A patient suddenly becomes unresponsive. The LPN checks for a pulse and finds none. What should the LPN do NEXT?

Begin chest compressions. Current BLS guidelines follow CAB: Compressions, Airway, Breathing. After confirming no pulse, the nurse should immediately begin chest compressions at a rate of 100-120 per minute. The AED should be applied as soon as available but compressions should not be delayed to wait for it.

A patient eating lunch suddenly clutches their throat and cannot cough or speak. What should the LPN do?

Perform abdominal thrusts (Heimlich maneuver). For a conscious adult with complete airway obstruction (cannot cough or speak), abdominal thrusts (Heimlich maneuver) are the intervention. Back blows are used for infants. Finger sweeps are only performed if an object is visible in the mouth of an unconscious victim.

A patient receiving an IV antibiotic develops hives, facial swelling, and difficulty breathing. The LPN should FIRST:

Stop the IV infusion and call for help. This patient is experiencing anaphylaxis. The immediate priority is to stop the allergen exposure (stop the IV) and call for emergency help. Epinephrine, not diphenhydramine, is the priority medication for anaphylaxis. Documentation occurs after the emergency is managed.

3.2 Emergency Response Procedures | NCLEX-PN (Practical Nurse) | Free Exam Prep

Emergency Response Procedures

LPN/LVNs must be prepared to respond to medical emergencies. Knowing what to do in the first minutes of an emergency can save lives.

Recognizing Emergencies

Signs of a Medical Emergency:

System	Emergency Signs
Airway	Stridor, complete obstruction, cyanosis
Breathing	Apnea, severe respiratory distress, gasping
Circulation	No pulse, severe bleeding, shock
Neurological	Unresponsive, seizures, stroke symptoms

Basic Life Support (BLS) for Adults

CAB: Compressions, Airway, Breathing

Step	Action
1	Check responsiveness - Tap and shout
2	Call for help - Activate emergency response, get AED
3	Check pulse - Carotid, no more than 10 seconds
4	Begin compressions - If no pulse
5	Open airway - Head tilt/chin lift
6	Give breaths - If trained, 30:2 ratio
7	Use AED - As soon as available

Compression Guidelines:

Element	Adult	Child (1-puberty)	Infant
Depth	At least 2 inches	About 2 inches	About 1.5 inches
Rate	100-120/min	100-120/min	100-120/min
Method	Two hands, heel	One or two hands	Two fingers
Ratio (1 rescuer)	30:2	30:2	30:2
Ratio (2 rescuers)	30:2	15:2	15:2

Choking (Foreign Body Airway Obstruction)

Conscious Adult/Child:

Sign	Intervention
Can cough, speak	Encourage coughing, don't interfere
Cannot cough/speak, clutching throat	Abdominal thrusts (Heimlich)

Abdominal Thrusts:

Stand behind the patient
Place fist above navel, below xiphoid
Grasp fist with other hand
Quick upward thrusts
Repeat until object expelled or patient unconscious

Unconscious Victim:

Begin CPR
Check mouth for visible objects before breaths
Remove only if visible

Infant Choking:

Five back blows (between shoulder blades)
Five chest thrusts (same as CPR compression location)
Repeat until object expelled or infant unconscious

Anaphylaxis

Anaphylaxis is a severe, life-threatening allergic reaction.

Signs and Symptoms:

Difficulty breathing, wheezing, stridor
Swelling of face, lips, tongue, throat
Hives, itching, flushing
Hypotension, rapid weak pulse
Anxiety, sense of doom

Emergency Response:

Priority	Action
1	Call for help, activate emergency response
2	Stop exposure to allergen if possible
3	Administer epinephrine (if ordered/available)
4	Position supine with legs elevated (if no respiratory distress)
5	Maintain airway, prepare for intubation
6	Start IV access, prepare for fluid resuscitation

Shock

Types of Shock:

Type	Cause	Signs
Hypovolemic	Blood/fluid loss	Tachycardia, hypotension, cool skin
Cardiogenic	Heart failure	Jugular distension, pulmonary edema
Septic	Infection	Fever, warm flushed skin (early), hypotension
Anaphylactic	Allergic reaction	Hives, angioedema, bronchospasm
Neurogenic	Spinal injury	Bradycardia, hypotension, warm dry skin

General Shock Management:

Call for help
Position supine with legs elevated (unless contraindicated)
Maintain airway
Administer oxygen
Establish IV access
Keep patient warm
Monitor vital signs frequently

Stroke Recognition: FAST

Letter	Assessment
F - Face	Ask to smile - is one side drooping?
A - Arms	Ask to raise both arms - does one drift down?
S - Speech	Ask to repeat a sentence - is speech slurred?
T - Time	Note time of symptom onset, call emergency

Time is critical. "Time is brain" - every minute of stroke equals more brain tissue lost.

Cardiac Emergency: Chest Pain

Assessment of Chest Pain:

Factor	Questions
Onset	When did it start? Sudden or gradual?
Provocation	What makes it better or worse?
Quality	Describe the pain (crushing, sharp, burning)
Region/Radiation	Where is it? Does it radiate?
Severity	Rate on 0-10 scale
Timing	Constant or intermittent? How long?

Nursing Actions for Chest Pain:

Stay with patient, remain calm
Call for help
Position in semi-Fowler's
Administer oxygen if ordered/available
Obtain vital signs, continuous monitoring
Prepare for 12-lead ECG
Administer nitroglycerin/aspirin if ordered

Emergency Equipment

Know the location of:

Crash cart/code cart
AED (Automated External Defibrillator)
Emergency medications
Suction equipment
Oxygen and airway supplies
Fire extinguishers

On the NCLEX-PN

Expect questions about:

BLS procedures and compression rates
Choking interventions by patient type
Recognition of medical emergencies
Priority actions in emergency situations

NCLEX-PN

1Introduction to the NCLEX-PN

2Chapter 2: Coordinated Care

3Chapter 3: Safety and Infection Prevention and Control

4Chapter 4: Health Promotion and Maintenance

5Chapter 5: Psychosocial Integrity

6Basic Care and Comfort

7Pharmacological and Parenteral Therapies

8Reduction of Risk Potential

9Physiological Adaptation

Key Takeaways