CEN "Key Points" Sample

1. Preload is end-diastolic volume. Decrease preload with diuretics, NTG, and non-invasive positive-pressure ventilation (NIPPV) in acute CHF.

2. Anticipate an order for a barium contrast enema in intussusception.

3. Patients with Ehlers Danlos are at higher risk for aortic aneurysm.

4. Neurogenic shock is classified as distributive shock and is characterized by bradycardia and hypotension.

5. Suspect a chance fracture and hollow organ injury (bowels) in lap-restraint only injury.

6. The dose of sodium bicarbonate in metabolic acidosis-induced cardiac arrest is 1 mEq/Kg.

7. A patient with a recent body piercing complains of fever and chills. If you notice splinter hemorrhages and auscultate a heart murmur, suspect endocarditis.

8. Dobutamine is a positive inotrope administered to increase contractility in heart failure.

9. Perform an Allen’s test to assess blood flow to the hand prior to radial arterial line cannulation.

10. Monitor the patient with crush injury for compartment syndrome and rhabdomyolysis.

11. Maintain systolic blood pressure (SBP) above 100 mm Hg in traumatic brain injury, and above 110 mm Hg in older adults with traumatic head injury.

12. Phentolamine (Regitine) is used in vasopressor extravasation.

13. If you suspect SCIWORA, the preferred diagnostic test is an MRI.

14. Normal ankle-brachial index (ABI) is 0.9-1.2, it is used to detect arterial occlusion.

15. Reperfusion dysrhythmias such as accelerated idioventricular rhythm (AIVR) may be seen post fibrinolytic administration for STEMI.

16. Pressure from swelling or bleeding can cause compartment syndrome, resulting in intense pain.

17. A massive pulmonary embolus is classified as obstructive shock.

18. Treat rhabdomyolysis with aggressive fluid administration to prevent acute kidney injury.

CEN References

· Emergency Nurses Association. Sheehy’s Emergency Nursing Principles and Practice, 7th ed. Elsevier, 2020.

· Emergency Nurses Association. Trauma Nursing Core Curriculum, 8th ed., 2019.