CCRN

CCRN Subarachnoid Hemorrhage Overview

Pathophysiology

A subarachnoid hemorrhage is bleeding into the subarachnoid space.  The subarachnoid space is the area between the arachnoid membrane and the pia mater surrounding the brain.  This may occur spontaneously, usually from a ruptured cerebral aneurysm, or may result from head injury. SAH is form of stroke and comprises 1 - 7% of all strokes.  It is a medical emergency and can lead to death or severe disability, even when recognized and treated at an early stage.  Up to half of all cases of SAH are fatal and 10 - 15 percent of casualities die before reaching a hospital, and those who survive often have neurological or cognitive impairment.

Signs and Symptoms

• Severe Headache
• Vomiting
• Confusion
• Altered LOC
• Seizures
• Neck stiffness
• Sensitivity to light
• Decreased vision
• Coma

Causes

• Most cases are d/t trauma
• Rupture of cerebral aneurysm
• Use of blood thinners
• Disorders of blood vessels (AV malformations)

Diagnosis

• Medical history
• Physical examination
• CT scan of Head without contrast
• MRI of the brain
• Lumbar puncture
• Cerebral angiography
• ECG changes

Classification

• Grade 1:  Asymptomatic or minimal headache and slight neck stiffness; 70% survival
• Grade 2:  Moderate to severe headache; neck stiffness; no neurologic deficit cranial nerve palsy; 60% survival
• Grade 3:  Drowsy, minimal neurologic deficit; 50% survival
• Grade 4:  Stuporous; moderate to severe hemiparesis; possible early decerebrate rigidity and vegetative disturbances; 20% survival
• Grade 5:  Deep coma; decerebrate rigidity; moribund; 10% survival

Treatment

Management involves general measures to stabilize the patient while also using specific investigations and treatments.  These include the prevention of rebleeding by obliterating the bleeding source, prevention of a phenomenon known as vasospasm, and prevention and treatment of complications. Stabilizing the patient is first priority.  Those with a depressed LOC may need to be intubated and mechanically ventilated.  Monitor VS and LOC. Neurosurgeon consult for possible ventricular drain placement. Prevention of rebleeding and vasospasm  

CCRN - Why Choose a Specific Nursing Specialty?

The healthcare industry is constantly growing and in some respects, that means it is becoming more complex. For this reason, more and more nursing students are deciding to focus their efforts on a specific area of nursing. Choosing a particular area to specialize, such as the ICU (CCRN), grants a nurse greater job security, more career satisfaction, and in some cases an increased chance of salary. There are many factors to consider in order to truly determine the field of study that is best for you. Here is what you should factor in when picking a field.

Aspects to Consider When Picking Your Nursing Specialty

Many factors should be considered when choosing you are picking your nursing field but the most important is your personality. Every specialty comes with its own pace and you need to decide on one that best fits your personality type. For example, if you do not buckle under pressure then nursing in the emergency room or trauma center can be a great fit for your personality type. Being in a field that allows your best traits to shine can lead to promotions. Job position is another factor you should keep in mind. An executive decision is perfect if you are comfortable in a leadership position then a field where you are allowed to grow. . Alternatively, there are nursing specialties that allow you to solely work with patients or alone in a clinical environment. It all depends again, on your personality and tasks you are comfortable with. While each specialty has their own set of pressures, this should not be a discouragement as you will come to be an expert in your field after you have gained the experience. Remember than nursing does not always mean that you have to work in a hospital setting either. When you research nursing specialties, you will find that nurses also work in non-hospital settings including schools, public health departments, research labs, and more. If you decide on a typical hospital setting, it is still important that you consider an alternative setting before making a concrete decision. Even a clinical specialty comes with their own unique set of demands and overall environment but with higher demands comes a set of perks. One that you will see in your bank account. Stated before, there are certain positions that can offer a better salary or at least a chance to earn it. As with any job, an increase of salary typically comes with more responsibility such as an executive position. If you are one of those individuals who is not interested in a leadership position then there are other options for you. You are not bound to run a department if you do not want to. Clinical specialty is also in-demand but also has a high salary potential. Keep in mind that a high salary always means higher demands, after a while this should not be a problem as you will be a pro in your respected field.

Sample CCRN Questions

It is a good rule of thumb to consider these factors prior to starting your nursing studies. As any nurse knows, the first hurdle to completing your dream is completing your schooling. That is another pressure that is all of its own. That does not mean you have to be discouraged by it. At Elite Reviews, we provide resources for nursing students that make it easier to achieve their goals. We have online sources that offer reviews and samples questions for important tests like the CCRN. For additional information about our packages, peruse our site here. If you are interested in some of the courses we offer, click on the links below for more information....  

 

CCRN Exam Questions

CCRN Certification Overview

The CCRN certification was introduced in 1976 for registered nurses providing direct care to patients in the critical care setting.  Nurses interested in this certification may work in any of the following areas such as ICU, CCU, Trauma units, and/or critical care transport/flight.  In order to be successful on the CCRN Exam, you must dedicate some time to studying on a daily basis.  In times past, the most beneficial has been to find a really good review course that offers at least 1500 to 2000 CCRN Exam Practice Questions and detailed overview of content.

CCRN Questions

The CCRN Exam is a 3 hour test that contains 150 test items.  125 items are scored and 25 are used to gather statistical data on item performance for future exams (AACN.org).  The items are based on the AACN Synergy Model for Patient Care, with 80% focusing on clinical judgment and 20% focusing on Professional Caring and ethical practice.   In order to be successful on your first attempt, you must score greater than a 70% on the exam.  If you want to be successful on your first attempt, you must answer at least 2000+ CCRN style exam questions prior to test day with an 85% or greater.  We have designed several courses that we feel will aid in your studies.  Some of the courses that we have to offer are listed below…

CCRN Test Plan

The content of the CCRN Exams is described in the test plans on AACN.org.  Candidates are tested on a variety of patient care problems that are organized under major categories.  Listed below is a detailed list of the content areas. Cardiovascular (20%) Pulmonary (18%) Neurology (12%) Multisystem (8%) Gastrointestinal (6%) Renal (6%) Endocrine (5%) Behavioral/Psychosocial (4%) Hematology/Immunology (2%) Professional Caring/Ethical Practice (20%)

CCRN Cardiovascular Sample Question

Listed below is an example of a CCRN Exam Practice Question that will be included in one of our review courses. 1)  A patient is admitted with complaints of chest pain accompanied by nausea and vomiting. The skin is cool and clammy. The following are noted: VS: BP 136/87, HR 125, RR 24; CVP 10 mm Hg; PCWP 20 mm Hg; CO 3.5 L/min; CI 2.1 L/min; S3 Heart sound; 12-lead ECG shows acute changes in I, aVL, V5, and V6. The goals of therapy for this patient would include which of the following A)  Decrease preload and afterload B)  Increase preload and afterload C)  Increase contractility and preload D)  Decrease contractility and afterload Answer:  Correct Response is A Rationale:  These findings are consistent with lateral wall MI, significantly decreasing LV function by decreasing preload, strain on the LV wall will be decreased.  In addition, decreasing the afterload will also allow the LV to pump more effectively.  Both of these goals are important for this patient.   

CCRN Certification Course

Passing the CCRN Certification Exam can be a very tough process. Because of this tough process, we set out to design a course that can be done all online in the comfort of your home. Our CCRN Certification Review Course contains the most up-to-date guidelines as reflected on the most recent test blueprint by AACN.org. Each and every time AACN makes changes to the CCRN Exam course outline, we immediately update the course content to reflect those changes. Lecture Content The Lecture content that we have included in our CCRN Certification Course includes all of the topics needed to master this exam. We have taken all of the testable content that the AACN states that will be included on the CCRN Certification Exam and included those topics in this review course. The topics that will be included in this online review are: • Gastrointestinal, Endocrine, Renal • Hematology, Multisystem, Behavioral • Psychology, Pharmacology, Neurology • Cardiovascular, Pulmonary, ECG/Pacemakers • Hemodynamic Monitoring Multiple Choice Questions This is by far the most in-depth CCRN Certification Course on the market. Not only have we included all of the testable subject areas in this course; we have also included a substantial amount of CCRN Exam-style multiple choice questions as well. We have embedded well over 2000 multiple choice questions within this course. You will have the option to study any of the exams by subject areas and multisystem. You will also have the option to repeat any of the exams as well. We really want you to pass your board certification exam on the first attempt. We are committed to helping you succeed. Listed below is a detailed list of the many ways to contact us. Please feel free to contact us or just go the website (EliteReviews.net) for further details.