Adult Exam 3: Breakdown/Focus Areas

**she is still making the test, so this is not everything but what she remembered so
far!
Test 50 Questions, 75 minutes
-25 questions (shock/hemodynamics) MAINLY FOCUS!
-25 questions (dermatology, burns, end of life/triage)
-5 to 10 select all that apply

Chapter 61: know a basic overview

-difference between herpes types and treatments
-herpes zoster: follow a single nerve route/dermatome, biggest thing is pain control especially
once they leak, these pts will be on antiviral med
-skin cancer: they will always have surgery to remove
-Focus a lot on Psoriasis: know topical creams, phototherapy
-Parasites/Scabies: pyrethrin treatment
-Know general idea of what a cancerous cell would like look (ABCDE) question might say: there
is a 3-inch diameter mole with 3 different colors in it, what would you suggest? Answer would
be to get it checked out for potential melanoma

Chapter 62: Burns

-Understand rule of 9 and parklands formula!!
-Wound Care:
-different types of grafting: specifically, that homograft is the only permanent graft and
that autograft means you also must care for the donor site
-Silver Cream!!
-Certain areas of the body do not get dressing (head), leave fingers and toes separate from
hand/feet in their own individual wrapping
-debridement will happen, it is necessary for every burn! Don’t worry about the specific
type of debridement, just know that it will occur.
-Acute Phase:
-Infection prevention, pain control, and nutritional aid BIG!!!
-wear PPE, only give antibiotic if needed, watch blood glucose levels
-enteral and parenteral feedings
Adult Exam 3: Breakdown/Focus Areas
**she is still making the test, so this is not everything but what she remembered so
far!

-Emergent Phase:
-ABCs IMOPORTANT to prioritize!
-look for internal/organ damage from burns
-Carbon monoxide poisoning
**if your patient has an airway injury, they will immediately get intubated!
-Pathophysiology
-understand that they will have a decrease in cardiac output, potentially go into
hypovolemic shock, there will be swelling/edema, hyperkalemia, fluid shift, paralytic
ileus, gut slowing down so really listen to bowel sounds before feeding
-Types of burns: degrees (1-3): she is more than likely going to put a picture on the test and we
have to decide which degree it is based off the skin layer
-NOT TESTING US OVER ZONES!!!

Chapter 14: Hemodynamics / Shock (BIG FOCUS AREA)

-If you can have the preload/afterload chart memorized it will help you tremendously!!
-if SVR is increased—what medication would you give?
-know manifestations for each type!
-SVO2, understand that if it says 95% that is not good!!
-Know 4 stages of shock! Do not worry too much about 1 and 4 but focus on 2 and 3
-2nd stage: Compensatory (tissue organ) so we will see SNS, HR, etc. be affected
-3rd stage: Deep cellular changes
-Maybe one question on the 3 different lines we use to monitor BP
-Understand that with septic, neurogenic, and hypovolemic shock we will give fluid in all! But
the amount and when we give it would differ
-Medications!! Be careful dopamine and dobutamine sound similar!!
-Know specific manifestations for each shock!
-cardiogenic: fluid overload
-septic: high fever, WBCs, possible DIC
Adult Exam 3: Breakdown/Focus Areas
**she is still making the test, so this is not everything but what she remembered so
far!

-Recognize that hemodynamically hypovolemic and cardiogenic shock is similar, the only
difference is preload!
-Hypovolemic: preload decreased
-Cardiogenic: preload increased
-Know your treatments, causes, and manifestations!!! (she kept repeating this!!!)
-Recognize neurogenic is the only shock with decreased HR
-Be able to read a hemodynamic then select which shock it is and then how to treat it!
Hemodynamic  Which shock?  Treatment?

**The content we are covering tomorrow 06/12 is very light and easy to understand, mainly
review! All end of life stuff and triaging.