CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
Critical Care Environment - reorient patient
- tell them what you're doing
- day and night adjust lights, recognize day and night
- provide care to family (in room for code)
Rapid Response - prevents code
- s/s of septic shock
Advance Directive - have before admission
- NO SLOW CODES
- right to say no
Visitation - based on the needs of the patient
- hospital will never restrict visitation
Brain Death perfusion and oxygenation until organ transplant
CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
,CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
Respiratory Failure - decreased pH
- increased CO2
- decreased PaO2
Intubation - sedate
- paralyze
- auscultate
- chest xray
- fall and rise bilateral
- CO2 detector - gold is good
ARDS - decreased Pa02 despite increasing FaO2
- injury to lungs
- tachypnic and tachycardic
- respiratory acidosis
- decreased compliance
- INCREASED PEEP
ARDS: Intervention - prone (maintain airway)
- elevate HOB 30-45 degrees
VAP Bundle - HOB 30-45 degrees
- Oral care w/ Chlorhexidine
- DVT Care - Heparin and Lovenox
- PPI's prevent PUD
- Sedation Vacation
- Drain condensation away from patient
What should you do after 7 days on a Trach them
Ventilator?
Terminal Weaning - DNR
- take them off ventilator to die
- COMFORT IS KEY, NO PAIN (benzos, pain meds)
American Association of Critical Care - assists NURSES to attain knowledge and influence
Nurses: Focus of the Group - healthy work environment initiative
Highest setting you can put a Nasal 6 L, humidify at 4L
Cannula?
Patient is on 90% Fi02 (10L), Respiratory INTUBATE
Distress...What do I do?
CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
,CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
Overdose on CNS Depressant? - respiratory depression
- respiratory acidosis
- hypoventilation
Panic Attack: Respiratory - respiratory alkalosis
- hyperventilation
- tingling, numbness in fingers (decreased perfusion)
CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
, CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
What is a sign of decreased Perfusion? cyanosis
ARDS: Chest Xray? - broken glass
- white out
What does PEEP increase? PaO2
Ready to wean? - PaO2 >60 and FiO2 <.4
- PEEP <5-8 cm
- PaO2/FiO2 should be 150-200
Vented patient is Asystole, don't know if he stop the code
has DNR?
High Pressure Alarm - biting the tube
- mucus plug
- kinked tube
if you can't figure it out, bag patient and call an RT
Low Pressure Alarm something is disconnected
Prepare you patient for weaning tell patient breathing will be hard
Weaning is not working - RR increases
- HR increases
- O2 decreases
- low hemoglobins will not be successful
Patient is Tachy (150), hypotensive, signs of - vagel maneuver first
shock, heart failure... - synchronized cardioversion
Patient is brady (35), hypotensive, transcutaneous pacing
diaphoresis, dizzy and SOB
Anxious on Ventilator - sedate
- neuromuscular block (SEDATE FIRST)
- pressure ulcers are common as well as corneal abrasions
(can't close eyes).
RASS - agitation and sedation
- tells you if you need a neuro block
- 4 needs a neuro block
- 2 is typical
CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
Critical Care Environment - reorient patient
- tell them what you're doing
- day and night adjust lights, recognize day and night
- provide care to family (in room for code)
Rapid Response - prevents code
- s/s of septic shock
Advance Directive - have before admission
- NO SLOW CODES
- right to say no
Visitation - based on the needs of the patient
- hospital will never restrict visitation
Brain Death perfusion and oxygenation until organ transplant
CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
,CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
Respiratory Failure - decreased pH
- increased CO2
- decreased PaO2
Intubation - sedate
- paralyze
- auscultate
- chest xray
- fall and rise bilateral
- CO2 detector - gold is good
ARDS - decreased Pa02 despite increasing FaO2
- injury to lungs
- tachypnic and tachycardic
- respiratory acidosis
- decreased compliance
- INCREASED PEEP
ARDS: Intervention - prone (maintain airway)
- elevate HOB 30-45 degrees
VAP Bundle - HOB 30-45 degrees
- Oral care w/ Chlorhexidine
- DVT Care - Heparin and Lovenox
- PPI's prevent PUD
- Sedation Vacation
- Drain condensation away from patient
What should you do after 7 days on a Trach them
Ventilator?
Terminal Weaning - DNR
- take them off ventilator to die
- COMFORT IS KEY, NO PAIN (benzos, pain meds)
American Association of Critical Care - assists NURSES to attain knowledge and influence
Nurses: Focus of the Group - healthy work environment initiative
Highest setting you can put a Nasal 6 L, humidify at 4L
Cannula?
Patient is on 90% Fi02 (10L), Respiratory INTUBATE
Distress...What do I do?
CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
,CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
Overdose on CNS Depressant? - respiratory depression
- respiratory acidosis
- hypoventilation
Panic Attack: Respiratory - respiratory alkalosis
- hyperventilation
- tingling, numbness in fingers (decreased perfusion)
CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
, CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
What is a sign of decreased Perfusion? cyanosis
ARDS: Chest Xray? - broken glass
- white out
What does PEEP increase? PaO2
Ready to wean? - PaO2 >60 and FiO2 <.4
- PEEP <5-8 cm
- PaO2/FiO2 should be 150-200
Vented patient is Asystole, don't know if he stop the code
has DNR?
High Pressure Alarm - biting the tube
- mucus plug
- kinked tube
if you can't figure it out, bag patient and call an RT
Low Pressure Alarm something is disconnected
Prepare you patient for weaning tell patient breathing will be hard
Weaning is not working - RR increases
- HR increases
- O2 decreases
- low hemoglobins will not be successful
Patient is Tachy (150), hypotensive, signs of - vagel maneuver first
shock, heart failure... - synchronized cardioversion
Patient is brady (35), hypotensive, transcutaneous pacing
diaphoresis, dizzy and SOB
Anxious on Ventilator - sedate
- neuromuscular block (SEDATE FIRST)
- pressure ulcers are common as well as corneal abrasions
(can't close eyes).
RASS - agitation and sedation
- tells you if you need a neuro block
- 4 needs a neuro block
- 2 is typical
CAS Review - Exam 1 - NR 341, complex exam 1 with complete solutions
