Float Nurse

Identify the following rhythms 1. a. Junctional rhythm b. Accelerated junctional rhythm c. Junctional tachycardia d. Junctional bradycardia 2. a. Junctional rhythm b. Accelerated junctional rhythm c. Junctional tachycardia d. Junctional bradycardia 3. a. Junctional rhythm b. Accelerated junctional rhythm c. Junctional tachycardia d. Junctional bradycardia 4. a. Junctional rhythm b. Accelerated junctional rhythm c. Junctional tachycardia d. Junctional bradycardia 5. a. Junctional rhythm b. Accelerated junctional rhythm c. Junctional tachycardia d. Junctional bradycardia 6. a. Junctional rhythm b. Accelerated junctional rhythm c. Junctional tachycardia d. Junctional bradycardia 7. a. Junctional rhythm b. Accelerated junctional rhythm c. Junctional tachycardia d. Junctional bradycardia 8. a. Junctional rhythm b. Accelerated junctional rhythm c. Junctional tachycardia d. Jun...

"I've seen things you people wouldn't believe. Attack ships on fire off the shoulder of Orion. I've watched c-beams glitter in the dark near the Tannhäuser Gate. All those ... moments will be lost in time, like tears...in rain......Time to die....."  Roy Battey- from the Movie Blade Runner. Idioventricular rhythm Agonal rhythm Agonal rhythm Agonal rhythm Agonal rhythm Asystole "I don't know why he saved my life. Maybe in those last moments he loved life more than he ever had before. Not just his life... anybody's life... my life. All he'd wanted was the same answers the rest of us want. Where do I come from? Where am I going? How long have I got? All I could do is sit there and watch him die." Decker- from the movie Blade Runner

Medications ·          Inotropic agents ·          Vasopressors ·          Vasodilators ·          Inodilators Epinephrine ·          Acts directly on adrenergic receptors ·          Low dose cause increased myocardial contractility, heart rate, pulse pressure, and SBP ·          Higher doses produce increased SBP and DBP pressures and a narrowing of the pulse pressure. Epinephrine Indications ·          Inadequate cardiac output ·          Hypotension ·          Symptomatic bradycardia ·          Pulseless arrest · ...

Fluid Resuscitation Goals ·          Restore circulating fluid volume ·          Restore oxygen-carrying capacity ·          Reducing oxygen demand ·          Correct metabolic imbalances secondary to fluid depletion Note:  Early resuscitation of circulating blood is important in halting the progression of shock to cardiac arrest Fluid Resuscitation Give isotonic crystalloids 20ml/kg over 5-20 minutes Repeat 20ml/kg boluses to restore BP and tissue perfusion Frequently reassess the child to determine response to therapy Fluid Replacement ·          Crystalloid ·          Colliods ·          Blood products Crystalloids- ·       ...

Anaphylactic Shock Results from a severe reaction to medications, food, vaccines, venom, or other antigens Symptom onset may occur within minutes or hours Characterized by systemic vasodilation and increased capillary permeability and pulmonary vasoconstriction Symptoms ·          Anxiety, agitation ·          Nausea, vomiting ·          Urticaria ·          Angioedema ·          Respiratory distress, stridor ·          Hypotension ·          Tachycardia Management of Anaphylactic Shock ·          Administer supplemental oxygen ·          Fluid boluses with 20ml/kg isotonic crystalloids ·  ...

Management of Septic Shock The clinical symptoms associated with septic shock are due to the changes  in the patient’s hemodynamic and metabolic status.  These are the result of their response to infection and the release or activation of inflammatory mediators.  Primary Goals ·          Restoration of hemodynamic stability ·          Identification and Control of Infection Symptoms ·          Tachypnea ·          Tachycardia ·          Bounding peripheral pulses ·          Brisk or delayed capillary refill ·          Warm flushed skin (warm shock) ·          Pale, mottled skin (cold shock) ·      ...