SOLUTION BUNDLED
◉ What ventilator parameter indicates fluid volume excess? Answer:
An A:a gradient greater than 10 mm Hg is a reflection of a diffusion
defect. Note that the process of diffusion is between A (alveolus) and
(a) arterial blood. An increase in intraalveolar fluid dilutes and
inactivates surfactant, causing alveolar collapse (decreasing vital
capacity) and decreases lung compliance. Peak inspiratory pressure
increases reflect a decrease in lung compliance
◉ What does autonomy refer to? Answer: The patient's right to
make decisions for themselves
◉ What does beneficence mean? Answer: Obligation to do good
◉ What does nonmaleficence mean? Answer: Obligation to do no
harm
◉ What does fidelity mean? Answer: the obligation to abide by
agreements and responsibilities
◉ What does veracity mean? Answer: The obligation to tell the truth
,◉ What are Diagnosis-Related groups? Answer: DRGs constitute a
prospective payment program for Medicare patients. Payment is
based on primary and secondary diagnosis, primary and secondary
procedures, age, and length of hospitalization
◉ BNP is secreted in response to? Answer: Ventricular wall stretch
◉ What are omnious signs in a patient with status asthmaticus?
Answer: A normalization or increase in the PaCO2. This patient is
still tachypneic, and if ventilation is normal, PaCO2 should be
decreased. The other ominous sign in this patient would be absence
of wheezing or rhonchi, because they would indicate that ventilation
is insufficient to cause these noises.
◉ What problems arise from losses from the GI tract? Answer: Any
loss results in hypokalemia. Vomiting results in loss of acidic
contents, whereas losses below the pylorus result is alkalitic losses
leading to metabolic acidosis. Fluid is sequestered in the intestine
leading to hypovolemia, which could cause hypovolemic shock.
◉ Actual problems are worse than potential problems!! Answer:
◉ How can you differentiate the cause of jaundice? Answer: An
increase in direct bilirubin is associated with biliary obstruction
because direct bilirubin is conjugated. An increase in indirect
, bilirubin is associated with hepatic disease or excessive hemolysis
because indirect bilirubin is unconjugated
◉ What antihypertensive meds work best in African american
patients? Answer: African-Americans do not respond well to
angiotensin-converting enzyme inhibitors (e.g., captopril [Capoten]),
but they do respond well to an angiotensin II blocker (valsartan
[Diovan]). Of the beta-blockers, labetalol works best. Of the calcium
channel blockers, diltiazem works best
◉ What lab values define acute respiratory failure? Answer: 50-50!
PaO2<50 and/or PaCO2>50
◉ Hyperkalemia can cause what? Answer: Diarrhea-increases
gastric motility
Flaccid paralysis- partially depolarizes muscle cells, prevents further
depolarization
◉ Every 1 inch increase in abdominal girth equates to how much
blood accumulation in the abdomen Answer: 500-1000mL
◉ What pacing method would be used in a patient in atrial fib?
Answer: VVI- you don't want to sense or pace the atria.
1st letter-paced chamber