PCCN (Adult) flashcards

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

Mean arterial pressure formula

MAP equals diastolic pressure plus one-third of the pulse pressure; an alternate formula is (SBP + 2DBP) divided by 3.

Normal cardiac index

Cardiac index is cardiac output divided by body surface area; the normal adult range is about 2.5 to 4.0 L/min/m².

Stroke volume formula

Stroke volume equals end-diastolic volume minus end-systolic volume; normal resting stroke volume is roughly 60 to 100 mL per beat.

Sepsis-3 clinical criteria

Sepsis is suspected infection plus an acute increase in SOFA score of at least 2 points; it indicates life-threatening organ dysfunction.

Septic shock criteria

Septic shock is sepsis with persistent hypotension requiring vasopressors to maintain MAP at least 65 mmHg and lactate above 2 mmol/L despite adequate fluid resuscitation.

STEMI contiguous leads

ST elevation in two or more anatomically contiguous leads suggests acute STEMI; obtain a 12-lead ECG within 10 minutes of arrival and activate reperfusion.

Posterior MI clues

Posterior myocardial infarction may show ST depression, tall R waves, and upright T waves in leads V1 through V3; obtain posterior leads.

Ventilator plateau pressure

Plateau pressure reflects alveolar pressure and should generally be kept at or below 30 cm H2O to reduce barotrauma risk.

Driving pressure formula

Driving pressure equals plateau pressure minus positive end-expiratory pressure; elevated driving pressure is associated with ventilator-induced lung injury.

Hypoglycemia treatment

For blood glucose below 70 mg/dL in a conscious patient, give 15 to 20 g fast-acting carbohydrate and recheck in 15 minutes.

Hyperkalemia ECG changes

Hyperkalemia may cause peaked T waves, PR prolongation, QRS widening, and a sine-wave pattern; give intravenous calcium first when ECG changes are present.

Stroke thrombolysis window

Intravenous thrombolysis for ischemic stroke is generally given within 4.5 hours of last known well; blood pressure must be below 185/110 mmHg.

AKI urine output criterion

Acute kidney injury includes urine output less than 0.5 mL/kg/hour for at least 6 hours or a creatinine rise of at least 0.3 mg/dL within 48 hours.

Normal central venous pressure

Central venous pressure normally ranges about 2 to 8 mmHg; trends and physical assessment matter more than a single value.

PEEP definition

Positive end-expiratory pressure keeps alveoli open at end expiration, improving oxygenation and reducing atelectasis; it can decrease venous return and cardiac output.

Pulsus paradoxus threshold

Pulsus paradoxus is an inspiratory systolic blood pressure drop greater than 10 mmHg; it can occur in cardiac tamponade and severe asthma.

Glasgow Coma Scale range

The Glasgow Coma Scale totals eye, verbal, and motor scores from 3 to 15; a score of 8 or less generally indicates severe neurologic depression.

CAM-ICU purpose

The CAM-ICU is a validated tool to screen for delirium in critically ill patients; it assesses acute change, inattention, altered consciousness, and disorganized thinking.

DKA initial fluid

Diabetic ketoacidosis begins with isotonic intravenous fluid resuscitation; insulin infusion follows after potassium is checked and adequate fluids are started.

Transfusion reaction first action

If a transfusion reaction is suspected, stop the transfusion immediately, keep the intravenous line patent with normal saline, and notify the provider and blood bank.

Informed consent elements

Valid informed consent requires patient capacity, adequate disclosure, comprehension, and voluntariness; the provider obtains consent and the nurse may witness the signature.

Competent patient refusal

A competent adult may refuse treatment even if refusal risks death; document the refusal, notify the provider, and ensure the patient is informed.

HIPAA minimum necessary

HIPAA requires sharing only the minimum protected health information needed for treatment, payment, or operations; disclose to others only as permitted or required.

Mandatory abuse reporting

Nurses must report suspected abuse, neglect, or exploitation to designated authorities under state law and facility policy, regardless of patient wishes.

Delegation accountability

The registered nurse retains accountability for delegated tasks; delegation requires the right task, circumstance, person, direction, supervision, and evaluation.

Autonomy principle

Autonomy is respecting a patient's right to make informed decisions about care, including accepting or refusing recommended treatments.

Beneficence principle

Beneficence means acting to promote the patient's good, such as providing effective treatment and comfort while weighing benefits and risks.

Nonmaleficence principle

Nonmaleficence means avoiding harm; it requires weighing interventions so that intended benefit outweighs potential injury or suffering.

Justice principle

Justice means fair distribution of healthcare resources and equal treatment of patients regardless of background, diagnosis, or ability to pay.

Advance directive purpose

An advance directive documents a patient's healthcare wishes or appoints a surrogate decision maker for use if the patient loses decision-making capacity.

Chain of command use

Use the chain of command when a provider is unavailable or an order seems unsafe; notify the charge nurse or supervisor and document the concern.

DNR order clarification

A do-not-resuscitate order addresses cardiopulmonary resuscitation only; it does not automatically withhold comfort care, antibiotics, or other treatments.