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Medical surgical 1 (Cardiac and respiratory)

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Stroke for Certified Emergency Nursing (CEN)

Stroke for Certified Emergency Nursing (CEN)

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Study Tools For Stroke for Certified Emergency Nursing (CEN)

Stroke Locations (Cheatsheet)

Stroke Pathochart (Cheatsheet)

Blood Pressure Normal Values Cheatsheet (Cheatsheet)

Ischemic Stroke MCA (Image)

Circle Of Willis Showing Stroke (Image)

Stroke Assessments (Mnemonic)

Types of Strokes (Picmonic)

Right Hemisphere Stroke Assessment (Picmonic)

Left Hemisphere Stroke Assessment (Picmonic)

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Outline

Stroke

Definition/Etiology:

I know that you know this, but a stroke occurs when something blocks blood supply to part of the brain or when a blood vessel in the brain bursts. In either case, parts of the brain become damaged or die.

Risk factors for stroke include, but are not limited to:
Hypertension, hyperlipidemia, A-fib, Diabetes, smoking, oral contraceptives, cardiac disease, and recent neck trauma.

Pathophysiology:

As we know, there are 2 types of strokes: Ischemic and hemorrhagic. We could get really deep into the patho behind each, but here is the important point: Ischemic stroke is caused by deficient blood and oxygen supply to the brain; hemorrhagic stroke is caused by bleeding or leaky blood vessels.

Clinical Presentation:

Signs of ischemic stroke –
Sudden onset of:

Unilateral facial weakness
Unilateral weakness of the arm or leg
Expressive or receptive aphasia, or both
Headache, nausea, vomiting
Vertigo, ataxia
Visual disturbances
Numbness or tingling

Hemorrhagic stroke signs:

The above as well as
Rapidly decreasing level of consciousness – leading to possible coma
HTN

Findings more common with a bleed: N/V, photophobia, phonophobia

Collaborative Management:

CODE STROKE (or whatever your facility calls it)
Need immediate CT to determine type and location of stroke
Lab work – CBC, CMP, Coags, cardiac enzymes if cardiac related
Blood Glucose
Neuro or neurosurge involvement
NIHSS
Determine need for TPA
If GCS <8, intubate?
2 large bore IV
O2

Evaluation | Patient Monitoring | Education:

Frequent, frequent, frequent neuro checks
NIHSS
GCS
Determine effectiveness of TPA – follow hospital protocols
Antihypertensive meds – Do not drop too low. Maintain SBP <185 and DBP <110

Linchpins: (Key Points)

Time is brain
What type
Frequent reassessments

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

Emergency Nurses Association. (2022). Emergency Nursing Orientation 3.0. Cambridge, MA: Elsevier, Inc.
Sheehy, S. B., Hammond, B. B., & Zimmerman, P. G. (2013). Sheehy’s manual of emergency care (Vol. 7th Edition). St. Louis, MO: Elsevier/Mosby.

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Medical surgical 1 (Cardiac and respiratory)

Concepts Covered:

Study Plan Lessons

02.06 Heart Murmurs for CCRN Review

02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review

02.12 Myocardial Infarction- Inferior Wall for CCRN Review

02.13 Myocardial Infarction – Anterior Septal Wall for CCRN Review

02.14 Shock Stages for CCRN Review

02.15 Hypovolemic Shock for CCRN Review

02.16 Cardiogenic Shock for CCRN Review

02.17 Septic Shock for CCRN Review

02.18 Cardiovascular Practice Questions for CCRN Review

10.04 Pulmonary Question Review for CCRN Review

1st Degree AV Heart Block

2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)

2nd Degree AV Heart Block Type 2 (Mobitz II)

3rd Degree AV Heart Block (Complete Heart Block)

Acute Kidney Injury Case Study (60 min)

Acute Renal (Kidney) Module Intro

Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)

ACE (angiotensin-converting enzyme) Inhibitors

Absolute Neutrophil Count (ANC) Lab Values

Absolute Reticulocyte Count (ARC) Lab Values

Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)

Admissions, Discharges, and Transfers

Airway Suctioning

Anaphylaxis Nursing Interventions for Certified Perioperative Nurse (CNOR)

Anemia for Progressive Care Certified Nurse (PCCN)

Aneurysm (Dissecting, Repair) for Progressive Care Certified Nurse (PCCN)

Aneurysm and Dissection for Certified Emergency Nursing (CEN)

Angiotensin Receptor Blockers

Anion Gap Acidosis 1 Nursing Mnemonic (KULT)

Aortic Aneurysm – Management Nursing Mnemonic (CRAM)

Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)

Aortic Stenosis Symptoms Nursing Mnemonic (SAD)

Artificial Airways

ASA (Aspirin) Nursing Considerations

Aspiration for Certified Emergency Nursing (CEN)

Asthma (Severe) for Progressive Care Certified Nurse (PCCN)

Asthma for Certified Emergency Nursing (CEN)

Atenolol (Tenormin) Nursing Considerations

Atorvastatin (Lipitor) Nursing Considerations

Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)

Atrial Fibrillation (A Fib)

AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)

AVPU Mnemonic (The AVPU Scale)

Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)

Bleeding Complications (Minor) Nursing Mnemonic (BEEP)

Bleeding for Certified Emergency Nursing (CEN)

Bleeding Precautions Nursing Mnemonic (RANDI)

Blood Flow Through The Heart

Blood Salvage Transfusion Anticipation for Certified Perioperative Nurse (CNOR)

Blunt Chest Trauma

Calcium Channel Blockers

Cardiac Course Introduction

Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)

Cardiac Labs – What and When to Use Them – Live Tutoring Archive

Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive

Cardiac Stress Test

Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)

Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)

Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)

Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)

Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)

Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)

Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)

Cardiovascular Angiography

Cardiovascular Disorders (CVD) Module Intro

Causes of Anaphylaxis Nursing Mnemonic (Many Boys Love Food)

Causes of Dyspnea Nursing Mnemonic (The 6 P’s)

Chest Tube Assessment Nursing Mnemonic (Two AA’s)

Chest Tube Management

02.02 Cardiomyopathy for CCRN Review

02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review

02.14 Shock Stages for CCRN Review

02.16 Cardiogenic Shock for CCRN Review

02.17 Septic Shock for CCRN Review

03.03 Hypoglycemia for CCRN Review

06.05 Wide Complex Tachycardia for CCRN Review

ACE (angiotensin-converting enzyme) Inhibitors

Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)

Acute Kidney Injury Case Study (60 min)

Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)

Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)

Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)

Amputation for Certified Emergency Nursing (CEN)

Anemia for Progressive Care Certified Nurse (PCCN)

Aneurysm and Dissection for Certified Emergency Nursing (CEN)

Angiotensin Receptor Blockers

Anti Tumor Antibiotics

Antineoplastics

Aspiration for Certified Emergency Nursing (CEN)

Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)

Atrial Fibrillation (A Fib)

AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)

AVPU Mnemonic (The AVPU Scale)

Blood Flow Through The Heart

Blood Salvage Transfusion Anticipation for Certified Perioperative Nurse (CNOR)

Brain Natriuretic Peptide (BNP) Lab Values

Burns for Certified Emergency Nursing (CEN)

Calcium Acetate (PhosLo) Nursing Considerations

Calcium Carbonate (Tums) Nursing Considerations

Calcium Channel Blockers

Cardiac (Heart) Enzymes

Cardiac A&P Module Intro

Cardiac Anatomy

Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)

Cardiac Course Introduction

Cardiac Labs – What and When to Use Them – Live Tutoring Archive

Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive

Cardiac Stress Test

Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)

Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)

Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)

Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)

Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)

Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)

Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)

Cerebral Metabolism

Chemotherapy Patients

Cirrhosis for Certified Emergency Nursing (CEN)

Cold Temperature-related Emergencies for Certified Emergency Nursing (CEN)

Compartment Syndrome for Certified Emergency Nursing (CEN)

Congestive Heart Failure Concept Map

Coronary Artery Disease Concept Map

Creatine Phosphokinase (CPK) Lab Values

Cushing’s Syndrome Case Study (60 min)

Day in the Life of a Med-surg Nurse

Disease Specific Medications

Dobutamine (Dobutrex) Nursing Considerations

Dopamine (Inotropin) Nursing Considerations

Dysrhythmias for Certified Emergency Nursing (CEN)

Dysrhythmias Labs

Echocardiogram (Cardiac Echo)

Endocarditis Case Study (45 min)

Endocarditis for Certified Emergency Nursing (CEN)

Envenomation Emergencies for Certified Emergency Nursing (CEN)

Epinephrine (EpiPen) Nursing Considerations

General Anesthesia

GERD (Gastroesophageal Reflux Disease)

Heart (Cardiac) and Great Vessels Assessment

Heart (Cardiac) Failure Module Intro

Heart (Cardiac) Failure Therapeutic Management

Heart (Cardiac) Sound Locations and Auscultation

Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)

Heart Failure Case Study (45 min)

Heart Failure for Certified Emergency Nursing (CEN)

Heat Temperature-related Emergencies for Certified Emergency Nursing (CEN)

Hemorrhagic Fevers for Certified Emergency Nursing (CEN)

Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)

Hypertensive Crisis Case Study (45 min)

Hyperthyroidism Case Study (75 min)

Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)

Hypoparathyroidism

Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)

Influenza for Certified Emergency Nursing (CEN)

Intake and Output (I&O)

Interdisciplinary Team Participation for Certified Perioperative Nurse (CNOR)

Intraoperative Positioning

Lactate Dehydrogenase (LDH) Lab Values

Malignant Hyperthermia

MI Surgical Intervention

Minimally-Invasive Cardiac Surgery (Non-Sternal Approach) for Progressive Care Certified Nurse (PCCN)

Myocardial Infarction (MI) Case Study (45 min)

Neurogenic Shock for Certified Emergency Nursing (CEN)

Noncardiac Pulmonary Edema for Certified Emergency Nursing (CEN)

Norepinephrine (Levophed) Nursing Considerations

Nursing Care and Pathophysiology for Anaphylaxis

Nursing Care and Pathophysiology for Cardiogenic Shock

Nursing Care and Pathophysiology for Cushings Syndrome

Nursing Care and Pathophysiology for Gonorrhea (STI)

Nursing Care and Pathophysiology for Heart Failure (CHF)

Nursing Care and Pathophysiology for Hyperthyroidism

Nursing Care and Pathophysiology for Hypothyroidism

Nursing Care and Pathophysiology for Hypovolemic Shock

Nursing Care and Pathophysiology for Ischemic Stroke (CVA)

Nursing Care and Pathophysiology for Myasthenia Gravis

Nursing Care and Pathophysiology for Pneumothorax & Hemothorax

Nursing Care and Pathophysiology for Pulmonary Edema

Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)

Nursing Care and Pathophysiology for Valve Disorders

Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)

Nursing Care and Pathophysiology of Angina

Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)

Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)

Nursing Care and Pathophysiology of Endocarditis and Pericarditis

Nursing Care and Pathophysiology of Hypertension (HTN)

Nursing Care and Pathophysiology of Myocardial Infarction (MI)

Nursing Care and Pathophysiology of Myocarditis

Nursing Care Plan (NCP) for Activity Intolerance

Nursing Care Plan (NCP) for Acute Kidney Injury

Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome

Nursing Care Plan (NCP) for Anaphylaxis

Nursing Care Plan (NCP) for Anemia

Nursing Care Plan (NCP) for Angina

Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)

Nursing Care Plan (NCP) for Blunt Chest Trauma

Nursing Care Plan (NCP) for Cardiogenic Shock

Nursing Care Plan (NCP) for Cardiomyopathy

Nursing Care Plan (NCP) for Chronic Kidney Disease

Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)

Nursing Care Plan (NCP) for Cushing’s Disease

Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)

Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)

Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis

Nursing Care Plan (NCP) for Endocarditis

Nursing Care Plan (NCP) for Gastroesophageal Reflux Disease (GERD)

Nursing Care Plan (NCP) for Glomerulonephritis

Nursing Care Plan (NCP) for Hashimoto’s Thyroiditis

Nursing Care Plan (NCP) for Heart Valve Disorders

Nursing Care Plan (NCP) for Hyperthyroidism

Nursing Care Plan (NCP) for Hypoparathyroidism

Nursing Care Plan (NCP) for Hypovolemic Shock

Nursing Care Plan (NCP) for Lyme Disease

Nursing Care Plan (NCP) for Myasthenia Gravis (MG)

Nursing Care Plan (NCP) for Myocardial Infarction (MI)

Nursing Care Plan (NCP) for Pancreatitis

Nursing Care Plan (NCP) for Pericarditis

Nursing Care Plan (NCP) for Pneumonia

Nursing Care Plan (NCP) for Pulmonary Embolism

Nursing Care Plan (NCP) for Sepsis

Nursing Care Plan (NCP) for Stroke (CVA)

Nursing Care Plan (NCP) for Syncope (Fainting)

Nursing Care Plan (NCP) for Thrombophlebitis / Deep Vein Thrombosis (DVT)

Nursing Care Plan for Coronary Artery Disease (CAD)

Nursing Care Plan for Distributive Shock

Nursing Care Plan for Myocarditis

Nursing Care Plan for Pulmonary Edema

Nursing Case Study for Acute Kidney Injury

Nursing Case Study for Cardiogenic Shock

Nursing Case Study for Hepatitis

Nursing Case Study for Rheumatic Heart Disease

Nursing Case Study for Type 1 Diabetes

Nutrition (Diet) in Disease

Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)

Peptic Ulcer Disease Case Study (60 min)

Performing Cardiac (Heart) Monitoring

Pericardial Tamponade for Certified Emergency Nursing (CEN)

Phenobarbital (Luminal) Nursing Considerations

Pleural Effusion for Certified Emergency Nursing (CEN)

Post-Anesthesia Recovery

Premature Ventricular Contraction (PVC)

Product Evaluation and Selection for Certified Perioperative Nurse (CNOR)

Protein in Urine Lab Values

Pulmonary Embolus for Certified Emergency Nursing (CEN)

Renal Failure for Certified Emergency Nursing (CEN)

Renal Failure- Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD) for Progressive Care Certified Nurse (PCCN)

Respiratory Trauma for Certified Emergency Nursing (CEN)

Seizure Disorders for Certified Emergency Nursing (CEN)

Septic Shock (Sepsis) Case Study (45 min)

Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)

Sinus Bradycardia

Sinus Tachycardia

Specialty Diets (Nutrition)

Stroke Case Study (45 min)

Stroke for Certified Emergency Nursing (CEN)

Stroke for Progressive Care Certified Nurse (PCCN)

Stroke Therapeutic Management (CVA)

Supraventricular Tachycardia (SVT)

Sympatholytics (Alpha & Beta Blockers)

Thyroxine (T4) Lab Values

Toxicity Sepsis- Signs and Symptoms Nursing Mnemonic (The 6 T’s)

Transient Ischemic Attack (TIA) for Certified Emergency Nursing (CEN)

Triiodothyronine (T3) Lab Values

Troponin I (cTNL) Lab Values

Valvular Heart Disease for Progressive Care Certified Nurse (PCCN)

Ventilator Settings

Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)

Ventricular Fibrillation (V Fib)

Wound Bleeding (Uncontrolled External Hemorrhage) for Certified Emergency Nursing (CEN)

02.02 Cardiomyopathy for CCRN Review

Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)

AIDS Case Study (45 min)

Airway Suctioning

Anemia for Progressive Care Certified Nurse (PCCN)

Anesthetic Agents

Anesthetic Agents

ARDS Case Study (60 min)

ARDS causes Nursing Mnemonic (GUT PASS)

Artificial Airways

Aspiration for Certified Emergency Nursing (CEN)

Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)

Asthma for Certified Emergency Nursing (CEN)

AVPU Mnemonic (The AVPU Scale)

Carbon Dioxide (Co2) Lab Values

Chest Tube Management

Chest Tube Management Case Study (60 min)

Chronic Obstructive Pulmonary Disease (COPD) Case Study (60 min)

Chronic Obstructive Pulmonary Disease (COPD) for Certified Emergency Nursing (CEN)

Coronavirus (COVID-19) Nursing Care and General Information

Day in the Life of a Med-surg Nurse

General Anesthesia

Heart Failure Case Study (45 min)

Heart Failure for Certified Emergency Nursing (CEN)

Infectious Diseases: Influenza for Progressive Care Certified Nurse (PCCN)

Nursing Care and Pathophysiology for Asthma

Nursing Care and Pathophysiology for Influenza (Flu)

Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)

Nursing Care and Pathophysiology of Pneumonia

Nursing Care Plan (NCP) for Acute Bronchitis

Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome

Nursing Case Study for Pneumonia

Respiratory A&P Module Intro

Respiratory Alkalosis

Respiratory Course Introduction

Respiratory Depression (Medication-Induced, Decreased-LOC-Induced) for Progressive Care Certified Nurse (PCCN)

Respiratory Distress Syndrome for Certified Emergency Nursing (CEN)

Respiratory Failure (Acute, Chronic, Failure to Wean) for Progressive Care Certified Nurse (PCCN)

Respiratory Infections (Pneumonia) for Progressive Care Certified Nurse (PCCN)

Respiratory Infections Module Intro

Respiratory Procedures Module Intro

Respiratory Trauma for Certified Emergency Nursing (CEN)

Respiratory Trauma Module Intro

Trach Suctioning

Tuberculosis for Certified Emergency Nursing (CEN)

Vaccine-Preventable Diseases (Measles, Mumps, Pertussis, Chicken Pox, Diphtheria) for Certified Emergency Nursing (CEN)