FCCS Review with complete solutions 2023

FCCS Review with complete solutions 2023What does a DNR mean? take care of the patient but DO NOT do chest compressions Who takes care of patients and their comfort measures and specifically focuses on the quality of life? Palliative care You intubate someone how do you confirm you did it correctly? capnography (end tidal CO2 monitor) **aka qualitative CO2 exhale monitor **the line on the capnography machine will turn purple to yellow and this means youre exhaling CO2 A child comes in and is choking and SOB, you listen to this child and get an CXR you see hyperinflation in RL. What happened? Child aspirated a foreign body Someone fell and has a seizure what do you immediately give to treat the seizure? benzodiazepine (fast acting) T/F before giving phenytoin or phosphenytoin you need to know if a patient is epileptic, if this was d/t fever or if they have an electrolyte abnormality True Do you want to give a paralytic to a patient that is seizing? No that is unethical and you wont know if they are seizing How do you diagnose a patient with a dissecting thoracic aortic aneurysm? What do you do next? (think imaging) What do you do to treat it? 1. Chest pain that is ripping tearing and radiates to the back 2. Unequal pulses in extremities 3. BP is high initially (hypertensive emergency (180 SBP or 120 DBP) - Chest CXR to find widened mediastinum Treatment: labetolol (to slow HR via BB) **B/c shearing force is dependent on the HR Someone OD's on Drugs 4 hours ago, what would you do meaning is there anyway to get the drug out of the system? - You can give reversal agent (antidote) - If it is > 2 hrs the drug is gone out of the GI nothing you can do for local control (NG or charcoal are local control) You have a patient you suspect is having a PE. The patient has a history of COPD do you do a V/Q scan or a CTA? CTA **b/c V/Q scan will automatically be abnormal wether or not there is a PE b/c lung disease causes and abnormal V/Q (ventilation perfusion) **if no lung disease then do V/Q You have a patient w/DKA. a. You start them on insulin drip and fluid. When you give them insulin what is the goal? b. If BS is 200 and anion gap is still open what do you do? c. What BS number do you add dextrose? d. You keep giving D5 and insulin gtt until when? a. To lower anion gap and lower BS by 50 mg/dl per hr b. add D5 to insulin c. <250 d. until anion gap closes You have a DKA patient you start them on insulin drip and fluid. You started D5 when the patient hit a BS <250 mg/dL. The anion gap is now 8 what do you do and why? add long acting insulin 1 hr prior to turning of insulin and D5 ggt. Do this so the patient does not rebound back into DKA. ***keep ggt running 1 hr after giving long actin insulin A man comes in with septic shock. His CXR shows pneumonia. His BP is 70/35 mmHg. How much fluid do you give? 30 ml/kg