Clinical simulation RRT 100% correct answers already graded A+

Clinical simulation RRT 100% correct anappropriate PH for ARDS? 7.30-7.45 Plateau pressure (Pplat) normal? =30 The oxygenation (PaO2) the acceptable range of a patient with ARDS? acceptable range of 55 - 80 for a patient with ARDS. signs of respiratory failure and what are you supposed to do ? tachypnea, hypercarbia, and hypoxemia) NIV should be implemented to prevent further deterioration. Prednisolone 60mg tablet, Prednisone can be used to gain quick control in patients in acute exacerbation, and is recommended as part of the EPR-3 guidelines for patients with severe persistent asthma recovering from exacerbation.) Beclomethasone Dipropionate HFA (Qvar) 80mcg: 2puffs bid Ordered (EPR-3 guidelines recommend use of a medium-high dose inhaled corticosteroid as a viable option for treatment in patients with severe persistent asthma.) EXITHELPTIME Asthma severity classification? FEV1 greater than 80%-mild FEV1 60 to 80 ? Moderate FEV1 less than 60? Severe Up to 2 days a week? Intermittent Less than 2 days a week? Mild-persistent Moderate? Symptoms daily severe? Symptoms throughout the day Asthma Control Test (ACT) scores ? The ACT 5-item self-administered questionnaire that ranges from score of 0 (worst) to 25 (best). Any score less than 5 indicates poor control with scores of 19 indicating well controlled asthma.) PaO2/FiO2 ratio weaning parameter (The PF ratio allows a credible assessment of generalize oxygenation status in comparison to the concurrent level of oxygen therapy. A normal PF ratio is greater or equal to 350. Any PF ratio less than 150-200 usually indicates ongoing significant oxygenation impairment.) Rapid shallow breathing index (RSBI)Weaning parameter (The RSBI is a comparison of respiratory rate and spontaneous tidal volume (f/VT), used as a long-established credible metric to assess extubation readiness. RSBI less than 105 is considered acceptable for a majority of patients.) Vital Capacity (VC) weaning parameters (A VC maneuver can be easily acquired during mechanical ventilation by having a patient breath in maximally and slowly breath out completely (to residual volume). A VC measurement should be greater than 10-15 mls/kg of predicted body weight in order to consider extubation readiness.) Maximal inspiratory force (MIP) weaning parameters (The MIP, also known as negative inspiratory force (NIF), is a standard measurement of inspiratory muscle strength and potential cough ability. The greater the negative value, the better; a NIF should be less than -20 to -30 cmH2O before consideration of extubation readiness.) Wedge shaped infiltrates on left side what is it? Pulmonary embolus Test to detect pulmonary embolism? STAT V/Q scan Pulmonary angiogram(2rd) Treatment plan for pulmonary embolus? Low dose IV heparin Physician agrees (prevents PE from recurring) Pnuematic compression device Physician agrees (prevents PE from forming) Sedate patient and administer 1 mg/kg of succinylcholine. For quick intubation? Instill lidocaine into the ET tube? Stops coughing How do you treat a pneumothorax? Increase the FIO2 to 1.0 and place a chest tube in the second anterior intercostal space on the right side. Resuscitation steps in newborn who fail the rapid assessment? 1)Put under radiant warmer2)open and clear the airway3) dry the skin4)asses heart rate and respiration A heart rate less than 100 on newborns requires what? PPV Appropriate parameters for bag valve resuscitation? FiO2 of 0.24%,PIP of 20,PEEP of 5,breaths of 60,flow meter adjusted to 10 Normal P:F ratio (PaO2/FIO2)? 200 or more PH 7.27,PaCO2 25 torr,PaO2240 torr,bircabonate 11 Carboxyhemoglobin 35% Severe metabolic acidosis administration of sodium bicarbonate Drooling is a sign of? epiglottitis Thump sign? epiglottitis breath sounds are absent over the right basalar blunting of the costaphrenic angle? pleural effusion how do we resolve a pleural effusion? thoracentesis Exudative Fluid disease process that is involved? pneumonia evel of impairment? 2 times a week intermittent evalution tests for suspected epiglotitties? Respiratory rate Pulse rate breath sounds epiglotities can present with which breath sounds? stridor once the pt is stable(intubated for epiglotities) what further assesment are done? vital signs ABG skin color general apperence lateral neck radiograph breath sounds Throat culture regime for managing epiglots once intubated and test have been run) sedate administer antibiotics(fever) instute mechanical ventilatory support apply wrist strains Monitor pulse oximetery Croup (laryngotracheobronchitis) A loud barking cough Steeple sign subglottic narrows down everyone gets pt interview? sensorium social history medical history signs of COPD? shortness of breath Accesory muscle usage digital clubbing Increased A-P diameter confirmation of cystic fibrosis? -chest randigraph that shows hyperlucent lung field patchy infiltrate in right middle lobe(locolized pneumonia) -Sweat chloride test 70 management of asthmaticus astma? -administer SVN with albutrol 2.5mg in norml saline,q5-20 min as needed -administer methylpredisolone(solu-Medrol) -apply O2 via NC at 4Llmin 32 weeks,10 min post-partum what will you evalute? general apperearance breath sounds APGAR respiration HR L/S ratio SpO2 chest radiograph Meternal history normal PIP level on PC/IMV for neonates? 2swers already graded A+