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Exam 1
Cardiac Monitoring
| Question | Answer |
|---|---|
| Diazepam | Valium |
| Lorazepam | Ativan |
| Diprivan | Propofol |
| Midazolam | Versed |
| Dexmedatomidine | Precedex |
| An altered state of consciousness, consisting of confusion, distractibility, disorientation, disordered thinking/memory, and defective perception (hallucinations) | delirium |
| A standardized evidence-based tool that enables non-psychiatrically trained clinicians to identify and recognize delirium quickly and accurately in both clinical and research settings | CAM |
| Naloxone | Narcan |
| Flumazenil | Romazicon |
| Delivery of high intensity charge to the heart that results in complete depolarization of the myocardium | defibrillation |
| What type of shock is defibrillation? | unsynchronized |
| Scale used to measure the level of sedation a pt. is experiencing | RASS |
| Drug induced depression of consciousness during which the patient responds purposefully to verbal command, either alone or accompanied by light tactile stimulation, necessary to maintain a patent airway. Good spont. ventilation and cardiovascular function | moderate sedation |
| What does SBAR stand for? | situation, background, assessment, and recommendation |
| Goal of this team is to bring critical care expertise to the patient bedside | RRT (rapid response team) |
| Name of monitor that continuously records the electrical activity of the heart for up to 48 hrs. or more. | Holter |
| Used to terminate dysrhythmias that are refractory to drugs or when an immediate conversion to improve rhythm is needed | cardioversion |
| What type of shock does a cardioversion deliver? | synchronized |
| What does the cardioversion machine sense before sending a shock? | R wave |
| Atrium or ventricle pacing | single heart chamber |
| Both atrium and ventricle pacing | double heart chamber |
| Spike following by a P wave indicates | atrial pacing |
| Spike followed by a QRS complex indicates | ventricular pacing |
| Spike followed by a P wave and a QRS wave indicates | dual chamber pacing |
| Minimally invasive procedure which tests the electrical conduction system of the heart | electrophysiology study |
| A procedure which renders a small section of heart tissue inactive by scarring or destroying tissue in the heart that triggers abnormal heart rhythm. | cardiac ablation |
| Bursts of radiofrequency energy are delivered through a catheter to the heart tissue to destroy the focus of the arrhythmia or block the conduction pathway | radiofrequency cardiac ablation |
| First type of patient assessment priorities | visual and touch |
| Second type of patient assessment priorities | basic and specialized tests |
| When you need to slow down a pts. metabolism, most often seen post cardiac resuscitation | induced hypothermia |
| Goal temperature of induced hypothermia | 33C / 91.4F |
| In regards to blood pressure, what can mechanical ventilation cause? | hypotension |
| What heart rhythm score indicates no pulse is detected | 0 |
| What score indicates a normal pulse in regards to rate and rhythm? | +3 |
| What heart rhythm score is indicated if pts. pulse is thready or pulse can come and go? | +1 |
| What is the byproduct of tissue metabolism due to consumption of O2? | CO2 |
| Hyper-resonance / tympany indicates | open space, pneumothorax |
| A dullness sound when percussing indicates | plural effusion, consolidation pneumonia, atelectasis, tumor |
| Decreased density of the lungs dur to fluid or air | decreased fremitus |
| Decreased fremitus indicates | pneumothorax, large plural effusion, large peripheral tumor, COPD, obesity |
| Increased density of the lungs, more vibrations through more solid mass | increased fremitus |
| Increased fremitus indicates | consolidation, atelectasis, pneumonia |
| Heart sounds where valves do not completely close | murmurs |
| Range of the Glasgow Coma Scale with the highest number indicating the normal value | 3-15 |
| Temporary loss of consciousness caused by reduced blood flow and therefore a reduced supply of oxygen and nutrients get to the brain. | syncope |
| Sleepy but arousable and reacts appropriately | lethargy |
| Does not wake up easily or without stimuli, but then DOES respond appropriately | obtunded |
| Responds slowly to stimuli with decreased mental awareness | stuporous |
| Does not respond to stimuli | comatose |
| can be used in neurological assessment because it assess cranial nerves IX (glossopharyngeal) and X (vagus) | gag reflex |
| Assessment scale used to measure dyspnea | modified Borg |
| Assessment scale used for pain | Wong-Baker scale |
| Extension posturing | Decerebrate posturing |
| Abnormal flexion posturing | Decorticate posturing |
| Normal range for WBC | 4,000-11,000 |
| HCT (hematocrit) normal range for females | 35-49% |
| HCT normal range for males | 40-54% |
| Normal range for platelets | 150,000-400,000 |
| Normal range for RBC in females | 4-5 |
| Normal range for RBC in males | 5-6 |
| First show sign of glucose insufficiency | brain |
| Normal range for potassium | 3.5-5.5 |
| Normal range for sodium | 135-145 |
| Patients complain of excessive thirst and dry/sticky mouth | hypernatremia |
| Often caused by diuretics, pt may show confusion, muscle twitching, or seizures | hyponatremia |
| Can lead to cardiac arrhythmias, may indicate kidney disease | hyperkalemia |
| Can be associated with cardiac, skeletal muscle, and/or gastrointestinal dysfunction | hypokalemia |
| Normal value for lactate | < 2 |
| Ketoacidosis, should monitor steroid use | hyperglycemia |
| Sweating, shaking, weakness, headaches, lethargy or coma | hypoglycemia |
| Is a function of skeletal muscle breakdown. A good indicator of glomerular filtration and hence renal function | creatinine |
| One of the best indicators of the adequacy of both cardiac output and arterial pressure | output |
| Fights against MAP | ICP |
| Normal range for ICP in a healthy patient | 10-15 |
| At what ICP value is venous drainage impended and edema develops in uninjured tissue? | 30-35 |
| Goal for PaCO2 with mechanically vented patients | 35 |
| Measures diaphragm strength and intercostal muscles | MIP |
| Normal range for minute ventilation | 6-10 lpm |
| If you are having an oxygenation issue with NPPV, what mode should you set? | EPAP (PEEP) |
| If you are having a ventilation issue (with or without oxygenation issues), what mode should you se your NPPV to? | spontaneous/timed |
| What are the control variables? | time, flow, pressure, and volume |
| What you are attempting to achieve during inhalation | target |
| What or who stops the inhalation process, stoping the breath | cycle |
| Uses the Edi, controls triggering, breath delivery, and cycling of the vent. | NAVA (neuro assisted ventilatory assist) |
| Can reach and maintain a preset level before inspiration ends but does not terminate inspiration | target variable |
| What is the formal name for set modes on the ventilator? | breath sequence |
| Variables that remain constant and never change regardless of breath sequence, examples include volume (control/limited/targeted) ventilation or pressure | control variables |
| A predetermined goal of ventilator output; description of how the ventilator achieves preset targets | targeting scheme |
| Uses microprocessor to control ventilator function; main difference is the ability to compare and adjust based on patient effort parameters | closed loop system |
| Patient breaths are delivered via preset volumes, pressures, etc. | assisted breath |
| Designed to provide 2 levels of CPAP and to allow spontaneous breathing at both levels when spontaneous effort is present. Most often used with ARDS pts. | APRV |
| VAPS (volume assured pressure supported ventilation) is also knows as | pressure augmentation |
| Provides pressure-limited ventilation with volume delivery targeted for every breath; begins with patients pressure supported breath. Ventilator will then adjust flow or pressure to reach targeted volume | VAPS |
| Similar to PRVC mode except there is no set frequency; "Volume-targeted PSV" | VS |
| If patient is unable to reach desired Vt with their own breaths, the ventilator will switch from VAPS to what? | VC |
| Provides pressure-limited breaths that target a volume and rate | ASV |
| Pressure, flow, and volume delivery are proportional to the patients effort. | PAV |
| What does Pplat indicate? | compliance |
| What does PIP indicate? | resistance |
| Normal value for static compliance | 50-100 ml/cmH2O |
| Static compliance formula | Vt / (Pplat - PEEP) |
| Airway resistance formula | (PIP - Pplat) / Flow |
| Normal value for airway resistance | 0.6-2.4 cm/L/sec |
| Normal value for airway resistacne in an intubated patient | 5-10 cm/L/sec |
| Normal mean airway pressure | < 10 cmH2O |
| Normal mean airway pressure for COPD pts. | 10-20 cmH2O |
| Normal mean airway pressure for ARDS pts. | 15-30 cmH2O |
| Acceptable value for static compliance | > 25 ml/cmH2O |
| Acceptable static compliance for intubated patient | 30-40 ml/cmH2O |
| Vent indicated frequency | > 30 bpm or < 6 bpm |
| Vent indicated Vt | < 5 ml/kg |
| Vent indicated VC | < 10 ml/kg |
| Vent indicated MIP | > -20 |
| Vent indicated RSBI | > 105 |
| Vent indicated Ve | > 10 lpm or < 6 lpm |
| Vent indicated VD/VT | > 55% |
| Vent indicated PaCO2 | > 50 or < 30 |
| Vent indicated A-aDO2 | > 300 on 100% FiO2 |
| Vent indicated a/A ratio | < 60% |
| Vent indicated Qs/Qt | > 20% |
Created by:
lexleis
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