Clinical Simulation Study Set Questions With Complete Solutions

Visuals (things you will always choose...) correct answer: -general appearance -appearance of chest -respiratory pattern -sensorium -posture -patient color -pulse Infant normals correct answer: Pulse: 110 - 160 BP: 60/40 mm Hg RR: 30 to 60 Birth Wt: 3000g APGAR: 7 to 10 Hemodynamic Normals correct answer: BP: 120/80 (90/60 to 140/90) MAP: 93 to 94 CVP: 2 to 6 mm Hg (4 to 12 cmH2O) PAP: 25/8 (mean 13 to 14) PWP/PCWP: 4 to 12 mm Hg CO: 4 to 8 LPM CI: 2.5 to 4 L/min/sq m UNACCEPTABLE bedside ventilatory parameters correct answer: VC: 10mL/kg (or 2 x VT) MIP/NIF: 20 cm H2O RR: 20 bmp or 8 Vt: 5mL/kg Ve: 10 LPM MEP: 40 cm H2O Vent Parameters... correct answer: Tidal Volume: 5 to 10 mL/kg -------asthma/ards use 4 mL/kg Pressure: Pplat from VC or up to 3 cm H2O Rate: 10 to 20 FiO2: 40 to 60% or set to prior PEEP: 2 to 6 or set to prior Infant vent settings correct answer: Vt: 4-6 mL/kg PIP: 20 to 30 Rate: 20 to 30 FiO2: 40 to 60% PEEP: 2 to 4 Airway resistance correct answer: PIP-Plateau Used to indicate the amount of pressure support neccessary to overcome airway resistance Body box is most accurate measurement Acid-fast Bacillus (AFB) correct answer: Staining (Ziehl-Neelsen) Dx of TB Organisms appear red against blue background Takes 2-3 weeks - Albumin correct answer: Normal 3.5-5.0 g/dl Decreased levels are seen in liver disease Angiogram correct answer: X-rays of vessels (veins and arteries) Evaluates blood flow to the brain, heart, lungs, etc. - Anion Gap correct answer: Normal: 8-18 MEq/L Identifys the cause of metabolic acidosis - Ascorbic acid level correct answer: Determination of the amount of vitamin C in the blood - Babinski relfex correct answer: Tests brainstem and spinal cord function Dorsiflex of the toes after stroking foot indacates positive test (lesion may be present) Used in stable, yet unconcious patients Basal metabolic rate correct answer: Term: Basal energy expenditure (BEE), Minimal energy expenditure (MEE) Determined through indirect calorimetry Helpful in determining a patients nutrional needs Basic metabolic panel (BMP) correct answer: Blood test (glucose, lytes, fuid levels, and kidney function) BCG vaccine correct answer: Immunization for TB - Bilirubin level correct answer: Normal: 0.1-1.0 mg/dl Orange-yellow pigment of bile