critical care NUR 425 exam 1 UPDATED ACTUAL Questions and CORRECT
Answers
pain
agitation/sedation
PADIS delirium
immobility
sleep disruption
A - assess, prevent, and manage pain
B - use spontaneous awakening trials and spontaneous breathing trials
C - choice of analgesia and sedation
ICU Liberation Bundle
D - delirium
E - early mobility and exercise
F - family engagement and empowerment
What pain assessments do we use for BPS (Behavioral Pain Scale) or CPOT
patients who are nonverbal?
- facial expressions
What do the BPS and CPOT tests assess - body movements
for? - muscle tension
- compliance with the ventilator (intubated patients) or vocalization (if extubated)
What are the first choices for sedation? Propofol and Dexmedetomidine
How often should you have spontaneous at least once a day
awakening trials (SAT)/interruptions in
sedations?
What is the onset of Propofol? very fast onset and offset
What do we need to be careful of when watch for a drop in blood pressure
giving Propofol?
helps a patient calm down but does not usually affect their breathing; can be used
What is unique about Dexmedetomidine?
on intubated or extubated patients
, What test do we use to assess sedation? Richmond Agitation-Sedation Scale (RASS), Ramsey scale
sleep deprivation, medications (eg. sedatives like benzos, opioid analgesics,
What can be a cause of delirium in the
aminoglycosides), sensory overload (eg. invasive lines/tubes), anxiety, disease
ICU?
processes (eg. hypoxia)
- altered mentation (delusions, STML (short term memory loss), distractibility/short
attention span)
What can delirium look like?
- psychomotor behaviors (restlessness, lethargy)
- altered sleep-wake cycle (eg. night-time agitation)
What assessment do we use for assessing CAM-ICU (Confusion Assessment Method for ICU) or the Intensive Care Delirium
delirium? Screening Checklist (ISCDSC)
- older age, dementia, prior coma, trauma or surgery
Who is at an increased risk for delirium?
- benzodiazepine use, blood transfusions
How often should adult ICU patients be once per shift
assessed for delirium?
- Awakening and Breathing Coordination
- Delirium prevention and management
"ABCDEF" bundle
- Early physical mobility
- Family involvement
What kind of medications are Baclofen and muscle relaxants
Dantrolene?
What kind of medication if Lidocaine? local anesthetic
What is a major adverse effect of hypotension
lidocaine?
What kind of medication is Methohexital general anesthetic
Sodium?
What kind of medication is Midazolam? sedative
What kind of medication is Fentanyl? analgesic
What medications groups are used to treat Antilipemics - HMG-COA Reductase Inhibitors: Statins and Fibrins
Coronary Artery Disease?
- lower LDL and VLDL
What do statins do?
- increases HDL
- not safe in pregnancy
What do you have to be careful of with - hepatotoxicity
statins? - no grapefruit juice!
- myopathy
- lowers triglycerides
What do fibrates do?
- raise good cholesterol
When should you take statins? once at night
What are the precautions for fibrates? myopathy, hepatotoxicity, gall bladder
When do you take fibrates? 30 minutes before breakfast and evening meals
What medication treats angina? antianginals: nitrates
What do nitrates do? cause vasodilation
What are the adverse effects of nitrates? reflex tachycardia, orthstatic hypotension, tolerance, headache, dizziness
What is the rule when taking nitrates to if chest pain unrelieved after 5 minutes, call 911 and take a second tablet, if still
treat angina? unrelieved, take a third dose after 5 minutes
Answers
pain
agitation/sedation
PADIS delirium
immobility
sleep disruption
A - assess, prevent, and manage pain
B - use spontaneous awakening trials and spontaneous breathing trials
C - choice of analgesia and sedation
ICU Liberation Bundle
D - delirium
E - early mobility and exercise
F - family engagement and empowerment
What pain assessments do we use for BPS (Behavioral Pain Scale) or CPOT
patients who are nonverbal?
- facial expressions
What do the BPS and CPOT tests assess - body movements
for? - muscle tension
- compliance with the ventilator (intubated patients) or vocalization (if extubated)
What are the first choices for sedation? Propofol and Dexmedetomidine
How often should you have spontaneous at least once a day
awakening trials (SAT)/interruptions in
sedations?
What is the onset of Propofol? very fast onset and offset
What do we need to be careful of when watch for a drop in blood pressure
giving Propofol?
helps a patient calm down but does not usually affect their breathing; can be used
What is unique about Dexmedetomidine?
on intubated or extubated patients
, What test do we use to assess sedation? Richmond Agitation-Sedation Scale (RASS), Ramsey scale
sleep deprivation, medications (eg. sedatives like benzos, opioid analgesics,
What can be a cause of delirium in the
aminoglycosides), sensory overload (eg. invasive lines/tubes), anxiety, disease
ICU?
processes (eg. hypoxia)
- altered mentation (delusions, STML (short term memory loss), distractibility/short
attention span)
What can delirium look like?
- psychomotor behaviors (restlessness, lethargy)
- altered sleep-wake cycle (eg. night-time agitation)
What assessment do we use for assessing CAM-ICU (Confusion Assessment Method for ICU) or the Intensive Care Delirium
delirium? Screening Checklist (ISCDSC)
- older age, dementia, prior coma, trauma or surgery
Who is at an increased risk for delirium?
- benzodiazepine use, blood transfusions
How often should adult ICU patients be once per shift
assessed for delirium?
- Awakening and Breathing Coordination
- Delirium prevention and management
"ABCDEF" bundle
- Early physical mobility
- Family involvement
What kind of medications are Baclofen and muscle relaxants
Dantrolene?
What kind of medication if Lidocaine? local anesthetic
What is a major adverse effect of hypotension
lidocaine?
What kind of medication is Methohexital general anesthetic
Sodium?
What kind of medication is Midazolam? sedative
What kind of medication is Fentanyl? analgesic
What medications groups are used to treat Antilipemics - HMG-COA Reductase Inhibitors: Statins and Fibrins
Coronary Artery Disease?
- lower LDL and VLDL
What do statins do?
- increases HDL
- not safe in pregnancy
What do you have to be careful of with - hepatotoxicity
statins? - no grapefruit juice!
- myopathy
- lowers triglycerides
What do fibrates do?
- raise good cholesterol
When should you take statins? once at night
What are the precautions for fibrates? myopathy, hepatotoxicity, gall bladder
When do you take fibrates? 30 minutes before breakfast and evening meals
What medication treats angina? antianginals: nitrates
What do nitrates do? cause vasodilation
What are the adverse effects of nitrates? reflex tachycardia, orthstatic hypotension, tolerance, headache, dizziness
What is the rule when taking nitrates to if chest pain unrelieved after 5 minutes, call 911 and take a second tablet, if still
treat angina? unrelieved, take a third dose after 5 minutes
