Complex Adult Health nursing case study latest 100%

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Complex Adult Health

(Use Med Surg book and can use Critical Care book by Sole)
 Cardiac Exam 1: 70 questions
o How to study
 Go to cardiac workshop
 Read textbook- according to calender
 Test questions are not on test bank: read textbook and use YT video + powerpoints
o Know what is number one to do as a nurse for each dysrhythmia
 Be able to see the strip, read the scenario (BP down, HR, down, etc) and know that that’s
that dysrhythmia and answer choices will have the intervention - so you can’t answer
the intervention if you don’t know the condition
o INR warfarin - give vit K
o Digoxin adverse effects - yellow vision
o Nitroglycerin, patient has headache - normal adverse effect
o Troponin I - main indicator for damage to heart (should be <0.1)
o Femoral cath, notice hematoma - apply pressure (20 min)
o Artifact, patient has fever and EKG shows - shivering (picture) [look at yt video]
o One med calc - know mg to mL – easy
 My answer was 4 mL
o Left antecubital cath - check left radial pulse
o Hypokalemia - causes what changes in the EKG segments?
 Flat or inverted T wave
 ST depression
 Presence of U wave
 Increased amplitude and width of P wave
o Hospital has team set in place for complications - rapid response team
 Know that they go to every unit but the ICUs
 There is a SATA about scenerios and you have to determine what unit they will go to
 I put all of the ones that were not ICUs
o Sinus bradycardia - give atropine (anticholinergic)
o Asystole and you did CPR, give epinephrine
o KNOW order (helps with answering many questions)
 Unresponsive: asses circulation, airway, breathing (CAB)
 Responsive: monitor airway, breathing, circulation (ABC)
o Do you check vitals first, do EKG, labs? (know priority of what to do when)
o STEMI - ST elevation
o VT: what to assess first? Neuro check - LOC
o While doing CPR and before defib, check carotid pulse
 There was also another question about what to check when doing CPR on a patient – I
did apical pulse because carotid was not an option
o What meds to give for SVT
 Adenosine!!
o What rhythms are related to potassium
 A fib
 V tach
 PVCs
 V fib
 Torsades
o When to give atropine, amiodarone
 Atropine

,  Sinus Bradycardia (symptomatic)
 Amiodarone
 SVT
 V Tachy
 (2nd line antidysrhythmic) V Fib
o Defibrillate and cardiovert with what conditions
 Know when to do it
 Defib
 V tachy (no pulse)
 V Fib
 Cardioversion
 Ventricular Tachy (pulse)
 SVT
 Rapid A Fib
 A flutter
o Treatment for each dysrhythmia
 Look over the voice over powerpoint
 Another really good place to look is in the Critical Care Book by Sale
o What to do when patient is unresponsive
 Circulation
 Airway
 Breathing
 CPR
o Lab values
 PT, PTT, Hct, Hgb, platelet, K
o How CABG works and treatment
o Check for hypokalemia when giving furosemide
o What test for MI damage - troponin
o Prolonged QT wave showed what
 High risk of ventricular dysrhythmias and sudden death
o Patient has cardiac cath done - rest for at least 6 hours
 SATA
 Look it up in the book!!
o Nitroglycerin tablet
 Take 1, call 911 if not relieved, then take 2 more till ambulance comes
o A lot about myocardial infarction
o Code management powerpoint is very helpful!!! (and YT video for it)
 Documentation Nurse will be the one to document medicatons that are given
o Know what causes changes in the segments of the PQRST complexes
 P wave = atrial depolarization
 QRS Complex = atrial repolarization/ventricular depolarization
 T wave = ventricular repolarization
o Cause of QRS being wide
 V tachycardia
o One of the strips was a pacemaker problem
o There was a lot about PVCs and PCAs
o SATA with tPA
 Neuro checks
o Know PEA and the 6 causes
 H’s and T’s
 Hypoxia
 Hypovolemia