ANCC Adult Gerontology Acute Care
Review Test Exam 2023
Cardiac Index - ANS-2-4
SVR/Afterload - ANS-800-1200
MAP - ANS-mean CVx80/CO
PA pressure -
... [Show More] ANS-15-30
Wedge PCWP pressure - ANS-6-12
Hypovolemic Shock Parameters - ANS-Preload CVP decreased, SVR afterload
increased, CI decreased, Oxygen delivery Decreased, Venous Oxygen saturation
increased
Types of hypovolemic shock - ANS-Hemorrhage, burns, pancreatitis
Cardiogenic shock parameters - ANS-CVP preload increased, SVR afterload increased,
CI decreased, oxygen delivery decreased, SV02 decreased
Types of cardiogenic shock - ANS-Post mi, malignant dysrhythmia, acute myocarditis
Obstructive shock parameters - ANS-Preload either, SVR increased, CI decreased,
oxygen delivery decreased, SV02 decreased
Types of obstructive shock - ANS-Tension pneumo, cardiac tamponade, PE
Distributive shock parameters - ANS-Preload CVP decreased, afterload SVR
decreased, CI increased, SV02 decreased, oxygen delivery increased
Types of distributive shock - ANS-Septic shock, anaphylaxis, neurogenic shock
CVP Preload - ANS-2-8
Cardiac Output - ANS-4-8
MAP - ANS-70-90
Fractional Excretion of NA <1% - ANS-Prerenal state of kidney dysfunction (i.e.
dehydration)
Fractional Excretion of NA >2% - ANS-ATN (acute tubular necrosis)
CPP equation - ANS-MAP-ICP
SIADH Hyposmolar hyponatremia "inappropriate water retention" - ANS-serum sodium
low, serum osmo low <280, urine osmo high >100, no dehydration, tx restrict fluids
if neuro symptoms give 3%NS
DI Hyperosmolar hypernatremia dry - ANS-Serum sodium high, serum osmo high >290,
urine osmo low <100, urine spec grave 1.005 (urine is like water), urine sodium >20,
dehydration, if serum Na >150 give D5W to replace ½ volume deficit in 12-24 hours,
avoid rapid lowering of Na, DDAVP for acute situations
Serum Osmo - ANS-280
Urine Osmo - ANS-300-800
Sodium - ANS-~140
Total cholesterol - ANS-<200
Triglycerides - ANS-<150
HDL - ANS->40
LDL - ANS-<100
Management of pulm edema - ANS-02, sitting up, morphine 2-4mg, Lasix 40, another
Lasix 40 if needed
Left heart failure - ANS-LUNGS, dyspnea at rest, rales, wheezing, generally healthy
except acute event, S3, murmur of mitral regurg
Right heart failure - ANS-JVD, hepatomegaly, peripheral edema
MR ASS - ANS-Mitral regurg, aortic stenosis, systolic murmurs
MS ARD - ANS-Mitral Stenosis, aortic regurg, diastolic
Mitral murmur locations - ANS-5th ICS, apex
Aortic murmur locations - ANS-2nd or 3rd ICS, base
S1 - ANS-AV valves closed, SL open
S2 - ANS-SL closed, AV open
Cardiac blood flow - ANS-SVC,RA, tricuspid, RV, pulmonic valve, pulmonary artery,
lungs, pulmonary veins, LA, mitral, LV, Aortic valve, aorta, body
Cushing's - ANS-Moon face, buffalo hump, hypertension, HYPERglycemia,
HYPERnatremia, HYPOkalemia, tx depends on cause (stop meds, tumor)
Addison's ADRENOcorticoid deficiency - ANS-Remember: SEX, SALT, and SUGAR
Deficient cortisol, androgens, and aldosterone, hyperpigmentation in buccal mucosa,
tanning, HYPOtension, scant hair, HYPOglycemia, HYPOnatremia, HYPERkalemia,
cosyntropin is the rule out for addison's, manage: referral, glucorticoid, hydrocortisone,
fludrocortisone inpatient: hydrocortisone and fluids
HYPERthyroidism/Grave's - ANS-TSH LOW, T3 High, Grave's Disease, bulgy eyes,
weight loss, fine thin hair, smooth skin, a fib
Specialist referral, propranolol, methimazole, PTU, lugol's
Thyroid crisis - ANS-PTU or Methimazole with adjunct within 1 hour Lugol's propranolol,
hydrocortisone
No ASA
Hypothyroidism - ANS-(TSH assay most sensitive test) TSH ELEVATED, T4 LOW
hasimototo's most common, LOW AND SLOW, cold intolerance, weight fain, brittle
nails, brady, hypoactive BS, Levothyroxine 50-100mcg
Myxedema Coma - ANS-AIRWAY, fluid replacement PRN, levothyroxine 400mcgIVx1
Subacute thyroiditis - ANS-Treated symptomatically with propanonlol
Pheocromocytoma - ANS-Labile hypertension, TSH normal, postural hypotension,
plama-free metanephrines to rule out, CT to confirm, surgical removal, postop:
hypotension, adrenal insufficiency, hemorrhage
urine catecholamines, alpha blockers phentolamine
DKA - ANS--intracellular dehydration, kussmaul, hyperglycemia >250, ketonemia,
hyperkalemia
Management: 1L first hour>500ml/hr, 0.1/kg/hr, glucose <250 change to D51/2
when switching to subq insulin, inititate subQ insulin 2-3 hours prior to stopping insulin
drip
HHNK (Hyperosmolar Hyperglycemic NON KETOSIS) - ANS-Type 2 DM, super
elevated glucose >600, hyperosmolar >310, normal anion gap, elevated hgbA1c,
normal pH
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