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NGN NCLEX RN Study Guide
• The pediatric cardiac arrest algorithm known as the reversible causes include the four "H's"::
Answer:
hypoxia, hypovolemia, hyperkalemia, hypokalemia, other electrolyte disturbances, and the four "Ts": Tension pneumothorax, cardiac tamponade, drug toxicity and therapeutics, thromboembolism, and other outflow obstructions.
• Infant and Children CPR:
Answer:
For infants and children provide chest compressions that depress the chest at least 1/3 of the anterior posterior diameter of the chest, use chest compression rate of <100 to 120/min for infants and children.• Single rescuers compression to ventilation rate 30:2; two rescuers 15:
• Hands-Only CPR, High-Quality CPR, and In-Hospital CPR:
Answer:
Consists of two easy steps:
- Call 9-1-1 (or send someone to do that)
- Push hard and fast in the center of the chest
The focus is on early, high-quality chest compressions. The healthcare provider includes chest compressions before rescue breaths. "C-A-B" (Chest Compression, Airway, and Breathing) is now used for adults and children, whereas steps for the newborns remain "A-B-C" (Airway, Breathing, and Circulation).Automated external defibrillators (AEDs) can greatly increase a cardiac arrest victim's chances of survival. To minimize the time to defibrillation for cardiac arrest victims, deployment of AEDs should not be limited to only trained people (although training is still recommended).
• High-Quality CPR: High-quality CPR should be performed by anyone—
including bystanders. There are five critical components:
Answer:
- Minimize interruptions in chest compressions
- Provide compressions of adequate rate and depth
- Avoid leaning on the victim between compressions
- Ensure proper hand placement
- Avoid excessive ventilation
• In-Hospital Cardiac Arrest: . For healthcare providers and those trained:
Answer:
conventional CPR using chest compressions and mouth-to-mouth breathing at a ratio of 30:2 compressions-to-breaths. In adult victims of cardiac arrest, it is reasonable for rescuers to perform chest compressions at a rate of 100 to 120/min and to a depth of at least 2 inches (5 cm) for an average adult, while avoiding excessive chest compression depths (greater than 2.4 inches [6 cm])
• What is the first priority when an adult with an unwitnessed cardiac arrest
is found?:
Answer:
Call 9-1-1 (or send someone to do that) and begin CPR by pushing hard and fast in the center of the chest.
• Define myocardial infarction:
Answer:
Necrosis of the heart muscle due to poor perfusion of the heart.
• What criteria should alert a client with known angina who takes nitroglycerin
tablets sublingually to call EMS? Delete:
Answer:
Unrelieved chest pain after nitroglycerin.
• After calling out for help and asking someone to dial for emergency
services, what is the next action in CPR?: For adults, check carotid pulse and,
if no pulse, deliver CPR.
Answer:
• True or false? In feeling for presence of a carotid pulse, no more
than 5 seconds should be used.:
Answer:
False.Palpate for no more than 10 seconds, recognizing that arrhythmias or bradycardia could be occurring
• During one-rescuer CPR, what is the ratio of compressions to ventilations for an adult? During one-rescuer CPR, what is the ratio of compressions
to ventilations for a child?:
Answer:
Adults 30:2, use chest compression rate of <100 to 120/min for infants and
children. Single rescuers compression to ventilation rate 30:2; two rescuers 15:2.
• What is the first drug most likely to be used for an in-hospital cardiac
arrest?:
Answer:
Epinephrine
• A client in cardiac arrest is noted on bedside monitor to be in pulseless
ventricular tachycardia. What is the first action that should be taken?:
Answer:
Check for a carotid or femoral pulse. Watch for chest excursion and auscultate bilaterally for breath sounds.
• If a person is choking, when should the rescuer intervene?:
Answer:
Defibrillation
• How would the nurse assess the adequacy of compressions during CPR?
How would the nurse assess the adequacy of ventilations during CPR?:
Answer:
-When the person points to his or her throat and can no longer cough, talk, or make sounds.
• One should never make blind sweeps into the mouth of a choking child
or infant. Why: .
Answer:
Because the object might be pushed farther down into the throa
• Most common type of dehydration:
Answer:
is isotonic (isonatremic) dehydration, which effectively equates with hypovolemia; but the distinction of isotonic from hypotonic or hypertonic dehydration may be important when treating people with dehydration.Physiologically, dehydration is both loss of water and solutes (mainly sodium) usually lost in roughly equal quantities as to how they exist in blood plasma.
• Hypotonic or hyponatremic:
Answer:
(primarily a loss of electrolytes, sodium in particular).
• Hypertonic or hypernatremic:
Answer:
(primarily a loss of water)
• Which action should the nurse take before drawing a sample for ABGs
from the radial artery?:
Answer:
Perform the Allen test to assess collateral circulation.Make the client's hand blanch by obliterating both the radial and the ulnar pulses.Then release the pressure over the ulnar artery only. If flow through the ulnar artery is good, flushing will be seen immediately. The Allen test is then positive; therefore, the radial artery can be used for puncture. If the Allen test is negative, repeat on the other arm. If that test is also negative, seek another site for arterial puncture.The Allen test ensures collateral circulation to the hand if thrombosis of the radial artery should follow the puncture.
• What PO 2 value indicates respiratory failure in adults?:
Answer:
PO2 below 60 mm Hg
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