CNA Emergency Nursing (ENC(C)) flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Emergency Severity Index

A five-level triage scale that assigns level 1 for immediate life-saving intervention and levels 3 to 5 by counting the number of resources needed.

Shock index

Heart rate divided by systolic blood pressure. A value above 0.9 suggests occult hypoperfusion and should prompt escalation even when blood pressure appears normal.

Glasgow Coma Scale

A 3 to 15 point score summing eye, verbal, and motor responses. A total of 8 or less indicates severe impairment and need to secure the airway.

Primary survey

The initial trauma assessment sequence: airway with cervical spine protection, breathing, circulation with hemorrhage control, disability, and exposure with temperature control.

High-quality CPR parameters

Compressions at 100 to 120 per minute, 5 to 6 cm deep, with full recoil, interruptions under 10 seconds, and a 30:2 ratio before an advanced airway.

Defibrillation for pulseless VT

An unsynchronized shock delivered as soon as available for ventricular fibrillation or pulseless ventricular tachycardia, followed immediately by resumed compressions.

Reversible arrest causes

The Hs and Ts: hypovolemia, hypoxia, hydrogen ion, hypo or hyperkalemia, hypothermia, tension pneumothorax, tamponade, toxins, and thrombosis.

STEMI reperfusion times

Door-to-balloon goal is 90 minutes for primary PCI. When fibrinolysis is chosen, door-to-needle time should be 30 minutes or less.

Tension pneumothorax signs

Unilateral absent breath sounds, tracheal deviation away from the affected side, distended neck veins, and hypotension. Needle decompression is performed before imaging.

Status asthmaticus treatment

Inhaled short-acting beta agonist with ipratropium, early systemic corticosteroids, and intravenous magnesium sulfate for severe or refractory exacerbations.

Noninvasive ventilation indications

Positive pressure ventilation without intubation, indicated for COPD exacerbation with pH below 7.35 and cardiogenic pulmonary edema with respiratory distress.

Massive hemoptysis

Coughing more than 600 mL of blood in 24 hours. Priorities are airway protection, positioning the bleeding side down, and securing a definitive airway.

Stroke thrombolysis window

Intravenous alteplase may be given up to 4.5 hours from last known well. Door-to-needle goal is 60 minutes or less.

Alteplase stroke dosing

0.9 mg per kg up to a maximum of 90 mg. Ten percent is given as a bolus and the remainder infused over 60 minutes.

Cushing triad

A late sign of increased intracranial pressure: hypertension with widened pulse pressure, bradycardia, and irregular respirations, often with declining consciousness.

Status epilepticus

A seizure lasting more than 5 minutes or repeated seizures without recovery. First-line treatment is a benzodiazepine, followed by a second-line antiepileptic.

Hemorrhagic shock classes

Class I up to 15 percent loss, class II 15 to 30 percent with tachycardia, class III 30 to 40 percent with hypotension, class IV above 40 percent with profound instability.

Compartment syndrome signs

Pain out of proportion, pain on passive stretch, paresthesia, pallor, and paralysis. Pulselessness is a late finding. Pressure above 30 mmHg warrants fasciotomy.

Massive transfusion protocol

A balanced resuscitation strategy using approximately 1:1:1 packed red cells, plasma, and platelets, with tranexamic acid given within 3 hours of injury.

Fat embolism syndrome

Occurs 24 to 72 hours after long bone fracture and presents with hypoxemia, petechiae, and confusion. Treatment is supportive with oxygen and stabilization.

Diabetic ketoacidosis criteria

Glucose above 250 mg/dL, pH below 7.30, bicarbonate below 18 mEq/L, and ketonemia. Treatment is isotonic fluids, insulin infusion, and potassium replacement.

Hyperosmolar hyperglycemic state

Glucose above 600 mg/dL with serum osmolality above 320 mOsm/kg and minimal ketosis. Fluid deficits may exceed 8 liters and require aggressive isotonic resuscitation.

Sepsis bundle elements

Measure lactate, obtain blood cultures before antibiotics, give broad-spectrum antibiotics, and provide 30 mL/kg crystalloid for hypotension or lactate of 4 mmol/L or greater.

Hyperkalemia with ECG changes

Treated with intravenous calcium for membrane stabilization, followed by insulin with glucose, a beta agonist, and dialysis for refractory cases.

Postpartum hemorrhage

Blood loss above 500 mL after vaginal delivery or 1000 mL after cesarean. Uterine atony is the most common cause and is treated with massage and uterotonics.

Eclampsia magnesium dosing

Loading dose of 4 to 6 g intravenous magnesium sulfate, then 1 to 2 g per hour. Monitor deep tendon reflexes, respiratory rate, and urine output for toxicity.

Pediatric hypotension threshold

Systolic pressure below 70 plus twice the age in years for children aged 1 to 10. Hypotension is a late sign of shock in children.

Anticholinergic toxidrome

Dry flushed skin, dilated pupils, tachycardia, urinary retention, decreased bowel sounds, and delirium. Findings are summed up as dry as a bone and mad as a hatter.

Acetaminophen antidote

N-acetylcysteine. The Rumack-Matthew nomogram guides treatment using a serum level drawn 4 or more hours after ingestion.

Heat stroke cooling

Core temperature above 40 degrees Celsius with altered mentation. Cold water immersion is the preferred rapid cooling method, with supportive airway and circulation management.

EMTALA obligations

Requires a medical screening examination and stabilizing treatment regardless of ability to pay, with transfer only after stabilization or a certified appropriate transfer.

Forensic chain of evidence

Documented sequence of custody for specimens or belongings: labeling, sealed packaging, recorded transfers, and secure storage to preserve admissibility.