Solutions.
restore perfusion - CORRECT ANSWER>>-increase preload w/ fluid
boluses
-optimize afterload after fluid resuscitation, use pressors
-increase contractility using inotropes
antimicrobial therapy - CORRECT ANSWER>>from onset of
hypotension due to sepsis, every hour counts. antibiotics during first
hour = 80% survival
source control - CORRECT ANSWER>>goal for identification and
control within 12 hours. debride wound or remove line
glycemic control - CORRECT ANSWER>>glucose will be elevated
from stress and pressors. utilize insulin infusions per area protocol
Swan-Ganz catheter - CORRECT ANSWER>>a cardiac catheter with
a balloon at the tip that is used to measure pulmonary arterial
pressure; it is flow guided through a vein into the right side of the heart
and then into the pulmonary artery
inserted under sterile technique by provider. IJ, sublavian, or femoral
pulmonary arterial pressure - CORRECT ANSWER>>15-30/8-15
thermistor port - CORRECT ANSWER>>measures body temperature
,what can be injected into the red balloon port? - CORRECT
ANSWER>>1.5 mL or less of air
which port should you use to infuse calcium chloride? - CORRECT
ANSWER>>clear/white
what can be infused through the yellow port? - CORRECT
ANSWER>>3mL/hr NS flush
RN role with PAC - CORRECT ANSWER>>-use ports appropriately
-level, zero, square wave, waveform analysis
-prevent infection
-measure skin to tip q4h and document changes from placement
measurement
-print PA wave strip and ECG strip
-site care prn or once a week
-d/c lines asap w/ order
PAC safety - CORRECT ANSWER>>-secure device
-do not tape over plastic sheath
-monitor for wedging
-monitor for ventricular placement
-assure you are getting quality data
osmosis - CORRECT ANSWER>>diffusion of water across a
selectively permeable membrane
,pituitary gland - CORRECT ANSWER>>endocrine system's most
influential gland. under the influence of the hypothalamus, the pituitary
regulates growth and controls other endocrine glands
PaO2 - CORRECT ANSWER>>partial pressure of oxygen in arterial
blood, obtained using an ABG
80-100mmHG
PaO2 60=SpO2 90%
SpO2 - CORRECT ANSWER>>saturation of peripheral oxygen,
obtained using pulse ox
90-100%
SpO2 90%=PaO2 60
PaCO2 - CORRECT ANSWER>>35-45
respiratory acidosis - CORRECT ANSWER>>low pH, high CO2
causes: CNS depression from drugs such as sedation, injury, or
disease
breathe too slow, retaining CO2
respiratory alkalosis - CORRECT ANSWER>>high pH, low CO2
causes: pain, fever, sepsis
, breathe too fast, not retaining enough CO2
HCO3 - CORRECT ANSWER>>22-26
metabolic acidosis - CORRECT ANSWER>>low pH, low HCO3
causes: diarrhea, DKA, hyperkalemia
metabolic alkalosis - CORRECT ANSWER>>high pH, high HCO3
causes: vomiting, suctioning, hypokalemia
pH - CORRECT ANSWER>>7.35-7.45
reading ABGs - CORRECT ANSWER>>1. evaluate pH to identify
acidosis or alkalosis
2. match CO2 or HCO3 with pH state using ROME to determine
respiratory or metabolic
3. assess whether CO2 or HCO3 state is opposite of pH to determine if
it is uncompensated, partially compensated, fully compensated, or
corrected
non-invasive ventilation - CORRECT ANSWER>>CPAP/BiPAP
CPAP - CORRECT ANSWER>>continuous positive airway pressure;
provides inspiratory pressure