PHR 966 Block 1 Exam Study Guide
With Verified Solution
What does FAST-HUGS BID stand for? - ANSWER Feeding
Analgesia
Sedation
Thromboembolic prophylaxis
Head of bed
Ulcer prophylaxis
Glycemic control
Spontaneous breathing trial
Bowel regimen
Indwelling catheters
De-escalate antimicrobials
What are the analgesics of choice in the ICU? - ANSWER Opioids
What should be treated first in ICU patients? - ANSWER Pain
What should be treated second in ICU patients? - ANSWER Sedation
What are some common agents used for sedation in ICU patients? - ANSWER -
Dexmedetomidine
- Propofol
- Benzodiazepines
- Ketamine
What is the thromboembolic agent of choice for renal impairment and what is the dose?
- ANSWER - Heparin
- 5000 units SQ q8h
What are the enoxaparin doses used for VTE prophylaxis in ICU patients? - ANSWER -
40mg SQ daily
,- 30mg SQ BID (usually for surgery/trauma)
What should the head of bed be elevated to in ICU patients? - ANSWER 30 to 45 degrees
What are the major risk factors for stress ulcers in ICU patients? - ANSWER 1.
Mechanical ventilation for 48 hours or longer
2. Coagulopathy
What agents are used for ulcer prophylaxis in ICU patients? - ANSWER H2RA's and PPI's
What is the intensive glucose range and conventional glucose range in critically ill
patients? - ANSWER - 81-108 mg/dL
- 180 mg/dL or less
How often should spontaneous breathing trials be performed in ICU patients? - ANSWER
At least daily
Do we use docusate alone? - ANSWER No
What is the goal for bowel movements in ICU patients? - ANSWER Bowel movement in
2-3 days
What aspect of FAST HUGS BID is important to decrease infection risk? - ANSWER
Indwelling catheters
What is defined as the delivery of oxygenated blood to organs? - ANSWER Perfusion
What 5 variables affect oxygen delivery? - ANSWER 1. Hemoglobin
2. Oxygen saturation
3. Cardiac output
4. Oxygen consumption
5. Microcirculatory system
What values are used to see how much oxygen is being utilized in tissues
(hypoperfusion)? - ANSWER SvO2 or lactate
What is a measure of vascular tone? - ANSWER Systemic vascular resistance
How are MAP and CO calculated? - ANSWER - MAP = CO x SVR or MAP = [SBP + (2 x
DBP)]/3
- CO = HR x SV
What vasoactive medications are inodilators? - ANSWER - Dobutamine
- Milrinone
, What class of vasoactive medications increase SV and CO through direct stimulation of
myocardial contractility? - ANSWER Inodilators
What vasoactive medications are inoconstrictors? - ANSWER - Norepinephrine
- Epinephrine
- Dopamine
What class of vasoactive medications are highly effective vasopressors that directly
produce vasoconstriction and stimulate myocardial contractility to increase both CO
and SVR and are usually the first line vasopressors for patients with shock? - ANSWER
Inoconstrictors
What vasoactive medications are vasoconstrictors? - ANSWER - Phenylephrine
- Vasopressin
What are the hemodynamic effects of dobutamine? - ANSWER - Increased CO, SV, HR
- Tend to reduce SVR and stimulate contractility
What are the hemodynamic effects of milrinone? - ANSWER - Increased CO and HR
- Decreased SVR
What are the hemodynamic effects of norepinephrine? - ANSWER - Increased SVR, MAP,
HR
What are the results of lower doses of epinephrine? - ANSWER - Increase CO and/or HR
via beta-1 stimulation
What are the results of higher doses of epinephrine? - ANSWER - Increased alpha-1
mediated vasoconstriction
What are the hemodynamic effects of epinephrine? - ANSWER Increased CO, SVR, MAP,
and HR
What are the results of low doses (renal doses) of dopamine? - ANSWER - Splanchnic
and renal vasodilation
- Direct natriuretic effects
What are the results of moderate doses of dopamine? - ANSWER Inotropic effects
What are the results of high doses of dopamine? - ANSWER Vasopressor effects
What are the hemodynamic effect of dopamine? - ANSWER Increased CO, SVR, MAP,
and HR
What vasoactive medication is usually used in refractory cases when norepinephrine
With Verified Solution
What does FAST-HUGS BID stand for? - ANSWER Feeding
Analgesia
Sedation
Thromboembolic prophylaxis
Head of bed
Ulcer prophylaxis
Glycemic control
Spontaneous breathing trial
Bowel regimen
Indwelling catheters
De-escalate antimicrobials
What are the analgesics of choice in the ICU? - ANSWER Opioids
What should be treated first in ICU patients? - ANSWER Pain
What should be treated second in ICU patients? - ANSWER Sedation
What are some common agents used for sedation in ICU patients? - ANSWER -
Dexmedetomidine
- Propofol
- Benzodiazepines
- Ketamine
What is the thromboembolic agent of choice for renal impairment and what is the dose?
- ANSWER - Heparin
- 5000 units SQ q8h
What are the enoxaparin doses used for VTE prophylaxis in ICU patients? - ANSWER -
40mg SQ daily
,- 30mg SQ BID (usually for surgery/trauma)
What should the head of bed be elevated to in ICU patients? - ANSWER 30 to 45 degrees
What are the major risk factors for stress ulcers in ICU patients? - ANSWER 1.
Mechanical ventilation for 48 hours or longer
2. Coagulopathy
What agents are used for ulcer prophylaxis in ICU patients? - ANSWER H2RA's and PPI's
What is the intensive glucose range and conventional glucose range in critically ill
patients? - ANSWER - 81-108 mg/dL
- 180 mg/dL or less
How often should spontaneous breathing trials be performed in ICU patients? - ANSWER
At least daily
Do we use docusate alone? - ANSWER No
What is the goal for bowel movements in ICU patients? - ANSWER Bowel movement in
2-3 days
What aspect of FAST HUGS BID is important to decrease infection risk? - ANSWER
Indwelling catheters
What is defined as the delivery of oxygenated blood to organs? - ANSWER Perfusion
What 5 variables affect oxygen delivery? - ANSWER 1. Hemoglobin
2. Oxygen saturation
3. Cardiac output
4. Oxygen consumption
5. Microcirculatory system
What values are used to see how much oxygen is being utilized in tissues
(hypoperfusion)? - ANSWER SvO2 or lactate
What is a measure of vascular tone? - ANSWER Systemic vascular resistance
How are MAP and CO calculated? - ANSWER - MAP = CO x SVR or MAP = [SBP + (2 x
DBP)]/3
- CO = HR x SV
What vasoactive medications are inodilators? - ANSWER - Dobutamine
- Milrinone
, What class of vasoactive medications increase SV and CO through direct stimulation of
myocardial contractility? - ANSWER Inodilators
What vasoactive medications are inoconstrictors? - ANSWER - Norepinephrine
- Epinephrine
- Dopamine
What class of vasoactive medications are highly effective vasopressors that directly
produce vasoconstriction and stimulate myocardial contractility to increase both CO
and SVR and are usually the first line vasopressors for patients with shock? - ANSWER
Inoconstrictors
What vasoactive medications are vasoconstrictors? - ANSWER - Phenylephrine
- Vasopressin
What are the hemodynamic effects of dobutamine? - ANSWER - Increased CO, SV, HR
- Tend to reduce SVR and stimulate contractility
What are the hemodynamic effects of milrinone? - ANSWER - Increased CO and HR
- Decreased SVR
What are the hemodynamic effects of norepinephrine? - ANSWER - Increased SVR, MAP,
HR
What are the results of lower doses of epinephrine? - ANSWER - Increase CO and/or HR
via beta-1 stimulation
What are the results of higher doses of epinephrine? - ANSWER - Increased alpha-1
mediated vasoconstriction
What are the hemodynamic effects of epinephrine? - ANSWER Increased CO, SVR, MAP,
and HR
What are the results of low doses (renal doses) of dopamine? - ANSWER - Splanchnic
and renal vasodilation
- Direct natriuretic effects
What are the results of moderate doses of dopamine? - ANSWER Inotropic effects
What are the results of high doses of dopamine? - ANSWER Vasopressor effects
What are the hemodynamic effect of dopamine? - ANSWER Increased CO, SVR, MAP,
and HR
What vasoactive medication is usually used in refractory cases when norepinephrine
