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What is the most important sign in a critically ill pt? Why? - ANSWER
✔✔Tachypnea
Indicates metabolic acidosis w/ respiratory alkalosis compensation
A pt misses dialysis for a few days and comes in with fluid overload. He's
tachycardic and tachypneic. On physical exam, you find JVD, pulsus
paradoxus (20 mmHg drop during inspiration), and HoTN (80/40) with
distant, muffled heart sounds. Lungs are clear to auscultation. What is
the dx? - ANSWER ✔✔Cardiac tamponade; obstructive shock
,If a pt has a thyromental distance of 2 cm, what can you expect about
their airway? - ANSWER ✔✔Difficult airway w/ an anteriorly displaced
larynx
A COPD pt comes in with difficulty breathing. He then becomes apneic
and unresponsive. How would you ventilate this pt? - ANSWER
✔✔BVM
A pt arrives after falling from a ladder and has a frontal laceration. On
examination, you find papilledema and labored breathing w/o being able
to clear secretions. What is your biggest concern when intubating this
pt? - ANSWER ✔✔Cerebral edema/increasing ICP
Intubation tends to cause an increase in ICP. Administer lidocaine prior
to intubation to inhibit vagal stimulation.
An ESRD pt w/ hyperkalemia develops dyspnea and requires intubation.
Which paralytic agent/NMB should you avoid and why? - ANSWER
✔✔Succinylcholine
Worsens hyperkalemia
, A pt is admitted after an OD. He starts to have apneic episodes and his
SpO2 is dropping. You place him on a non-rebreather mask w/ 100%
O2, yet his SpO2 remains at 80%. Why is it not being corrected?
Then, if you try a BVM and it also fails, and video laryngoscopy is
unavailable, what is your next best choice for an airway? - ANSWER
✔✔The pt is having apneic episodes, which means that administering
high-flow O2 will be ineffective.
Choose an LMA if the BVM fails.
What intervention improves outcomes with ROSC after cardiac arrest? -
ANSWER ✔✔Targeted temperature management.
32-36 C
A shunt means there is perfusion without ventilation. What disease
process is an example of a shunt? - ANSWER ✔✔Pneumonia
Which type of respiratory failure occurs with CNS depression after an
OD? - ANSWER ✔✔Acute hypercapnic respiratory failure --> mixed
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