Critical Care Final

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Author:
plbernal
ID:
187749
Filename:
Critical Care Final
Updated:
2012-12-12 12:31:10
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finals Part one
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finals part one
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  1. Early signs of decreased neuro
    • Decreased LOC
    • Decreased Pupil Constriction
    • Restless
    • Agitation
  2. Venous System
    _______ pressure
    _______ volume
    _______% of total blood
    _______ sensitive to meds
    • Low pressure
    • High volume
    •  70% of total blood
    • less sensitive to meds
  3. Arterial System
    _____ pressure
    _____ volume
    _____ % of blood
    _____ sensitive to meds
    • High pressure
    • Low volume
    • 30% of total blood
    • More sensitive to meds
  4. How to treat increased preload
    • Too much volume
    • - Diuretics (lasix, mannitol)
    • - Vasodilate (nitro)
  5. Define CI
    • Output based on BMI
    • 2.5 - 4.2
  6. Define C.O.
    • Amount of blood ejected by ventricles
    • 4-8 L/mm
  7. What is PS?
    • Pressure Support
    • - Pushes patients own breath deeper
  8. Cholesterol
    less than 200
  9. LDL's
    Less than 100
  10. HDL's
    Higher than 50
  11. Triglycerides
    Less than 150
  12. Potassium
    3.5-5
  13. Magnesium
    1.8-2.7
  14. Sodium
    135-145
  15. Calcium
    8.5-10.5
  16. CK
    less then 200
  17. CK-MB
    less than 5%
  18. Troponin
    less than 0.5
  19. Myoglobin
    less than 100
  20. Ejection Fraction
    60-70%
  21. PaO2
    80-100
  22. SaO2
    • 92-100
    • Less than 90 = hypoxic
  23. pH
    7.35-7.45
  24. CO2
    35-45
  25. HCO3
    22-26
  26. FiO2
    21-100%
  27. Goal for FiO2
    less than 60%
  28. TV
    4-8 mL/kg
  29. PEEP
    5-20
  30. BNP
    less than 100
  31. What is this wave?  What does it mean?
    • TOMBSTONES
    • - elevated ST waves
    • - myocardial injury occuring
    • RIGHT NOW
  32. What is this wave?  What does it mean?
    • Q wave
    • MI already happened, necrotic tissue present
    • Infarction
  33. Define AMI
    Ischemia with cell death
  34. In an AMI, cell will remain viable if blood flow is re-established within ____ mins!
    20
  35. Name and describe 2 classes of MI's
    • SEMI - Q wave, total occlusion of coronary arter
    • NON STEMI - No Q wave, partial occlusion of coronary artery
  36. What do you do when suspected MI occurs?
    (6)
    • 1. O2
    • 2. Nitro
    • 3. Morphine
    • 4. Aspirin
    • 5. 12 lead EKG
    • 6. ROMI panel
  37. Indications for CABG
    • Multivessel disease
    • Stent failure
    • Left main failure
    • Stable angina not treatment successfuly
  38. What do statins do? 3 side effects?
    • Lower LDL's/ total cholesterol
    • Side Effects: headache, weakness, constipation, nausea, flatulence
  39. Why is aspirin given?  Why are aspirin + plavix given together?
    • Aspirin is an anti-platelet
    • Aspirin + plavix decreases risk of clotting especially in patient with history of heart events/MI
  40. Define heart failure
    Hearts inability to pump enough blood to meet demands of tissues
  41. S/S of heart failure
    • Dyspnea
    • Fatigue
    • Exercise Intolerance
    • Fluid Retention
  42. Left sided heart failure will cause ______ edema
    pulmonary
  43. Why do we intubate?
    (4)
    • -Establish airway
    • -Assist in secretion removal
    • -Prevent aspiration
    • -Provide mechanical vent
  44. After intubating, what 2 assessments do I complete?
    • 1. Lood for chest rise/fall
    • 2. Listen to chest/stomach
  45. Right sided heart failure will cause _____ edema
    Peripheral
  46. Why do we trach?
    (4)
    • 1. Long term vent (>2 weeks)
    • 2. Better tolerated
    • 3. Easier oral care
    • 4. More secure
  47. Why ET suction?
    (4)
    • 1. Visible secretions
    • 2. Coughing/Rhonchi
    • 3. Decreased O2 Sat
    • 4. Change in V/S, dyspnea, restless, increasd PIP or high pressure alarm
  48. 3 lab values that indicate need for mechanical vent
    • 1. pO2 < 60
    • 2. pCO2 > 50
    • 3. pH < 7.25
  49. Describe SIMV
    • Synchronized Intermittent Mandatory Ventilation
    • - Preset # of breaths and TV
    • - Can have own breaths with own TV
    • - Prevents respiratory muscle weakness
    • ***WEANING***
  50. Describe AC
    • Assist Control
    • - Preset # of breaths and TV
    • - Patient can take own breath but machine will give TV
    • - Used when vent needs to do the most work

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