CRNE June 2012

petethecanuck · May 23, 2012

A sample size of 2 exams (June and Oct 2010) is hardly any reason to worry. We still have 2 weeks until the exam and if you have properly prepared it shouldn't matter what the pass rate was 2 years ago.

allicandoispray · May 24, 2012

thanks pete. yes i have prepared very intensively however the decline is still worrisome and troubling.

there were two questions in one of the prep guides i used and i am not agreeing with the rationale for one. i am wondering if i would be able to post them and get ideas from any of you? wondering if this would be okay...

petethecanuck · May 24, 2012

Shouldn't be a problem to post review questions. :)

allicandoispray · May 26, 2012

Mr. Del Ray is experiencing an acute exacerbation of right sided heart failure. Which of the following independent nursing actions should the nurse implement to limit spread of Mr. Del Ray's ankle edema?

1. Restricting his fluids

2. Applying elastic bandages

3. Performing range-of-motion exercises

4. Elevating his legs

petethecanuck · May 26, 2012

1

My rationale: Patients with right sided HF are susceptible to systemic fluid overload. Restricting fluid intake will help mitigate edema in the lower extremities.

- I could see how answer 4 may look like a possible option. Elevating the patients legs could promote fluid movement and help with edema (in a healthy person). The fact this patient has RIGHT sided HF eliminates #4 as a possible option because the right ventricle has a lower ejection fraction and fluid is "backing up" into the venous system (causing an increased JVP, edema etc). Raising his legs and promoting venous return could in fact exacerbate his condition.

mapleleafcn · May 27, 2012

yeah I agreeeee. weeeeeh it will be in June 6. I am studying hard right now. whew!

mapleleafcn · May 27, 2012

what is the difference between no CPR and do not resuscitate request? Any samaritan nurse out there to explain. Thanks in advance?

petethecanuck · May 27, 2012

Do not resuscitate (DNR) basically means no life saving measures will be undertaken (intubation, ACLS protocols etc) in the event of a code. Someone with a no CPR (chest compressions) order is giving consent to all life saving measures sans chest compressions.

mapleleafcn · May 29, 2012

thank you eh!

Any techniques in differentiating

Primary prevention versus secondary prevention?

Health promotion somehow, I intertwined it with primary prevention.

:nurse:

petethecanuck · May 29, 2012

Think of health promotion as enabling someone to increase control over improving their health.

There are 3 levels of prevention.

Primary: Prevention of health problems or diseases before their onset and promoting health. IE) Immunizations, wearing seat belts, bike safety classes, safe driving classes

Secondary: The earliest possible identification of disease or health problems in asymptomatic persons. IE) Screening

Tertiary: Reduce the negative impact and complications in persons who already have a disease/health problem.

mapleleafcn · May 30, 2012

I am very much confuse on this issue... Are we going to give Regular insulin before a major surgery? Why and why not?

number 2...Mosby comprehensive review book says child's first teeth are the upper central incisors then on the other page it says first to appear are lower central incisors...which is which :no:

more quick challenging issues .... what could be the CRNE's point of view when it comes to medication administration. Are we going to give them on time, I mean the exact time or thinking that we are allowed to have 30 minutes before and 30 minutes after rule?

what could be the ideal time of medication administration?

Pediatric Critical Care Columnist · May 30, 2012

I am very much confuse on this issue... Are we going to give Regular insulin before a major surgery? Why and why not?

Regular insulin is short-acting. Think about what stress does to the diabetic person's metabolism.

number 2...Mosby comprehensive review book says child's first teeth are the upper central incisors then on the other page it says first to appear are lower central incisors...which is which

That type of question is SO unlikely to appear on the CRNE. But in response, most children cut their lower central incisors first.

more quick challenging issues .... what could be the CRNE's point of view when it comes to medication administration. Are we going to give them on time, I mean the exact time or thinking that we are allowed to have 30 minutes before and 30 minutes after rule?
what could be the ideal time of medication administration?

It is absolutely impossible to give ALL medications at EXACTLY the ordered time. when you have 6 patients in 6 different rooms, all of whom have 6 medications due at 0800, it takes organization and efficiency to get all of them given within the 30-minutes-before-to-30-minutes-after window. Where I work, I only have 1 patient most of the time and it's still impossible to get all meds given at the exact time they're ordered for.