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Registered Nurse (RN)
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HESI®
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HESI®-RN Comprehensive Review
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Shock

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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid

Shock
25 Picmonics to Learn | 48 mins
Types of Shock
Hypovolemic
Depleted Volume
Cardiogenic
Pump Failure
Obstructive
Indirect Pump Failure
Distributive
Lost Vascular Tone
Neurogenic
Anaphylactic
Septic
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2 mins
Severe Sepsis and Septic Shock Assessment
Microthrombi
DIC
Decreased Oxygen Saturation
Decreased WBC
Oliguria
High Output Heart Failure
Multiple Organ Failure
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2 mins
Sepsis Assessment
Signs and Symptoms
Systemic Infectious Process
Fever
Hypotension
Change in LOC
Increased WBC
Shift to the Left
Tachycardia
Tachypnea
Hyperglycemia
Edema
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2 mins
Hypersensitivity Type I
Previous Antigen Exposure
Immediate Reaction
IgE Cross-linking
Presensitized Mast Cells
Histamine Release
Vasodilation
Anaphylaxis
Allergies
Treatment
Epinephrine
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1 min
Anaphylaxis Intervention
Intervention
Assess Airway and Oxygen Needs
Reassure Patient with Anxiety
Supine Position
Methylprednisolone (Solu-medrol)
Epinephrine
Diphenhydramine (Benadryl)
Medical Alert Bracelet
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2 mins
Pulmonary Embolism Causes
Causes
FAT BAT Mnemonic
Fat
Air
Deep Vein Thrombosis (DVT)
Bacteria
Amniotic Fluid
Tumor
Risk Factors
Hypercoagulable
Central Venous Lines
Immobilized
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1 min
Burns Considerations
Maintain Body Temperature
Increased Risk of Infection
Venous Thromboembolism (VTE) Prophylaxis
Curling's Ulcer
Excision and Grafting
Adequate Nutrition
Contractures
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2 mins
Respiratory Acidosis Assessment
Assessment
Decreased pH < 7.35
Increased PaCO2 > 45
Reduced Respirations
Anxiety
Change in LOC
Tachycardia
Cyanosis
Increased Electrolytes
ECG Changes
Muscle Weakness
Hyporeflexia
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2 mins
Respiratory Alkalosis Assessment
Assessment
Increased pH > 7.45
Decreased PaCO2 < 35 mmHg
Hyperventilation
Brainstem Stimulation
Head Injury
Shock
Lightheadedness
Tingling Lips or Fingers
Trousseau's
Chvostek's Sign
Anxiety
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2 mins
Systemic Inflammatory Response Syndrome (SIRS) Criteria
Must have 2 or more of the following:
Temperature < 36C or > 38C
Pulse > 90 beats per minute
Respirations > 20/min or PCO2 < 32
WBC < 4,000 or > 12,000 or 10% bands
Mechanism
Subset of Cytokine Storm and Related to Sepsis
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2 mins
Types of Blood Products
Types
Whole Blood
Packed Red Blood Cells
Fresh Frozen Plasma
Immunoglobulins
Clotting Factors
Albumin
Platelets
Considerations
Use within 24 Hours
Washing Removes Antibodies
Irradiation Destroys WBCs
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2 mins
IV Solutions
Hypotonic (< 280 mOsm/L)
1/4 Normal Saline (0.225% NaCl)
1/2 Normal Saline (0.45% NaCl)
Isotonic (280-300 mOsm)
Normal Saline (0.9% NaCl)
Lactated Ringer's (LR)
Dextrose 5% in Water (D5W)
Hypertonic (> 300 mOsm)
3% or 5% NaCl
Dextrose 5% in 0.45% NaCl
Dextrose 10% in Water (D10W)
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3 mins
Opioids Overview
Indications
Pain
Weaning
Cough
Diarrhea
Mechanism of Action
Agonists at Mu (μ), Kappa (Κ), and Delta (δ) Receptors
Decrease Synaptic Transmission
Side Effects
Respiratory Depression
Addiction
Miosis
Constipation
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2 mins
Nitroprusside
Mechanism of Action
Direct Release of NO
Increase cGMP
Short Half-Life
Indications
Malignant Hypertension
Side Effect
Cyanide Toxicity
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1 min
Angiotensin-Converting Enzyme (ACE) Inhibitors
"-pril" Suffix
Mechanism of Action
Block Renin Angiotensin-Aldosterone System (RAAS)
Indications
Hypertension
Heart Failure
Side Effects
Dry Non-productive Cough
Hypotension
Dizziness
Possible Hyperkalemia
Angioedema
Nursing Considerations
Slowly Change Position
Do Not Stop Abruptly
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2 mins
Angiotensin II Receptor Blockers (ARBs)
Ends in "-sartan"
Mechanism of Action
Blocks Angiotensin II Receptor
Indications
Hypertension
Side Effects
Angioedema
Contraindications
Renal Artery Stenosis
Pregnancy
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1 min
Beta Blockers
"-olol" suffix
Mechanism
Decreases Heart Rate and Contractility
Decreases Peripheral Vascular Resistance
Decreases Renin Release
Indications
Hypertension
Heart Failure
Angina Pectoris
Contraindications
Asthma and Heart Block Patients
Nursing Considerations
Assess Blood Pressure and Heart Rate
Masking Signs of Hypoglycemia
Do Not Stop Abruptly
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2 mins
Calcium Channel Blockers (Verapamil and Diltiazem)
Mechanism of Action
Slows AV Conduction
Indications
Angina Pectoris
Arrhythmias
Essential Hypertension
Side Effects
Bradycardia
Hypotension
Constipation
Peripheral Edema
Gingival Hyperplasia
Nursing Consideration
Medication Education
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2 mins
Milrinone and Amrinone
Mechanism of Action
Phosphodiesterase 3 Inhibitor
Potentiates Beta Receptor Effects
Inotrope
Vasodilator
Indication
Acute Decompensated Heart Failure
Side Effects
Ventricular Arrhythmias
Hypotension
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2 mins
Patient Position Overview
Position Techniques
Trochanter Roll
Trapeze Bar
Ankle-Foot Orthotic (AFO) Devices
Positions
Fowlers Position
Supine Position
Trendelenburg
Side-Lying Position
Prone Position
Sims' Position
Nursing Considerations
Reposition q2 Hours/Prevent Skin Breakdown
Confirm Body Alignment
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2 mins
Vital Signs - Adult
Temperature (96.8-100.4 Degrees F) (36-38 Degrees C)
Rectal
Tympanic
Oral
Axillary
Temporal
Respiration (12-20)
Oxygen Saturation (95%-100%)
Pulse (60-100)
Blood Pressure (<120/80)
Pain
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2 mins
Alveolar Gas Equation
Equation
Partial Pressure of Alveolar Oxygen (PAO2)
Partial Pressure of Oxygen in the Inspired Air (PIO2)
PIO2 Normally Approximated = 150 mmHg
Arterial Partial Pressure of CO2 (PaCO2)
Respiratory Quotient (R)
R Normally Approximated = 0.8
PAO2 = PIO2 - (PaCO2/R)
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1 min
Patient Needs
Latex Allergy Risk Factors
Allergy to Banana, Papaya, Chestnuts and Kiwi
Asthma
Spina Bifida
History of Multiple Surgical Procedures
Fall Prevention
Call Light within Reach
Eliminate Physical Hazards
Leave Items within Reach
Bed in Low Position
Side Rails Up
Test-Taking Strategies
Patient Safety
Health Promotion and Maintenance
Psychosocial Integrity
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3 mins
Blood Transfusion Administration
Proper Patient Identification
Large Bore Needle
Y Tubing
Baseline Vital Signs
Slow IV Infusion
Monitor During First 15 Minutes or 50 mL of Blood
Monitor for Reactions
Considerations
Do Not Add Anything To Same IV Line
No Dextrose or Lactated Ringers
Jehovah's Witnesses, No Transfusions
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3 mins
Transfusion Reactions
Acute Hemolytic
Febrile, Non-Hemolytic
Mild Allergic
Anaphylactic
Circulatory Overload
Sepsis Reaction
Transfusion-Related Acute Lung Injury (TRALI)
Massive Blood Transfusion
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2 mins

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