CRITICAL CARE LAB EXAM
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Identify the indications that a patient needs suctioning.
- Course crackles or rhonchi over large airways
- Moist cough
- Increase in peak inspiratory pressure on mechanical ventilation
- Restlessness or agitation if accompanied by a decrease in O2 saturation
What is the purpose of an oropharyngeal airway?
- Maintain airway in unconscious patient
- Use as a bite block for patients with ET tubes
What is the purpose of a Nasopharyngeal (nasal trumpet) airway?
Facilitates suctioning in semi-conscious/conscious patients
What is the purpose for Endotracheal Tubes?
- Provide stabilization of airway
- Ensure proper ventilation via mechanical ventilator
- Facilitate removal of secretions
What are the Advantages of Oral ET Tubes?
- Can be rapidly inserted in an Emergency Situation
- A larger diameter tube can be used, resulting in reduced work of breathing because there is less airway resistance
What are the disadvantages of Oral ET Tubes?
- Difficult to place if head and neck mobility are limited
- Salivation is increased and swallowing is difficult
- A bite block or oral airway may be needed to prevent patient from biting the tube
- Mouth care is difficult
- Larger tubes can cause laryngeal trauma
- Pressure on lips can cause decubiti/necrosis
What are the Advantages of Nasal ET Tubes?
- More stable than oral tubes; more difficult to dislodge
- Can be placed "blindly", without visualization of the larynx
- Mouth care can be easily performed; a bite block is not needed
What are the disadvantages of Nasal ET Tubes?
- Nasal tubes kink (bend) more than oral tubes
- Increased WOB because of greater airway resistance
- Suctioning and secretion removal are more difficult
- Nasal tubes have been linked with increased sinus infection incidence
- Pressure on nares can cause decubiti/necrosis
What are the Side Effects of Epinephrine?
- Hypertension (increased BP)
What are the side effects of Atropine?
- Increased or Decreased BP
- A-V dissociation
What are the side effects of Adenosine?
- Transient Facial Flushing
What are the side effects of Amiodarone?
- Muscle Weakness
- Hypotension (Low BP)
- Corneal Microdeposits
What are the side effects of Vasopressin?
- Increased BP
- Heart Block
- Nausea & vomiting
What are the side effects of Lidocaine?
- Difficulty breathing/swallowing
What are the side effects of Procainamide?
- Agranulocytosis with repeated use
What are the side effects of Magnesium Sulfate?
- 3rd degree heart block
- Respiratory paralysis
What are the side effects of Diltiazem?
What are the side effects of Dopamine?
- Severe tissue damage with extravasation / IV infiltration
What are the side effects of Dobutamine?
- Increased HR
- Increased BP
- Anginal Pain
What are the side effects of Calcium Chloride?
- Decreased BP
- Cardiac arrest with rapid infusion
What are the side effects of Isoproterenol (Isuprel)?
- Ventricular arrhythmias
- Severe tissue damage with extravasation
What drug is used to treat acute pulmonary edema?
What drug improves myocardial contractility and is used in the treatment of HF?
Name an emergency condition in which Epinephrine should be used?
What drug must be infused in a glass IV bottle with special tubing?
What drug is used to restore cardiac rhythm in cardiac arrest through stimulation of both alpha and beta adrenergic receptors?
What drug is second-line for ventricular ectopy?
What drug is a narcotic analgesic which reduces myocardial oxygen requirements?
What drug is an alternate second-line choice to Lidocaine in suppressing ventricular tachycardia?
What CCB is used for treatment of atrial tachydysrhythmia?
What drug is a potent vasodilator used to lower systemic vascular resistance (BP)?
What pure alpha agonist is used to maintain BP?
Positive inotrope drug which has a range of effects, depending on dose?
Characteristics of Lidocaine Toxicity.
- Muscle twitching
- slurred speech
What drug is given in instances of bradycardia accompanied by hypotension or PVCs?
What drug is utilized in suspected hypoxemia of any cause?
What is an alternate route for several Arrest Drugs?
What drug should be given with caution if given at the same time as IV diltiazem (Cardizem)?
What drug is given only in late cardiac arrest after more definitive treatment has been unsuccessful?
What drug is used for symptomatic bradycardia unresponsive to Atropine, on rare occasions?
Characteristics of Digoxin Toxicity?
- Visual disturbances
- A variety of dysrhythmias
What is the first line treatment for paroxysmal supraventricular tachycardia?
What is Lasix used for ?
to increase renal output
What are the shockable Rhythms?
What are the NON-SHOCKABLE rhythms?
Define Hemodynamic Monitoring?
measurement of pressure, flow, and oxygenation within the cardiovascular system
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