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What does CVP reflect? CENTRAL VENOUS PRESSURE (CVP)

Right atrial pressure, right ventricular preload, and fluid status.

What is the normal CVP range?CENTRAL VENOUS PRESSURE (CVP)

Approximately 2–8 mmHg; reviewer also lists 2–6 mmHg in healthy adults.

Where is the phlebostatic axis? CENTRAL VENOUS PRESSURE (CVP)

4th intercostal space, mid-axillary line.

When should CVP be read during respiration? CENTRAL VENOUS PRESSURE (CVP)

At end-expiration.

What does CVP <2 mmHg suggest? CENTRAL VENOUS PRESSURE (CVP)

Low circulating volume, such as bleeding, dehydration, severe vomiting, shock, or sepsis.

What signs commonly accompany low CVP? CENTRAL VENOUS PRESSURE (CVP)

Tachycardia, hypotension, oliguria.

What does CVP >8 mmHg suggest? CENTRAL VENOUS PRESSURE (CVP)

Increased right-sided pressure/volume, such as fluid overload or right-sided heart failure

What other conditions can increase CVP? CENTRAL VENOUS PRESSURE (CVP)

Pulmonary hypertension, high PEEP, cardiac tamponade.

What signs commonly accompany high CVP? CENTRAL VENOUS PRESSURE (CVP)

JVD, peripheral edema, hepatomegaly.

Why is Trendelenburg used during IJ/subclavian central line insertion? CENTRAL VENOUS PRESSURE (CVP)

Engorges central veins and reduces air embolism risk.

Why is ECG monitored during central-line insertion? CENTRAL VENOUS PRESSURE (CVP)

A guidewire entering the right atrium/ventricle can cause dysrhythmias.

What should be done if the guidewire causes a dysrhythmia? CENTRAL VENOUS PRESSURE (CVP)

Withdraw it slightly until the rhythm normalizes.

Why is a chest X-ray obtained after IJ/subclavian line insertion? CENTRAL VENOUS PRESSURE (CVP)

Confirm catheter-tip position and rule out pneumothorax.

Sudden dyspnea, hypoxemia, and hypotension after central-line manipulation suggest what? CENTRAL VENOUS PRESSURE (CVP)

air embolism

Dyspnea with decreased breath sounds after central-line insertion suggests what? CENTRAL VENOUS PRESSURE (CVP)

pneumothorax

What should you NEVER do to an occluded central line? CENTRAL VENOUS PRESSURE (CVP)

force-flush it

What is the main purpose of chest physiotherapy?

Mobilize and remove retained airway secretions and improve ventilation.

What are the major techniques of CPT?

Postural drainage, percussion, vibration, deep breathing, and coughing.

What does postural drainage use to mobilize secretions? CHEST PHYSIOTHERAPY

gravity

What hand shape is used for chest percussion? CHEST PHYSIOTHERAPY

cupped hands

During what respiratory phase is vibration performed? CHEST PHYSIOTHERAPY

expiration

which lobes are drained first? CHEST PHYSIOTHERAPY

lower lobes, followed by upper lobes

Why are two coughs encouraged? CHEST PHYSIOTHERAPY

First loosens secretions; second expectorates them.

Name important contraindications to CPT.

Active hemoptysis/pulmonary hemorrhage, untreated pneumothorax, rib/chest trauma, increased ICP, unstable hemodynamics, severe osteoporosis.

What findings during CPT mean you should stop and reassess?

Worsening dyspnea, cyanosis, significant desaturation, pain, or hemoptysis.

Crackles that improve after coughing most likely indicate what? CHEST PHYSIOTHERAPY

Mobilized secretions.

What procedure is commonly used to obtain CSF? CSF ANALYSIS / LUMBAR PUNCTURE

Lumbar puncture (spinal tap).

What is normal CSF appearance? CSF ANALYSIS / LUMBAR PUNCTURE

Clear and colorless.

What is the normal CSF opening pressure in the reviewer?

Approximately 60–250 mm H₂O.

What is the normal CSF WBC count?

<5 cells/µL.

Are RBCs normally present in CSF?

no

What is normal CSF protein?

<50 mg/dL.

What lumbar spaces are commonly used for LP? CSF ANALYSIS / LUMBAR PUNCTURE

L3–L4 or L4–L5.

What positions can be used for LP?

Lateral fetal or sitting position.

Why should an infant's neck not be over-flexed during LP?

It can cause apnea.

How many CSF tubes are collected?

Four

What is Tube 1 used for in your reviewer? CSF ANALYSIS / LUMBAR PUNCTURE

cells

What is Tube 2 used for? CSF ANALYSIS / LUMBAR PUNCTURE

Chemistry

What is Tube 3 used for? CSF ANALYSIS / LUMBAR PUNCTURE

Microbiology

What is Tube 4 used for? CSF ANALYSIS / LUMBAR PUNCTURE

special tests

Blood that progressively clears from Tube 1 to Tube 4 suggests what? CSF ANALYSIS / LUMBAR PUNCTURE

traumatic tap

Blood that remains uniformly present across all four tubes suggests what?

Subarachnoid hemorrhage.

What CSF finding supports subarachnoid hemorrhage after centrifugation?

Xanthochromia

Neutrophil-predominant CSF commonly suggests what?

Bacterial meningitis.

Lymphocyte-predominant CSF may suggest what?

Viral, TB, fungal, or inflammatory disease.

Low CSF glucose may occur in what infections?

Bacterial, fungal, or TB meningitis.

What is the most common LP complication?

Post-lumbar puncture headache.

What is the classic characteristic of a post-LP headache?

Worsens when upright.

How much of the bowel does colonoscopy examine?

The entire colon, from rectum toward the cecum/terminal ileum.

How much does sigmoidoscopy examine?

Approximately the distal 60 cm of the large bowel.

Which requires the more extensive bowel preparation? COLONOSCOPY / SIGMOIDOSCOPY

Colonoscopy

Which usually requires sedation? COLONOSCOPY / SIGMOIDOSCOPY

Colonoscopy

Which usually requires little or no sedation? COLONOSCOPY / SIGMOIDOSCOPY

Sigmoidoscopy

What is the usual position for both procedures? COLONOSCOPY / SIGMOIDOSCOPY

Left lateral decubitus.

Why is air/CO₂ insufflated? COLONOSCOPY / SIGMOIDOSCOPY

To expand the colon for visualization.

What symptoms are expected afterward from insufflation? COLONOSCOPY / SIGMOIDOSCOPY

Mild bloating, gas, and cramping.

Severe abdominal pain, board-like rigidity, and fever after colonoscopy suggest what? COLONOSCOPY / SIGMOIDOSCOPY

Bowel perforation.

When can delayed post-polypectomy bleeding occur? COLONOSCOPY / SIGMOIDOSCOPY

Up to 7–14 days after the procedure.

What color should a healthy stoma be? COLOSTOMY / ENTEROSTOMY CARE

Pink to red.

What should a healthy stoma look like regarding moisture? COLOSTOMY / ENTEROSTOMY CARE

Moist and shiny.

What should normal peristomal skin look like? COLOSTOMY / ENTEROSTOMY CARE

Healthy, clean, and free of irritation.

What does a pale, bluish, or black stoma suggest? COLOSTOMY / ENTEROSTOMY CARE

Poor blood supply/tissue damage.

What can red, irritated peristomal skin indicate? COLOSTOMY / ENTEROSTOMY CARE

Leakage or an ill-fitting pouch.

No output with stomal swelling can indicate what? COLOSTOMY / ENTEROSTOMY CARE

Bowel obstruction or ileus.

Excessive watery ostomy output puts the patient at risk for what? COLOSTOMY / ENTEROSTOMY CARE

Dehydration and electrolyte imbalance.

When should the ostomy bag be emptied according to the reviewer? COLOSTOMY / ENTEROSTOMY CARE

When about ⅓ full.

Name serious stoma complications. COLOSTOMY / ENTEROSTOMY CARE

Gangrene, retraction, prolapse, parastomal hernia, mucocutaneous separation, infection, bowel obstruction

What is the main purpose of coronary angiography?

Directly visualize coronary artery narrowing/blockage and blood flow.

What contrast is used? CORONARY ANGIOGRAPHY

Iodinated contrast

What imaging technique is used? CORONARY ANGIOGRAPHY

Fluoroscopic X-ray imaging.

What are the two common arterial access sites? CORONARY ANGIOGRAPHY

Radial and femoral arteries.

What three major coronary arteries should you know?CORONARY ANGIOGRAPHY

RCA, LAD, and LCx.

What does 0% stenosis mean? CORONARY ANGIOGRAPHY

No narrowing.

What does 1–49% stenosis mean? CORONARY ANGIOGRAPHY

Mild/non-significant narrowing.

What does 50–69% stenosis mean? CORONARY ANGIOGRAPHY

Moderate narrowing.

What does 70–99% stenosis mean? CORONARY ANGIOGRAPHY

Significant/severe narrowing.

What does 100% stenosis mean? CORONARY ANGIOGRAPHY

Complete occlusion.

What left-main stenosis is considered significant/severe in the reviewer? CORONARY ANGIOGRAPHY

≥50%.

What renal labs are important before coronary angiography?

BUN and creatinine.

What must be assessed before contrast administration? CORONARY ANGIOGRAPHY

Renal function and previous contrast reactions.

What is a major nursing priority after coronary angiography?

Assess the access site and distal neurovascular circulation.

What should be monitored at the access site? CORONARY ANGIOGRAPHY

Bleeding, hematoma, and swelling.

Why is hydration encouraged afterward when allowed? CORONARY ANGIOGRAPHY

To help with contrast elimination.

What is the primary purpose of CTPA?

Detect or exclude pulmonary embolism (PE).

What does CTPA use?

CT + IV iodinated contrast.

What vessels are primarily examined? (CTPA)

Pulmonary arteries.

What is the classic CTPA finding of PE?

Intraluminal filling defect.

What does a large central filling defect suggest? (CTPA)

Significant PE.

What does RV enlargement/strain suggest in PE? (CTPA)

Increased right-heart pressure and potentially higher-risk PE.

What renal value is especially important before CTPA?

eGFR/renal function.

What eGFR level is specifically mentioned as a major concern in the reviewer? (CTPA)

<30 mL/min/1.73 m².

What position is used for CTPA?

Supine with arms raised.

What should the patient do during image acquisition? (CTPA)

Briefly hold their breath and remain still.

What sensations may occur with iodinated contrast? (CTPA)

Warm/flushed sensation and metallic taste.

What IV complication should be monitored during contrast injection? (CTPA)

Contrast extravasation

What two technologies make up a duplex scan?

B-mode ultrasound + Doppler ultrasound.

What does B-mode show? DUPLEX SCAN

Blood-vessel structure.

What does Doppler evaluate? DUPLEX SCAN

Direction and speed of blood flow.

What major venous disorder can duplex detect?

DVT

What happens to a normal deep vein when compressed?
DUPLEX SCAN

: It completely collapses.