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Preparation, Review, and Practice Exams
Second Edition
Alexander P. Johnson, MSN, RN, ACNP-BC, CCNS, CCRN
Clinical Nurse Specialist of Critical Care
Northwestern Medicine
Central DuPage Hospital
Winfield, Illinois
Hillary S. Crumlett, BSN, MS, RN, ANL
Director of Critical Care Services
Northwestern Medicine
Central DuPage Hospital
Winfield, Illinois
New York Chicago San Francisco Athens London Madrid
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Dedication
To my colleagues over the years, friends, and family (especially Angie and my
M&M boys): You have given me more than I have ever deserved.
Also, to my mentors, such as Tom Ahrens, whose guidance has helped make
opportunities such as this possible.
Alexander P. Johnson, MSN, RN, ACNP-BC, CCNS, CCRN
To Chuck, William, Henry, and Lily
You showed me an inspired world that has taught me that dreams can become reality.
To my parents, Maureen and Roger
For always believing in me more than I ever believed in myself, it has
meant everything.
Hillary S. Crumlett, BSN, MS, RN, ANL
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Contents
Reviewers ..............................................................................................................................................................................................................xi
Contributors ........................................................................................................................................................................................................xiii
Preface .................................................................................................................................................................................................................xv
Acknowledgments ..............................................................................................................................................................................................xvii
Test-Taking Tips .................................................................................................................................................................................................xix
Part I. CARDIOVASCULAR .................................................................................................................................1
1. Cardiovascular Anatomy and Physiology ......................................................................................................................3
2. Diagnosis and Treatment of Cardiovascular Disorders .............................................................................................15
3. The Normal ECG .............................................................................................................................................................25
4. The 12-Lead ECG ............................................................................................................................................................31
5. Hemodynamic Monitoring ............................................................................................................................................43
6. Acute Coronary Syndrome (Angina Pectoris and Myocardial Infarction) .............................................................53
7. Conduction Blocks .........................................................................................................................................................65
8. Heart Failure: Congestive Heart Failure, Pulmonary Edema, and Hypertensive Crisis .......................................75
9. Cardiogenic Shock .........................................................................................................................................................85
10. Hemorrhagic (Hypovolemic) Shock ............................................................................................................................89
11. Interpreting Dysrhythmias .............................................................................................................................................95
12. Cardiomyopathies and Pericarditis ..............................................................................................................................111
13. Treatment of Cardiac, Valvular, and Vascular Insufficiency and Trauma ..............................................................115
Cardiovascular Practice Exam ....................................................................................................................................................127
Part II. PULMONARY ................................................................................165
14. Pulmonary Anatomy and Physiology .........................................................................................................................167
15. Diagnosis and Treatment of Pulmonary Disorders ..................................................................................................185
16. Alternative Methods of Ventilatory Support ..............................................................................................................195
17. Acute Respiratory Dysfunction ...................................................................................................................................205
vii
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viii CONTENTS
18. Acute Pulmonary Embolism and Aspiration ..............................................................................................................215
19. Thoracic Trauma and Air-Leak Syndromes ...............................................................................................................221
Pulmonary Practice Exam ..........................................................................................................................................................231
Part III. ENDOCRINE ................................................................................247
20. Introduction to the Endocrine System ......................................................................................................................249
21. Anatomy, Physiology, and Dysfunction of the Pituitary Gland ...............................................................................253
22. Anatomy, Physiology, and Dysfunction of the Thyroid and Parathyroid Glands ................................................259
23. Anatomy, Physiology, and Dysfunction of the Pancreas .......................................................................................269
24. Anatomy, Physiology, and Dysfunction of the Adrenal Glands .............................................................................277
Endocrine Practice Exam ............................................................................................................................................................285
Part IV. IMMUNOLOGY AND HEMATOLOGY ............................................291
25. Physiology of the Immunologic and Hematologic Systems ..................................................................................293
26. Diagnosis and Treatment of Immunologic and Hematologic Problems .............................................................309
27. Hematologic and Immunologic Failure and Its Effects on Other Organ Systems ..............................................317
28. Organ Transplantation..................................................................................................................................................333
29. Life-Threatening Coagulopathies ..............................................................................................................................337
Immunology and Hematology Practice Exam .............................................................................................................................345
Part V. NEUROLOGY ................................................................................351
30. Anatomy and Physiology of the Nervous System ..................................................................................................353
31. Intracranial Pressure .....................................................................................................................................................373
32. Acute Head Injuries and Craniotomies .....................................................................................................................377
33. Stroke and Intracranial Aneurysms ............................................................................................................................385
34. The Vertebrae and Spinal Cord ...................................................................................................................................391
35. Encephalopathies and Coma ......................................................................................................................................401
36. Meningitis, Muscular Dystrophy, and Myasthenia Gravis .......................................................................................405
37. Seizures and Status Epilepticus .................................................................................................................................409
Neurology Practice Exam ............................................................................................................................................................417
Part VI. GASTROENTEROLOGY ...............................................................431
38. Anatomy and Physiology of the Gastrointestinal System ......................................................................................433
39. Gastrointestinal Hemorrhage and Esophageal Varices .........................................................................................453
40. Acute and Chronic Hepatic Failure, Cirrhosis, Hepatitis, and Acute Pancreatitis ..............................................463
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CONTENTS ix
41. Intestinal Infarction, Obstruction, Perforation, and Trauma ...................................................................................479
42. Management of the Patient with a Gastrointestinal Disturbance .........................................................................489
Gastroenterology Practice Exam ..................................................................................................................................................493
Part VII. RENAL ........................................................................................503
43. Anatomy and Physiology of the Renal System........................................................................................................505
44. Renal Regulation of Electrolytes .................................................................................................................................517
45. Diagnosis and Treatment of Kidney Injury ................................................................................................................527
Renal Practice Exam ...................................................................................................................................................................541
Part VIII. MULTIORGAN PROBLEMS ........................................................551
46. Sepsis and Multiorgan Syndrome ..............................................................................................................................553
47. Toxic Emergencies .......................................................................................................................................................559
48. Airway Obstruction .......................................................................................................................................................565
49. Burns ...............................................................................................................................................................................567
Multisystem Organ Dysfunction Practice Exam ..........................................................................................................................575
Part IX. PROFESSIONALISM, ETHICS, AND SYNERGY ............................581
50. Professional Caring and Ethical Practice ..................................................................................................................583
Synergy Practice Exam ................................................................................................................................................................587
Part X. BEHAVIOR ....................................................................................597
51. Behavioral and Psychologic Factors in Progressive Care .....................................................................................599
Behavior Practice Exam ..............................................................................................................................................................611
Index .................................................................................................................................................................................617
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