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1. Evaluate key components of a quick physical assessment designed to pinpoint causes of an acute respiratory emergency.
2. Discuss immediate interventions for patients experiencing an acute respiratory emergency, including techniques for emergent airway management.
3. Analyze evidenced-based interventions for the patient with a pulmonary embolism.
4. Explain the role of the newest oral anticoagulation agents in the treatment of pulmonary embolism.
5. Differentiate between cardiac and non-cardiac pulmonary edema in terms of clinical presentation and treatment.
6. Identify complications of ARDS, including lung trauma, pneumonia, and multisystem organ failure.
7. Manage the emergent treatment of a tension pneumothorax using the current practice standards.
8. Differentiate between heart failure and COPD exacerbations to be able to implement optimal treatment strategies.
9. Analyze how ARDS pathophysiology presents related to atelectasis, compliance, oxygenation, ventilation, perfusion, and other assessment data throughout the clinical course of the disease state.
10. Demonstrate individual interventions and overall strategies to minimize the impact of ARDS pathophysiology and promote a return to homeostasis.
11. List common etiologies of ARDS pathology.
12. Recognize differing ventilator modes for patients with ARDS to get the best patient outcomes.

The Pulmonary Triad

• Oxygenation, Ventilation & Perfusion
• Math Made Easy!
  • V/Q Match vs. Mis-Match
  • Calculating Shunting
  • Oxygen Delivery DO2
  • Oxygen Consumption VO2
  • Oxyhemoglobin Dissociation Curve
  • SVO2 Monitoring
  • StO2
• Putting it All Together

Easy Steps to ABG Analysis

• Acid Base Imbalances
• The 4 Abnormal Results
• Rapid Interpretation Tool

Respiratory Assessment Clues You Should NEVER Miss!

• Common Adventitious Breath Sounds
• What are the Causes & When Are They Heard?
  • Crackles/Rales – Wet vs. Dry
  • Wheezes – Not Always Airway Obstruction
  • Rhonchi – Differentiating the Differences
  • Stridor – Emergency Treatment
  • Pleural Friction Rub
• Advanced Assessment Skills
• Transmitted Voice Sounds
• Inspection & Percussion
• Changes on the Chest X-Ray

And the Assessment Indicates…

• Bronchitis Acute vs. Chronic
• Emphysema
• Pulmonary Fibrosis
• Obstructive Sleep Apnea

Pulmonary Drug Cabinet: From A to Z

• Anti-Cholinergic Agents
• Anti-Inflammatory Drugs
• Bronchodilators
• Combo-Drugs
• Inhalers & Spacers
• And More!

Airway Management Techniques

• Managing Obstruction
• Airway Adjuncts
• Know Your Role in Intubation
• The “5-Point Check”
• Rapid Sequence Intubation

Managing Chest Tubes

• Indications for Chest Tubes
• Emergent vs. Urgent
• Avoiding Common Complications

Know the Goal: CPAP & BiPAP

• Advantages & Disadvantages
• Contraindications
• Assessing the Fit
• Determining the Settings

Mechanical Ventilation for Nurses

• Responding to the Alarms
• Management Strategies that Improve Outcomes
  • Patient Comfort
  • Decreasing Workload
  • Frequent Assessment
  • Cardiac Output Clues
  • Suctioning
• Pressure vs. Volume Control
• Advanced Modes & Ventilator Extremes
• ECMO

Complications of Mechanical Ventilation

• BaroTrauma & VoluTrauma
• Oxygen Toxicity
• Ventilator-Associated Pneumonia

Weaning Patients Off the Ventilator

• Why, When and How
• Causes of Weaning Failure
• Setting up for Success!
• ABCDE Bundle

Restrictive Lung Diseases

• Pulmonary Edema
  • Signs & Symptoms
  • Treatment
  • Systolic Dysfunction
  • Diastolic Dysfunction
• ARDS
  • Progression Mnemonic
  • Staging
  • Presentation
  • Lab Findings
  • Changes on the Chest X-Ray
  • Respiratory Support
    • Oxygen Control
    • Early Intubation
    • Exogenous Surfactant
    • Proning
    • Liquid Mechanical Ventilation

Emergency Management of Asthma

• Assessment Findings
• Identifying the Trigger
• Steroid Considerations

The Patient with Pulmonary Embolisms

• The Likely Causes
• Prevention Measures
• Signs & Symptoms
• Diagnosis & Treatment

Managing the Patient in Shock

• Critical Assessment Clues
• Interventions
• Complications
• Sepsis

Cyndi Zarbano, MSN-Ed, CCRN, CMSRN, LNC, has been a nurse for nearly 30 years specializing in intensive care. She earned her legal nurse consultant training through the Vickie Milazzo Institute in 2008 and has worked on nearly 250 cases for various boards of nursing. She has worked with attorneys on pre-corrective action and with nurses to meet consultation requirements to fulfill corrective action guidelines.

Additionally, Cyndi has worked as a legal nurse consultant responsible to analyze medical records, determine merit, assist with client interviews, attend medical appointments, locate testing experts, complete chronologies, review billing for accuracy, provide deposition/jury question development, and assist in court strategy development. Cyndi is a renowned national seminar speaker having spoken for numerous companies since 2008, including her own, Clinical Review Consultants. She works for Mayo Clinic in Minnesota continuing her passion for bedside nursing in critical care. Speaker Disclosures:
Financial: Cynthia Zarbano is the owner of Clinical Review Consultants and has an employment relationship with Mayo Mankato. She receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Cynthia Zarbano has no relevant non-financial relationships.

Save time and $10 off the price of other submission methods – purchase & take the CE test online for $19.99 USD per participant. Additional processing fees apply for other submission methods (i.e. mail, fax, etc.). Please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion are available for email, download and/or printing from your online account immediately following the successful completion of the post-test/evaluation.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Nurses/Nurse Practitioners/Clinical Nurse Specialists - Credit Expired: 12/6/2019
No CE available for this board.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 12.5 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 12.5 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 15.2 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

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Other Professions
This self-study activity qualifies for 12.5 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

Nurses, Respiratory Care Practitioners, and other Healthcare Professionals