BKAT Study Set
what is the initial dosing of tpa? - CORRECT ANSWER--0.9 mg/kg
-10% as a bolus over 1 minute and 90% as continuous infusion over 60 minutes
What are the requirements for receiving tpa? - CORRECT ANSWER--onset of stroke
was within 3-4.5 hours
-CT negative for bleed or lesion
-glucose >50
During the thrombolytic infusion of tpa, neuros need to be assessed every ___ minutes -
CORRECT ANSWER-15
What are the frequency of neuro checks after receiving thrombolytic tpa infusion? -
CORRECT ANSWER--VS and neuro checks every 15 min for 1 hour
-every 30 min for 6 hours
-then every hour for 16 hours
What may a high pressure vent alarm indicate? - CORRECT ANSWER-Pt is biting on
the tubing, excessive secretions in the tubing, kinked tubing
What may a low pressure vent alarm indicate? - CORRECT ANSWER-cuff leak or the
tubing is disconnected somewhere
How do you verify positioning of an endotracheal tube? - CORRECT ANSWER--
auscultate lung bases and apices for bilateral breath sounds
-observe chest for symmetric chest wall movement
-confirm with end tidal CO2 measure
GOLD STANDARD: chest x-ray
t/f: people with ET tubes should be suctioned routinely - CORRECT ANSWER-FALSE--
they should be suctioned on an as needed basis
what should ET tube cuff pressure be kept at? - CORRECT ANSWER-20-25 mmHg
Normal blood gases; pH - CORRECT ANSWER-7.35-7.45
Normal blood gases: CO2 - CORRECT ANSWER-35-45
Normal blood gases: HcO3 - CORRECT ANSWER-22-26
, Normal blood gases: PO2 - CORRECT ANSWER-80 or above
Normal vacuum pressures for suction? - CORRECT ANSWER-120-140 mmHg
What measures should nurses take to avoid ET tube problems? - CORRECT
ANSWER--confirm that exit mark on ET tube remains constant when providing patient
care, repositioning, and transporting patient
-maintain proper cuff inflation (listen for an air leak-- if pt can talk, you must inflate more)
-continually monitor SpO2, RR, HR and rhythm, mental status, and ABGs
-pre-oxygenate before suctioning
What should be done if a patient is not tolerating ET tube suctioning? - CORRECT
ANSWER-STOP and manually hyperventilate with 100% oxygen
Measures to prevent aspiration? - CORRECT ANSWER--avoid bolus tube feedings
-monitor tube feeding residuals
-maintain HOB at LEAST 30 degrees or greater
-maintain proper ET tube cuff inflation
-perform frequent oral pharyngeal suctioning
-maintain an NG tube connected to low, intermittent suction if feeding tube is placed
below the pylorus
what are recommendations for preventing ventilator associated pneumonia? -
CORRECT ANSWER--manage ventilated patients without sedatives whenever possible
-interrupt sedation once a day (spontaneous breathing trials)
-provide early exercise and mobility
-provide regular oral care
-minimize pooling of secretions above the ET tube cuff
-use ET tubes with subglottic secretion drainage for patients likely to require greater
than 72 hours of intubation
-keep HOB elevated 30-45 degress
-change ventilator circuit only if visibly soiled or malfunctioning
What is the biggest complication associated with high cervical spinal cord injuries? -
CORRECT ANSWER-BREATHING-- the diaphragm is innervated by C3-C5 levels
C4-diaphragm
will likely need mechanical ventilation mgmt
signs and symptoms of increased intracranial pressure? - CORRECT ANSWER--altered
LOC
-headache
-bradycardia
-decreased respirations
-acute HTN with widening pulse pressure
what is the initial dosing of tpa? - CORRECT ANSWER--0.9 mg/kg
-10% as a bolus over 1 minute and 90% as continuous infusion over 60 minutes
What are the requirements for receiving tpa? - CORRECT ANSWER--onset of stroke
was within 3-4.5 hours
-CT negative for bleed or lesion
-glucose >50
During the thrombolytic infusion of tpa, neuros need to be assessed every ___ minutes -
CORRECT ANSWER-15
What are the frequency of neuro checks after receiving thrombolytic tpa infusion? -
CORRECT ANSWER--VS and neuro checks every 15 min for 1 hour
-every 30 min for 6 hours
-then every hour for 16 hours
What may a high pressure vent alarm indicate? - CORRECT ANSWER-Pt is biting on
the tubing, excessive secretions in the tubing, kinked tubing
What may a low pressure vent alarm indicate? - CORRECT ANSWER-cuff leak or the
tubing is disconnected somewhere
How do you verify positioning of an endotracheal tube? - CORRECT ANSWER--
auscultate lung bases and apices for bilateral breath sounds
-observe chest for symmetric chest wall movement
-confirm with end tidal CO2 measure
GOLD STANDARD: chest x-ray
t/f: people with ET tubes should be suctioned routinely - CORRECT ANSWER-FALSE--
they should be suctioned on an as needed basis
what should ET tube cuff pressure be kept at? - CORRECT ANSWER-20-25 mmHg
Normal blood gases; pH - CORRECT ANSWER-7.35-7.45
Normal blood gases: CO2 - CORRECT ANSWER-35-45
Normal blood gases: HcO3 - CORRECT ANSWER-22-26
, Normal blood gases: PO2 - CORRECT ANSWER-80 or above
Normal vacuum pressures for suction? - CORRECT ANSWER-120-140 mmHg
What measures should nurses take to avoid ET tube problems? - CORRECT
ANSWER--confirm that exit mark on ET tube remains constant when providing patient
care, repositioning, and transporting patient
-maintain proper cuff inflation (listen for an air leak-- if pt can talk, you must inflate more)
-continually monitor SpO2, RR, HR and rhythm, mental status, and ABGs
-pre-oxygenate before suctioning
What should be done if a patient is not tolerating ET tube suctioning? - CORRECT
ANSWER-STOP and manually hyperventilate with 100% oxygen
Measures to prevent aspiration? - CORRECT ANSWER--avoid bolus tube feedings
-monitor tube feeding residuals
-maintain HOB at LEAST 30 degrees or greater
-maintain proper ET tube cuff inflation
-perform frequent oral pharyngeal suctioning
-maintain an NG tube connected to low, intermittent suction if feeding tube is placed
below the pylorus
what are recommendations for preventing ventilator associated pneumonia? -
CORRECT ANSWER--manage ventilated patients without sedatives whenever possible
-interrupt sedation once a day (spontaneous breathing trials)
-provide early exercise and mobility
-provide regular oral care
-minimize pooling of secretions above the ET tube cuff
-use ET tubes with subglottic secretion drainage for patients likely to require greater
than 72 hours of intubation
-keep HOB elevated 30-45 degress
-change ventilator circuit only if visibly soiled or malfunctioning
What is the biggest complication associated with high cervical spinal cord injuries? -
CORRECT ANSWER-BREATHING-- the diaphragm is innervated by C3-C5 levels
C4-diaphragm
will likely need mechanical ventilation mgmt
signs and symptoms of increased intracranial pressure? - CORRECT ANSWER--altered
LOC
-headache
-bradycardia
-decreased respirations
-acute HTN with widening pulse pressure
