Critical Care Final

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Author:
plbernal
ID:
187903
Filename:
Critical Care Final
Updated:
2012-12-12 12:17:30
Tags:
Final Part four
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final part four
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  1. Who set the critical care competency criteria?
    AACN
  2. What 2 heart sounds are heard in heart failure?
    S3 & S4
  3. Describe S3
    • Lubb-dubba
    • Ken-Tuk-Y
    • Heard after S2
    • Overfilled heart
  4. Describe S4
    • Heard before S1
    • Tee-Lubb-Dubb
    • Te-ne-see
    • Force atrial contractions, too much volume
  5. Describe CAD
    • Progressive narrowing of 1+ Coronary arteries by plaque
    • Inflammatory Process from endothelial injury
  6. Toponin
    Means_____
    Normal Level
    Onset
    Peak
    • Cardiac specific
    • < 0.5
    • Several hours
    • 2 weeks
  7. Myoglobin
    Means _______
    Normal levels
    Onset
    • Muscle dying, non-specific
    • < 100
    • Onset before all others
  8. Normal CSF secretion rate
    • 400 mL/day
    • or
    • 18-24 mL/hour
  9. What happens if MAP gets to low?
    Ischemia - infarction if not corrected
  10. How to calculate CPP
    CPP= MAP-ICP
  11. Normal CPP
    70-100
  12. Brain needs glucose
     < _____= confusion
    < _____ = coma
    • < 70 for confusion
    • < 20 for coma
  13. Define autoregulation
    • Used by brain to maintain
    • BF reguarless of MAP, vessels dilate/constrict)
  14. Causes of false low bp in interal measurements
    (8)
    • Airbubbles
    • didn't zero transducer
    • blood in cath system
    • clot at end of cath
    • bent tubing
    • iv tubing instead of pressure tubing
    • too many stopcocks
    • improper cuff size/placemnt for external
  15. Is there a difference between periphal and internal bp readings?
    • yes, internal is 5-20 mmHg higher
    • internal more accurate
  16. Spinal Cord Injury
    C1-C2
    Vent dependant?
    yes
  17. Spinal shock vs Severed cord/lesion
    • Spinal shock mimics but will get better
    • Severed cord is permenant
  18. 3 Causes of stroke
    • Clot in cerebral arteries
    • Traveled clot
    • Hemorrhage
  19. Complications of an A Line
    (4)
    • -Thrombosis
    • -Embolism
    • -Blood loss
    • -Infection
  20. Common ND for the need for invasive hemodynamic monitoring
    • Ineffective/impaired __________ tissue perfusion
    • Decfreased cardiac output
    • FVD or FVE
  21. What protects the brain form harm/disease and what can cross?
    • Blood brain barrier
    • Fat soluble (glucose)
  22. Which cells create CSF?
    glial
  23. Complications from central line
    (5)
    • -Infection
    • -Pneumo/hemothorax
    • -Carotid puncture
    • -Dysrhythmias
  24. Nursing interventions for central line
    (6)
    • -zero transducer
    • -monitor waveform (no notch)
    • -vent-increase PEEP will show false decrease CO
    • -hob 0-60 degrees
    • -complications (pneumo/hemothorax)
  25. nursing interventions for A-line
    (8)
    • Set alarms
    • Document assessment q 2hours while inserted
    • Monitor wave form
    • Keep wristh in neutral position
    • Compare values with non-invasive
    • When removed
    •      -pressure for 5-20 min
    •      -achieve hemostasis
    •      -assess/document removal
    • Maintain pressure system
    • Check site/circulation
  26. What do you assess after A-line removal?
    (6)
    • Cap Refill
    • Skin Temp
    • Pulses
    • Sensations
    • Fine Motor check (touch finger to thumbs)
    • Did whole cath come out
  27. PA lumens - Temp Probe
    • No fluids
    • monitors temp of diff between injected fluid and pt body temp, CO through amount of time it takes for fluid to pass
  28. Nursing implication for inflating the balloon
    • <10 seconds
    • < 1.5mLs

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