ADULT GERONTOLOGY ACUTE CARE NURSE
PRACTITIONER 621 COMPLETE STUDY GUIDE
2026
◉ SVR/Afterload. Answer: 800-1200
◉ MAP. Answer: mean CVx80/CO
◉ PA pressure. Answer: 15-30
◉ Wedge PCWP pressure. Answer: 6-12
◉ Hypovolemic Shock Parameters. Answer: Preload CVP decreased,
SVR afterload increased, CI decreased, Oxygen delivery Decreased,
Venous Oxygen saturation increased
◉ Types of hypovolemic shock. Answer: Hemorrhage, burns,
pancreatitis
◉ Cardiogenic shock parameters. Answer: CVP preload increased,
SVR afterload increased, CI decreased, oxygen delivery decreased,
SV02 decreased
,◉ Types of cardiogenic shock. Answer: Post mi, malignant
dysrhythmia, acute myocarditis
◉ Obstructive shock parameters. Answer: Preload either, SVR
increased, CI decreased, oxygen delivery decreased, SV02 decreased
◉ Types of obstructive shock. Answer: Tension pneumo, cardiac
tamponade, PE
◉ Distributive shock parameters. Answer: Preload CVP decreased,
afterload SVR decreased, CI increased, SV02 decreased, oxygen
delivery increased
◉ Types of distributive shock. Answer: Septic shock, anaphylaxis,
neurogenic shock
◉ CVP Preload. Answer: 2-8
◉ Cardiac Output. Answer: 4-8
◉ MAP. Answer: 70-90
,◉ Fractional Excretion of NA <1%. Answer: Prerenal state of kidney
dysfunction (i.e. dehydration)
◉ Fractional Excretion of NA >2%. Answer: ATN (acute tubular
necrosis)
◉ CPP equation. Answer: MAP-ICP
◉ SIADH Hyposmolar hyponatremia "inappropriate water
retention". Answer: serum sodium low, serum osmo low <280, urine
osmo high >100, no dehydration, tx restrict fluids
if neuro symptoms give 3%NS
◉ DI Hyperosmolar hypernatremia dry. Answer: Serum sodium high,
serum osmo high >290, urine osmo low <100, urine spec grave
1.005 (urine is like water), urine sodium >20, dehydration, if serum
Na >150 give D5W to replace ½ volume deficit in 12-24 hours, avoid
rapid lowering of Na, DDAVP for acute situations
◉ Serum Osmo. Answer: 280
◉ Urine Osmo. Answer: 300-800
◉ Sodium. Answer: ~140
, ◉ Total cholesterol. Answer: <200
◉ Triglycerides. Answer: <150
◉ HDL. Answer: >40
◉ LDL. Answer: <100
◉ Management of pulm edema. Answer: 02, sitting up, morphine 2-
4mg, Lasix 40, another Lasix 40 if needed
◉ Left heart failure. Answer: LUNGS, dyspnea at rest, rales,
wheezing, generally healthy except acute event, S3, murmur of
mitral regurg
◉ Right heart failure. Answer: JVD, hepatomegaly, peripheral edema
◉ MR ASS. Answer: Mitral regurg, aortic stenosis, systolic murmurs
◉ MS ARD. Answer: Mitral Stenosis, aortic regurg, diastolic
PRACTITIONER 621 COMPLETE STUDY GUIDE
2026
◉ SVR/Afterload. Answer: 800-1200
◉ MAP. Answer: mean CVx80/CO
◉ PA pressure. Answer: 15-30
◉ Wedge PCWP pressure. Answer: 6-12
◉ Hypovolemic Shock Parameters. Answer: Preload CVP decreased,
SVR afterload increased, CI decreased, Oxygen delivery Decreased,
Venous Oxygen saturation increased
◉ Types of hypovolemic shock. Answer: Hemorrhage, burns,
pancreatitis
◉ Cardiogenic shock parameters. Answer: CVP preload increased,
SVR afterload increased, CI decreased, oxygen delivery decreased,
SV02 decreased
,◉ Types of cardiogenic shock. Answer: Post mi, malignant
dysrhythmia, acute myocarditis
◉ Obstructive shock parameters. Answer: Preload either, SVR
increased, CI decreased, oxygen delivery decreased, SV02 decreased
◉ Types of obstructive shock. Answer: Tension pneumo, cardiac
tamponade, PE
◉ Distributive shock parameters. Answer: Preload CVP decreased,
afterload SVR decreased, CI increased, SV02 decreased, oxygen
delivery increased
◉ Types of distributive shock. Answer: Septic shock, anaphylaxis,
neurogenic shock
◉ CVP Preload. Answer: 2-8
◉ Cardiac Output. Answer: 4-8
◉ MAP. Answer: 70-90
,◉ Fractional Excretion of NA <1%. Answer: Prerenal state of kidney
dysfunction (i.e. dehydration)
◉ Fractional Excretion of NA >2%. Answer: ATN (acute tubular
necrosis)
◉ CPP equation. Answer: MAP-ICP
◉ SIADH Hyposmolar hyponatremia "inappropriate water
retention". Answer: serum sodium low, serum osmo low <280, urine
osmo high >100, no dehydration, tx restrict fluids
if neuro symptoms give 3%NS
◉ DI Hyperosmolar hypernatremia dry. Answer: Serum sodium high,
serum osmo high >290, urine osmo low <100, urine spec grave
1.005 (urine is like water), urine sodium >20, dehydration, if serum
Na >150 give D5W to replace ½ volume deficit in 12-24 hours, avoid
rapid lowering of Na, DDAVP for acute situations
◉ Serum Osmo. Answer: 280
◉ Urine Osmo. Answer: 300-800
◉ Sodium. Answer: ~140
, ◉ Total cholesterol. Answer: <200
◉ Triglycerides. Answer: <150
◉ HDL. Answer: >40
◉ LDL. Answer: <100
◉ Management of pulm edema. Answer: 02, sitting up, morphine 2-
4mg, Lasix 40, another Lasix 40 if needed
◉ Left heart failure. Answer: LUNGS, dyspnea at rest, rales,
wheezing, generally healthy except acute event, S3, murmur of
mitral regurg
◉ Right heart failure. Answer: JVD, hepatomegaly, peripheral edema
◉ MR ASS. Answer: Mitral regurg, aortic stenosis, systolic murmurs
◉ MS ARD. Answer: Mitral Stenosis, aortic regurg, diastolic
