monitoring in the ICU

Early bird questions

Here are some questions regarding cardiac, so that I can actually practice before I get the test!!

Be forewarned that there is sound on the cardiac quiz site, so check your volume!
EKG simulator

Cardiac Quiz

Heart meds

Rhythms and Meds

Links to test banks

http://deltarnstudents.blogspot.com/2005/09/n4-test-neuro-icp-chapter-55.html
http://deltarnstudents.blogspot.com/2005/09/n4-test-head-injuries-and-icp.html
http://deltarnstudents.blogspot.com/2005/09/n4-test-cerebral-bleeding-and-icp.html
http://deltarnstudents.blogspot.com/2005/12/n4-n7-critical-care-neuro-quiz.html

http://deltarnstudents.blogspot.com/2005/12/n4-neuro-and-cranial-nerves-quiz.html

http://deltarns2007.blogspot.com/2005/10/disorders-of-fluid-volume-osmolality.html
http://deltarnstudents.blogspot.com/2005/10/n4-test-fluid-imbalances.html

http://futurenurses2008.blogspot.com/2008/04/n7-pharmacology-positive-inotropic.html
http://futurenurses2008.blogspot.com/2008/03/n7-pharmacology-antidysrhythmic-agents.html
http://futurenurses2008.blogspot.com/2008/04/n7-pharmacology-antianiginal-agents.html
http://futurenurses2008.blogspot.com/2008/03/n7-pharmacology-antihypertensive-agents.html
http://futurenurses2008.blogspot.com/2008/03/n7-pharmacology-diuretic-agents.html

RAA system

here is a great diagram showing how the RAAS works.

thank you wikipedia!!

RAAS diagram

Nursing 6 study resources

Companion website:
There are some great resources in our textbook's companion website. Check out this link: Maternal & Child Nursing Care.

It offers printable versions of the "Critical Concept Reviews" appearing at the end of each chapter (good quick chapter reviews!), and it also provides NCLEX questions (about 10/chapter).

Here are links to the first assigned chapters:

• 33 - Growth and Development
• 34 - Nutrition
• 35 - Pediatric Assessment
• 36 - Influences on the Child
• 37 - Health Promotion and Maintenance (infancy/early childhood)
• 38 - Health Promotion and Maintenance (older child/adolescent)
• 42 - Pain Assessment and Management

For additional NCLEX practice, animations and more, see the companion CD that should have been included at the back of your textbook.

Charting Errors

These are from actual medical charts.


The baby was delivered, the cord clamped and cut and handed to the pediatrician, who breathed and cried immediately.

Exam of genitalia reveals that he is circus sized.

The skin was moist and dry.

She stated that she had been constipated for most of her life until 1989 when she got a divorce.

The patient lives at home with his mother, father, and pet turtle, who is presently enrolled in day care three times a week.

Bleeding started in the rectal area and continued all the way to Los Angeles.

Both breasts are equal and reactive to light and accommodation.

She is numb from her toes down.

While in the emergency room, she was examined, X-rated and sent home.

The lab test indicated abnormal lover function.

Occasional, constant, infrequent headaches.

Examination reveals a well-developed male lying in bed with his family in no distress.

Patient was alert and unresponsive.

When she fainted, her eyes rolled around the room.

Nursing 7 Lecture Audio

In the right-hand column there are links to the Nursing 7 lectures.

Keep checking for more audio links.

Revving back up

Student Nurse Journey is a great general site you might want to peruse. You'll see there are lots of good resources there. Among many other bits of relevant information, it offers nursing fundamentals videos on many basic skills, such as:

• Mixing insulin
• Catheter insertion
• Priming an IV bag
• Intramuscular injection
• Reconstituting powder

Other areas of interest on the site include:

• Pediatric nursing
• Med-surg topics (by body system)
• Assessments
• Writing, charting and reporting
• Medications (classes, administration, etc.)
• Care plans

N6

School is almost here again!! I got a message from Julie Kay and if you don't already know.... Nursing 6 doesn't start until monday Aug 18th. I was confused about thursday being the first day of school, but we get 1 more week. See you all in soon.

-Maureen

Next SNA Meeting

The Nursing Market isn't what it used to be!! Get your foot in the door, gain some experience, get to know about your hospitals.

Two speakers will be at the next SNA meeting this Monday (note the different time) to talk about work experience/study and Versant.

This meeting is essential to get a jumpstart on your nursing career.

See you there!

Mrs. McAtee's Group

Just wanted the group to know I called county to set up a shadow day with Mrs. McAtee and according to the person answering the phone in the volunteer center, they no longer do shadowing and haven't for about a year now. I'm going to ask Mrs. Ippolito to pass that message along to McAtee to see what that's all about. Just thought I would let you guys know! N5 is just about over and so is our first year. Yay!

Nursing 4 -- renal system exam topics

Links:

Renal failure (from Critical Care Medicine Tutorials)
Summary of Renal and urological systems (from Docushare/FSison)
BPH (short animation/video)
Prostate Cancer (video library)