CEN flashcards

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

Beck triad

Cardiac tamponade triad of hypotension, distended neck veins, and muffled heart sounds, often accompanied by pulsus paradoxus and clear lungs on auscultation.

Nitroglycerin contraindications

Withhold nitrates in suspected right ventricular infarction, systolic BP below 90 mmHg, and within 24 hours of sildenafil or 48 hours of tadalafil use.

Adenosine dosing for SVT

Give 6 mg rapid IV push with a saline flush, then 12 mg if unresolved; contraindicated in asthma and pre-excited atrial fibrillation because it can accelerate the ventricular rate.

Status asthmaticus silent chest

Absence of wheezing during a severe asthma attack signals critically low airflow and imminent respiratory failure, requiring immediate epinephrine, magnesium, and preparation for intubation.

Tension pneumothorax signs

Unilateral absent breath sounds with hyperresonance, hypotension, distended neck veins, and tracheal deviation away from the affected side; treat with immediate needle decompression before imaging.

COPD oxygen target

In chronic obstructive pulmonary disease with suspected carbon dioxide retention, titrate oxygen to a saturation of 88 to 92 percent while monitoring mental status and ventilation.

Cushing triad

Hypertension with widened pulse pressure, bradycardia, and irregular respirations indicate rising intracranial pressure and impending herniation from a space-occupying intracranial lesion.

Cerebral perfusion pressure formula

Cerebral perfusion pressure equals mean arterial pressure minus intracranial pressure; normal intracranial pressure is 5 to 15 mmHg and a perfusion pressure of 60 to 80 mmHg is targeted.

tPA blood pressure limit

Before giving alteplase for acute ischemic stroke, blood pressure must be below 185 systolic and 110 diastolic; sustained higher readings disqualify the patient from thrombolysis.

Permissive hypotension in trauma

In hemorrhagic shock from trauma, target a systolic pressure near 90 mmHg until bleeding is controlled, avoiding aggressive crystalloid that dilutes clotting factors and worsens coagulopathy.

Tourniquet application rule

Place 2 to 3 inches proximal to the wound, never directly over a joint, tighten until bleeding stops, and document the application time on the patient or dressing.

Neurogenic shock features

Cervical or high thoracic cord injury causes hypotension with bradycardia and warm, dry skin from loss of sympathetic tone, treated with fluids, vasopressors, and atropine if needed.

DKA potassium before insulin

If serum potassium is below 3.3 mEq/L, hold insulin and give potassium first, because insulin drives potassium intracellularly and can precipitate fatal dysrhythmias.

Anaphylaxis epinephrine dose

Give epinephrine 0.3 to 0.5 mg intramuscularly of the 1:1000 concentration into the anterolateral thigh, repeating every 5 to 15 minutes as needed.

Sepsis fluid bolus

For sepsis-induced hypoperfusion, give 30 mL/kg of crystalloid within the first three hours, along with broad-spectrum antibiotics and an initial lactate measurement.

Cholinergic toxidrome

Salivation, lacrimation, urination, diarrhea, gastrointestinal cramping, and emesis plus bradycardia, bronchorrhea, and miosis; treat with atropine and pralidoxime.

Carbon monoxide poisoning

Pulse oximetry reads falsely normal, carboxyhemoglobin confirms exposure, and 100 percent oxygen is given, with hyperbaric therapy for severe symptoms or pregnancy.

Acetaminophen antidote timing

N-acetylcysteine is the antidote; risk is plotted on the Rumack-Matthew nomogram using a serum level drawn at least four hours after ingestion.

Upper GI bleed signs

Hematemesis and melena suggest bleeding above the ligament of Treitz, whereas hematochezia usually indicates a lower source with more rapid intestinal transit time.

Pancreatitis hallmark

Severe epigastric pain radiating to the back with elevated lipase; treatment is nothing by mouth, aggressive isotonic fluids, and analgesia, with ERCP for gallstone obstruction.

Bowel obstruction findings

Colicky abdominal pain, vomiting, distension, and high-pitched then absent bowel sounds; insert a nasogastric tube, give fluids, and monitor for strangulation and perforation.

Ectopic pregnancy triad

Amenorrhea, unilateral lower abdominal pain, and vaginal bleeding, often with a positive pregnancy test but no intrauterine gestational sac on ultrasound; rupture causes shock.

Magnesium sulfate toxicity

Loss of deep tendon reflexes, respiratory depression, and oliguria signal magnesium toxicity during preeclampsia treatment; stop the infusion and give calcium gluconate as the antidote.

Placenta previa examination

Painless bright red vaginal bleeding after 20 weeks with a soft uterus; avoid digital or speculum examination until ultrasound locates the placenta.

Compartment syndrome hallmark

Pain out of proportion to injury, worsened by passive stretch, is the earliest sign; pallor, pulselessness, and paralysis appear late, and treatment is urgent fasciotomy.

Hip fracture presentation

The affected leg is shortened and externally rotated after a fall; immobilize, assess distal pulses, and provide analgesia while awaiting radiographs.

Wound irrigation pressure

Irrigate contaminated wounds with sterile saline at 8 to 12 psi, which removes bacteria and debris without driving contaminants deeper into tissue.

Alcohol withdrawal timeline

Symptoms begin 6 to 24 hours after the last drink, withdrawal seizures occur at 12 to 48 hours, and delirium tremens peaks at 48 to 96 hours with fever and hallucinations.

Restraint monitoring

Assess circulation, skin integrity, and patient needs every 15 minutes, obtain a time-limited physician order, and document ongoing indication and attempts at less restrictive measures.

Suicide risk assessment

Ask directly about suicidal ideation, plan, intent, and access to means; implement one-to-one observation and remove ligature and sharp items for high-risk patients.

SBAR handoff

A structured communication format reporting situation, background, assessment, and recommendation, reducing omissions during handoffs and transfers of care between providers.

Two patient identifiers

Verify identity using two independent identifiers, such as name and date of birth, before medication administration, procedures, transfusion, and specimen labeling.