ATI PROCTORED MDC 4 - Final exam review LATEST UPDATE 2021/2022 (1) RATED A+ RASMUSSEN COLLEGE

ATI PROCTORED MDC 4 - Final exam review
LATEST UPDATE 2021/2022 (1) RATED A+
RASMUSSEN COLLEGE

MDC 4 – Final Exam Review


 Safety issues in the ED: Pt identification, fall risk, skin breakdown, HAIs, med errors
and adverse events.

 Triage: sorting & classifying patients into priority levels depending on
illness/injury severity
- Triage nurse: gatekeeper in the emergency care system
- 3 levels: Emergent, Urgent, Nonurgent

 Primary Survey: organizes the approach so immediate threats are rapidly identified
and effectively managed. Use ABC Disability and Exposure

 Secondary Survey: comprehensive head-to-toe, identify other injuries. Ex: splint,
Foley, etc.

 Disaster: event in which illness/injuries exceed the resources capabilities of
a community or medical facility

 Internal disaster: any event inside a health care facility/campus that could endanger
the safety of patients/staff & creates a need for evacuation/relocation

 External disaster: any event outside the facility/campus. Somewhere in the
community, requires the activation of the facility’s emergency management plan

 Tension Pneumothorax: extreme respiratory distress and cyanosis
• S/S: hypotension, tachycardia/pnea, dyspnea, sharp cx pain, cyanotic
• Tx: needle thoracostomy (2nd intercoastal midclavicular space) & cx tube

ATI PROCTORED MDC 4 - Final exam review
LATEST UPDATE 2021/2022 (1) RATED A+
RASMUSSEN COLLEGE

,ATI PROCTORED MDC 4 - Final exam review
LATEST UPDATE 2021/2022 (1) RATED A+
RASMUSSEN COLLEGE
(4th intercoastal space)

 Intubation and Ventilation: ET tube in for 10-14 days, longer l/t vocal cord damage
- If the Pt cannot maintain airway after extubation, tracheostomy is needed
- DOPE: Displaced tube, Obstructed tube, Pneumothorax, Equipment problems
- Mouth care q2h w/ chx

 Preventing VAP: HOB at least 30º, suctioning, prevent aspiration
- Ulcer/DVT prophylaxis, pulmonary hygiene

 High Pressure Alarms causes: - 𝖳 amount of secretions
- Pt coughs, gags, bites the ET tube
- Airway  r/t wheezing, bronchospasm, pneumothorax




 Multi-casualty vs. Mass casualty event: based upon the scope & scale of the
incident and the number/severity of victims/casualties

 Mass casualty event: overwhelms local medical capabilities & may require collaboration
of multiple agencies & health care facilities

 Emergency Preparedness: define ways to meet the extraordinary need for beds,
meds, PPE, supplies, and medical devices

 Disaster Triage Tag System: • Red: Emergent: class I – immediate threat to life
• Yellow: Urgent: class II – tx within 30min to 2h time frame




ATI PROCTORED MDC 4 - Final exam review
LATEST UPDATE 2021/2022 (1) RATED A+
RASMUSSEN COLLEGE

, ATI PROCTORED MDC 4 - Final exam review
LATEST UPDATE 2021/2022 (1) RATED A+
RASMUSSEN COLLEGE
• Green: Nonurgent: class III – waking wounded, tx > 2h
• Black: Expected: class IV – expected to die or dead

• Neurogenic: loss of tone causes massive vasodilation. Causes: SCI, head
trauma, anesthesia
neurogenic shock is the ONLY bradycardic shock
• Septic: toxins cause massive vasodilation. Causes: gram pos/neg bacteria
• S/S: hypotension, tachycardia, 𝖳 capillary leak

 Sepsis: systemic inflammatory response syndrome (SIRS)
• S/S: mild hypotension, low UO, 𝖳 HR, glucose, temp (> 101 or < 96.8), elevated C-
protein
• Tx: fluid resuscitation, Abts, supine

 Septic Shock: sepsis induced hypotension persisting despite adequate fluid resuscitation
• Risk factors: reduced immunity, central lines, trauma, invasive procedures
• S/S:  CO and BP, UO, lactic acid > 4mmol
• Inter: O2, abts, heparin for DIC

 Stages of shock: a) Initial Stage: - Mild vasoconstriction, 𝖳 HR/Resp
- 𝖳 anaerobic metabolism in some tissues w/ production of lactic acid
- Slight increase in DBP

b) Nonprogressive Stage:  MAP of 10-15mmHg from baseline
- Moderate vasoconstriction, 𝖳 HR,  pulse pressure/UO
• S/S: restlessness, tachycardia, 𝖳 RR,  UO, rising DBP, 2-5%  in O2,
- Mild acidosis/hyperkalemia

c) Progressive Stage:  MAP > 20mmHg from baseline
- Anoxia/ischemia of nonvital organs
- Hypoxia of vital organs
- Feeling of impending doom
• S/S: rapid/weak pulse, low BP, pallor/cyanosis or nail beds/oral mucosa, anuria

ATI PROCTORED MDC 4 - Final exam review
LATEST UPDATE 2021/2022 (1) RATED A+
RASMUSSEN COLLEGE