CRITICAL CARE HESI 2023 QUESTIONS AND ANSWERS ALREADY PASSED A+

spinal cord injury at the scene - CORRECT ANS Nursing interventions are focused on stabilization of the spine, preserving the airway and respiratory status and preventing complications associate with SCI. Assessment of respiratory and neurological status is first priority, might need to be tubed. If in neurogenic shock, they cannot regulate body temperature teaching for ICD - CORRECT ANS site care and symptoms of complications, hematoma at the site is common, wear a medic alert bracelet, when device fires the patient will feel either tingling or discomfort or wont even know it went off. avoid strong magnetic fields (MRI), keep cell phones 6 inches from ICD, may fire when tachycardic, avoid driving for 6 months if hx of cardiac arrest, teach family CPR ventilator alarms - CORRECT ANS can be caused by biting tube, kinks, need suctioned or trying to talk ARDS and lung trauma - CORRECT ANS Refractory hypoxemia: hallmark sign of ARDS. FiO2 could be 100% but Pao2 is <60%. only intervention is ECMO which is difficult because adults need anticoagulation therapy. Bilateral patchy infiltrates: patches of white on a lung x ray Noncompliance of the lung: it will not expand, need to be sedated -initial ABGs show low CO2 because of hypervention then it flips to metabolic acidosis - lungs clamp down so it is difficult to breath, capillary membrane damage) Treatment: ventilator, lung protective strategies (low TV, FiO2 at nontoxic levels ~60%, unconventional vent settings i.e. RR 300-420 BPM) VAP - CORRECT ANS main cause is aspiration, poor oral hygiene, contaminated equipment. strategies to reduce VAP: - elevated HOB 30-45 degrees, hand hygiene and gloves when suctioning, suction above cuff before deflation, oral hygiene Q2!!!! documentation of pneumothorax breath sounds - CORRECT ANS they are absent tension pneumothorax and trauma - CORRECT ANS tension pneumo can be caused by mechanical ventilation. pressurized air enters the pleural space and continues to accumulate which causes an increase in pressure, increasing amount of alveoli collapse and pressure on the heart and great veins. immediate insertion of a chest tube is needed and removed from vent chest tube assessment - CORRECT ANS splint insertion site to facilitate coughing and deep breathing. do not milk the tube, do not clamp the tube mechanical ventilator and respiratory acidosis - CORRECT ANS If the ventilator