CCRN (CRITICAL CARE NURSING)
CERTIFICATION EXAM 2024/2025 | 3 VERSIONS | LATEST
UPDATED
WITH STUDY GUIDE, COMMON TERMINOLOGIES AND
QUANTIFIERS FOR KAPLAN
SIADH
too much water, dilutional hyponatremia. Decreased osmolarity=hypoosmolar. Decreased urinary
output.
CSF normal protein, glucose, WBCs, specific gravity,
Protein <100, Glucose: 70 WBCs: 4 cells/mm2 Specific gravity 1.007
Poikothermia
fluctuation of core body temperature of more than 2° C due to changes in ambient room
temperature
pathophysiology of a seizure
neurons in the cerebral cortex fire at the same time in a paroxysmal burst.
System driven outcome
include length of stay, readmission rate, and resource utilization.
Arterial supply to the brain: vertebrobasilar, common carotid, meningeal arteries
The vertebrobasilar arteries supply the posterior portion of the brain. The common carotid
arteries supply the anterior area of the brain. The meningeal arteries supply the superior portion
of the brain.
Pheochromocytoma
adrenal medulla,hi epi/norepi. s/s: hypertension, sweating, headache, palpitations, apprehension,
nausea/vomiting, tremor, pallor, abdominal pain, chest pain, and hyperglycemia.
Acute radiation syndrome
large doses of ionizing radiation , Circulatory collapse, increased intracranial pressure, vasculitis,
and meningitis causing death within 3 days
Complications of SIADH
seizure activity
,Treatment of SIADH (avoid what solutions?)
Fluid restriction
3% nacl (1500 osmolarity over 25cc/hr or less)
Dont do hypotonic solutions!
Asses for fluid overload
hypertonic solutions
D5LR; D5 1/2 NS; D5NS
hypotonic solutions
0.5% NS (HNS or 0.45% NS); 2.5% dextrose in 0.45% NS (D2.5 45% NS)
Osmolality and Sodium
275-295= normal osmolality. Sodium=135-145. Usually 2X of Na
Causes of SIADH
Viral PNA
Oat cell carcinoma
Head problems
Increased serum osmolality
Anesthesia and analgesics
Stress
Diabetes insipidus (urine specific gravity?)
No ADH, can't keep water, increased UOP. Hypernatremic, hyperosmolar, increased urinary
output (6-24L a day of clear urine)
urine specific gravity 1.001-1.005
Severe hypovolemia
Causes of diabetes insipidus (what medication?)
Head problem
Dilantin (DI)
Treatment of diabetes insipidus (medication, fluid, monitoring x2)
Pitressin/vasopressin (same as ADH)
Give fluids (increase intravascular volume)
Monitor urine specific gravity
EKG monitor for ischemia
Hypoglycemia s/s
, Tachycardia, palpitations, diaphoresis, irritable, restlessness
Confusion, lethargy, slurred speech, seizure, coma, death. IF YOU ARE IN A BETA
ADRENERGIC BLOCKER, you only see the CNS symptoms
DKA (BS, breathing, acid vs K)
Blood Sugar 400 to 900, Dehydration, No insulin, Ketones, Kussmaul breathing
Whenever high acid =hi K. For every drop of 0.1 in pH =increase by 0.6 of K
HHNK (who gets, BS, breaths)
old age, diet controlled diabetics, TPN patients, who get a lot of inteavascular sugar, and
pancreatitis as pancreas is eating itself, does not work properly.
Blood sugar 1000-2000, severe dehydration, (6 to 10 Liters behind.
Patient still makes insulin, so it can occur over months, preventing the breakdown of fats which
causes no acidosis, Shallow breaths.
Treatment DKA
insulin (a lot)
A fair amount fluids first saline and then D5 1/2 NS
Treatment HHNK
Only a little insulin
A lot if fluids
Leukopenia
Abnormally low WBC count < 5000.
Caused by viral illness, bone marrow disorder or medications such as chemotherapy, HIV
regimens, lupus and its meds, antibiotics such as bactrim and immunosuppressive meds. Patients
present with malaise, chills, fever.
Patients should have neutropenic precautions, assess root cause and delay treatment if necessary
until levels are higher, steroids and monitoring.
TIA
ischemic or hemorrhagic causes. Symptoms get better in 24 hours
RIND (stands for)
Reversible ischemic neurological deficit. Can be a result of ischemic or hemorrhagic causes.
Usually takes 3 months or more to improve
Cerebral infarct (which artery, consequences)
CERTIFICATION EXAM 2024/2025 | 3 VERSIONS | LATEST
UPDATED
WITH STUDY GUIDE, COMMON TERMINOLOGIES AND
QUANTIFIERS FOR KAPLAN
SIADH
too much water, dilutional hyponatremia. Decreased osmolarity=hypoosmolar. Decreased urinary
output.
CSF normal protein, glucose, WBCs, specific gravity,
Protein <100, Glucose: 70 WBCs: 4 cells/mm2 Specific gravity 1.007
Poikothermia
fluctuation of core body temperature of more than 2° C due to changes in ambient room
temperature
pathophysiology of a seizure
neurons in the cerebral cortex fire at the same time in a paroxysmal burst.
System driven outcome
include length of stay, readmission rate, and resource utilization.
Arterial supply to the brain: vertebrobasilar, common carotid, meningeal arteries
The vertebrobasilar arteries supply the posterior portion of the brain. The common carotid
arteries supply the anterior area of the brain. The meningeal arteries supply the superior portion
of the brain.
Pheochromocytoma
adrenal medulla,hi epi/norepi. s/s: hypertension, sweating, headache, palpitations, apprehension,
nausea/vomiting, tremor, pallor, abdominal pain, chest pain, and hyperglycemia.
Acute radiation syndrome
large doses of ionizing radiation , Circulatory collapse, increased intracranial pressure, vasculitis,
and meningitis causing death within 3 days
Complications of SIADH
seizure activity
,Treatment of SIADH (avoid what solutions?)
Fluid restriction
3% nacl (1500 osmolarity over 25cc/hr or less)
Dont do hypotonic solutions!
Asses for fluid overload
hypertonic solutions
D5LR; D5 1/2 NS; D5NS
hypotonic solutions
0.5% NS (HNS or 0.45% NS); 2.5% dextrose in 0.45% NS (D2.5 45% NS)
Osmolality and Sodium
275-295= normal osmolality. Sodium=135-145. Usually 2X of Na
Causes of SIADH
Viral PNA
Oat cell carcinoma
Head problems
Increased serum osmolality
Anesthesia and analgesics
Stress
Diabetes insipidus (urine specific gravity?)
No ADH, can't keep water, increased UOP. Hypernatremic, hyperosmolar, increased urinary
output (6-24L a day of clear urine)
urine specific gravity 1.001-1.005
Severe hypovolemia
Causes of diabetes insipidus (what medication?)
Head problem
Dilantin (DI)
Treatment of diabetes insipidus (medication, fluid, monitoring x2)
Pitressin/vasopressin (same as ADH)
Give fluids (increase intravascular volume)
Monitor urine specific gravity
EKG monitor for ischemia
Hypoglycemia s/s
, Tachycardia, palpitations, diaphoresis, irritable, restlessness
Confusion, lethargy, slurred speech, seizure, coma, death. IF YOU ARE IN A BETA
ADRENERGIC BLOCKER, you only see the CNS symptoms
DKA (BS, breathing, acid vs K)
Blood Sugar 400 to 900, Dehydration, No insulin, Ketones, Kussmaul breathing
Whenever high acid =hi K. For every drop of 0.1 in pH =increase by 0.6 of K
HHNK (who gets, BS, breaths)
old age, diet controlled diabetics, TPN patients, who get a lot of inteavascular sugar, and
pancreatitis as pancreas is eating itself, does not work properly.
Blood sugar 1000-2000, severe dehydration, (6 to 10 Liters behind.
Patient still makes insulin, so it can occur over months, preventing the breakdown of fats which
causes no acidosis, Shallow breaths.
Treatment DKA
insulin (a lot)
A fair amount fluids first saline and then D5 1/2 NS
Treatment HHNK
Only a little insulin
A lot if fluids
Leukopenia
Abnormally low WBC count < 5000.
Caused by viral illness, bone marrow disorder or medications such as chemotherapy, HIV
regimens, lupus and its meds, antibiotics such as bactrim and immunosuppressive meds. Patients
present with malaise, chills, fever.
Patients should have neutropenic precautions, assess root cause and delay treatment if necessary
until levels are higher, steroids and monitoring.
TIA
ischemic or hemorrhagic causes. Symptoms get better in 24 hours
RIND (stands for)
Reversible ischemic neurological deficit. Can be a result of ischemic or hemorrhagic causes.
Usually takes 3 months or more to improve
Cerebral infarct (which artery, consequences)
