Critical care final exam study guide
exam question and answers
american association of critical care nurses (ACCN) - ANSWER - mission is to assist acute and
critical care nurses to attain knowledge and influence to deliver excellent care
professional journals; critical care nurse, american journal of critical care, AACN advanced
critical care
synergy model - ANSWER - - states that the needs of pts and families influence and drive
competencies of nurses
- create a healthcare system driven by pts and families needs in which critical care nurses make
their optimum contributions
healthy work environment - ANSWER - - quality of resources
critical care environment - ANSWER - pt variable s
- sensory overload (lights, noise, loss of privacy, pain(
- deprivations (perceptual disturbances, lack of personal touch, loss of routine, sleep loss)
- pt characteristics (support system, medical history, age, source of illness/injury, culture,
education/ability to understand)
how does care differ in the ICU - ANSWER - - psychosocial support for both pt and family (often
overlooked by many critical care nurses)
- identify who the core family is, including decision maker/spokesperson
ethical dilemma warning signs - ANSWER - - emotionally charged
- significant change in pts condition
,- confusion about facts
- hesitancy about the correct set of actions
- deviation from customary practice
- need for secrecy regarding proposed actions
ex,,,,
ethical principles - ANSWER - autonomy; right to self-determination (concerning medical care)
beneficence; duty to prevent harm, remove harm, and promote the good of another person
nonmaleficence; no to intentionally inflict harm
justice; fair distribution of healthcare resources
veracity; truthfulness
fidelity; faithfulness to commitment
confidentiality; respect for the right to control information
CPR issues - ANSWER - - should a patient be "coded"
- a do not resuscitate (DNR) order is needed to not initiate a code
- advance directives are useful in guiding decision making PRIOR to code
- family presence during codes is promoted
, persistent vegetative state - ANSWER - permanent, irreversible unconsciousness condition that
demonstrates an absence of voluntary action or cognitive behavior or an inability to
communicate or interact purposefully with the environment
brain death - ANSWER - complete and irreversible cessation of brain function
*how to determine time of death
life support - ANSWER - withholding; not initiating (not initiating hemodialysis)
withdrawal; weaning or removing (autonomy/futility of treatment; terminal weaning from
mechanical vent)
ethical principles related to withholding and withdrawing treatment - ANSWER - - death of a
product of underlying disease
- goal; relieve suffering not hasten death
- withholding life-sustaining treatment; more equivalent of withdrawing treatment
- any treatment may be withheld or withdrawn with pt and family consent but symptom control
maintained (pain, nausea, secretions, etc.)
- any dose of analgesic or anxiolytic meds may be reasonable used to control pain and relieve
suffering
- accommodate for cultural/religious perspectives
patient-self determination act - ANSWER - - pts right to initiate advanced directive (followed
when the pt is incapacitated)
- DNR
- living will; treatment desired, what should be withheld
- durable POA for healthcare; determines who makes decisions; healthcare surrogate or proxy
- pts right to consent for or refuse treatment
exam question and answers
american association of critical care nurses (ACCN) - ANSWER - mission is to assist acute and
critical care nurses to attain knowledge and influence to deliver excellent care
professional journals; critical care nurse, american journal of critical care, AACN advanced
critical care
synergy model - ANSWER - - states that the needs of pts and families influence and drive
competencies of nurses
- create a healthcare system driven by pts and families needs in which critical care nurses make
their optimum contributions
healthy work environment - ANSWER - - quality of resources
critical care environment - ANSWER - pt variable s
- sensory overload (lights, noise, loss of privacy, pain(
- deprivations (perceptual disturbances, lack of personal touch, loss of routine, sleep loss)
- pt characteristics (support system, medical history, age, source of illness/injury, culture,
education/ability to understand)
how does care differ in the ICU - ANSWER - - psychosocial support for both pt and family (often
overlooked by many critical care nurses)
- identify who the core family is, including decision maker/spokesperson
ethical dilemma warning signs - ANSWER - - emotionally charged
- significant change in pts condition
,- confusion about facts
- hesitancy about the correct set of actions
- deviation from customary practice
- need for secrecy regarding proposed actions
ex,,,,
ethical principles - ANSWER - autonomy; right to self-determination (concerning medical care)
beneficence; duty to prevent harm, remove harm, and promote the good of another person
nonmaleficence; no to intentionally inflict harm
justice; fair distribution of healthcare resources
veracity; truthfulness
fidelity; faithfulness to commitment
confidentiality; respect for the right to control information
CPR issues - ANSWER - - should a patient be "coded"
- a do not resuscitate (DNR) order is needed to not initiate a code
- advance directives are useful in guiding decision making PRIOR to code
- family presence during codes is promoted
, persistent vegetative state - ANSWER - permanent, irreversible unconsciousness condition that
demonstrates an absence of voluntary action or cognitive behavior or an inability to
communicate or interact purposefully with the environment
brain death - ANSWER - complete and irreversible cessation of brain function
*how to determine time of death
life support - ANSWER - withholding; not initiating (not initiating hemodialysis)
withdrawal; weaning or removing (autonomy/futility of treatment; terminal weaning from
mechanical vent)
ethical principles related to withholding and withdrawing treatment - ANSWER - - death of a
product of underlying disease
- goal; relieve suffering not hasten death
- withholding life-sustaining treatment; more equivalent of withdrawing treatment
- any treatment may be withheld or withdrawn with pt and family consent but symptom control
maintained (pain, nausea, secretions, etc.)
- any dose of analgesic or anxiolytic meds may be reasonable used to control pain and relieve
suffering
- accommodate for cultural/religious perspectives
patient-self determination act - ANSWER - - pts right to initiate advanced directive (followed
when the pt is incapacitated)
- DNR
- living will; treatment desired, what should be withheld
- durable POA for healthcare; determines who makes decisions; healthcare surrogate or proxy
- pts right to consent for or refuse treatment
