Question

(ANSWER ALL!)

A patient receiving mechanical ventilation is very anxious and agitated, and neuromuscular blocking agents (NMB) are used to promote ventilation. The nurse recognizes that the

1. medication will prevent seizures activity.
2. the patient needs to be given sedation.
3. the dose needs to be adjusted based on time.
4. visitors should stimulate the patient.

Rationale: _______________________________________________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________________________________________________________

A patient transferred to the intensive care unit from the emergency department is on a Dobutamine drip. Your order reads 5mcg/kg/min and titrates for SBP greater than 90 mmHg. Your concentration is 500mg/250 cc D5W. Your patient weighs 150 lbs. You set your pump at which of the following?

1. 7 mL
2. 10 mL
3. 13 mL
4. 15 mL

Rationale: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The nurse is admitting a patient to the emergency department following a severe head injury. You assess urine output of 1500ml/hr over the past two hours in absence of any diuretic. You suspect

1. diabetes insipidus.
2. hyperpituitarism
3. loss of parasympathetic control.
4. syndrome of inappropriate antidiuretic hormone

Rationale: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

You are assessing a chest trauma patient for signs of pneumothorax. You determine an emergent situation when you discover which of the following?

1. decreased breath sounds on the right
2. dislocation of the clavicle
3. displaced trachea
4. dropping SpO₂

Rationale: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Answer 1

1. A patient receiving mechanical ventilation is very anxious and agitated, and neuromuscular blocking agents (NMB) are used to promote ventilation. The nurse recognizes that the medication will prevent seizures activity.

Answer - medication will prevent seizures activity.

Neuromuscular agents prevent seizure activity by blocking neuromuscular transmission, it means NMB agents blocks nerve impulse transmission to muscles and paralyzes the patient.

2.

A patient transferred to the intensive care unit from the emergency department is on a Dobutamine drip. Your order reads 5mcg/kg/min and titrates for SBP greater than 90 mmHg. Your concentration is 500mg/250 cc D5W. Your patient weighs 150 lbs.

Answer - 10ML

150 lbs = 68kg

So, the required dose will be

then per hour

20,400 mcg = 20.4mg

Drug concentration is 500mg/250 cc D5W

After rounding it will be 10ml.

Question 3.

The nurse is admitting a patient to the emergency department following a severe head injury. You assess urine output of 1500ml/hr over the past two hours in absence of any diuretic. You suspect diabetes insipidus.

Answer - diabetes insipidus.

Head trauma can cause pituitary dysfunction due to an injury, which affects the secretion of Antidiuretic hormones(ADH) that leads to excess hypotonic urine output.

Question 4.

You are assessing a chest trauma patient for signs of pneumothorax. You determine an emergent situation when you discover dropping SpO2.

Answer - dropping SpO2

Decrease oxygen saturation in body can cause tissue hypoxia, which can lead to irreversible organ damage, cardiac arrest and death. so, it is and emergency situation associated with pneumothorax which needs immediate intervention.