CRITICAL CARE NURSING FINAL EXAM REVISION
QUESTIONS AND ANSWERS COMPLETE RATED A.
What lab values would be primary indicators of hepatic failure? (2-7)
Verified Answer -- increased AST
- increased ALT
- increased bilirubin, INR, and PTT
- decreased albumin and fibrinogen
Which common medication should not be given to patients with liver
failure?
Verified Answer -acetaminophen (Tylenol)
How do most patients die in the ICU? (2)
Verified Answer -withholding/withdrawal of life support or sudden death
What symptoms do patients and families fear when discontinuing
technology in the ICU? (2-4)
Verified Answer -- pain
- dyspnea
(make sure there are care conferences addressing grief and guilt)
- dying alone
- suffering
Why do patients with certain cardiac devices need advanced directives?
Verified Answer -possible dysfunction of devices
- ICD defibrillates patient as they are dying (will cause additional pain)
,What is the first line treatment for hypovolemic shock?
Verified Answer -IV fluids
What are the consequences of hypothermia?
Verified Answer -prolonged bleeding time (alters coagulation)
How can hypothermia be prevented in a patient with trauma? (2)
Verified Answer -- warm IV fluids
- limit skin exposure
How do you manage warfarin following trauma?
Verified Answer -reverse effects of warfarin with vitamin K and FFP
What drug is the reversal for heparin?
Verified Answer -protamine
What is the equation for calculating cerebral perfusion pressure (CPP)?
Verified Answer -MAP - ICP = CPP
The patient has been mechanically ventilated for 10 days without much
progress toward weaning after a severe head injury. What change in
treatment would you anticipate?
Verified Answer -tracheostomy
What should you assess if you suspect abdominal compartment syndrome
in a patient? (3-5)
Verified Answer -- abdominal distention
- UO
- bladder pressure
, (pt may also have increased ICP and ventilation issues)
What medication should you administer if cerebral perfusion pressure
(CPP) is poor?
Verified Answer -vasopressor: norepinephrine
What medication should you administer if a patient has increased ICP?
Verified Answer -osmotic diuretic: mannitol (will decrease cerebral
swelling)
What is the purpose of hyperventilation in a patient with increased ICP?
Verified Answer -keeps CO2 low (the use of an ambu bag will be the last
ditch effort)
What does the brain need a continuous supply of? (2)
Verified Answer -- oxygen
- glucose
How do you monitor oxygen and glucose levels in the brain?
Verified Answer -measured with a catheter
- brain tissue oxygen pressure
- PbtO2
(make sure nutritional status is satisfactory)
Why might patients get worse over a few days following a brain injury?
Verified Answer -secondary injury causing inflammation and cerebral
edema
QUESTIONS AND ANSWERS COMPLETE RATED A.
What lab values would be primary indicators of hepatic failure? (2-7)
Verified Answer -- increased AST
- increased ALT
- increased bilirubin, INR, and PTT
- decreased albumin and fibrinogen
Which common medication should not be given to patients with liver
failure?
Verified Answer -acetaminophen (Tylenol)
How do most patients die in the ICU? (2)
Verified Answer -withholding/withdrawal of life support or sudden death
What symptoms do patients and families fear when discontinuing
technology in the ICU? (2-4)
Verified Answer -- pain
- dyspnea
(make sure there are care conferences addressing grief and guilt)
- dying alone
- suffering
Why do patients with certain cardiac devices need advanced directives?
Verified Answer -possible dysfunction of devices
- ICD defibrillates patient as they are dying (will cause additional pain)
,What is the first line treatment for hypovolemic shock?
Verified Answer -IV fluids
What are the consequences of hypothermia?
Verified Answer -prolonged bleeding time (alters coagulation)
How can hypothermia be prevented in a patient with trauma? (2)
Verified Answer -- warm IV fluids
- limit skin exposure
How do you manage warfarin following trauma?
Verified Answer -reverse effects of warfarin with vitamin K and FFP
What drug is the reversal for heparin?
Verified Answer -protamine
What is the equation for calculating cerebral perfusion pressure (CPP)?
Verified Answer -MAP - ICP = CPP
The patient has been mechanically ventilated for 10 days without much
progress toward weaning after a severe head injury. What change in
treatment would you anticipate?
Verified Answer -tracheostomy
What should you assess if you suspect abdominal compartment syndrome
in a patient? (3-5)
Verified Answer -- abdominal distention
- UO
- bladder pressure
, (pt may also have increased ICP and ventilation issues)
What medication should you administer if cerebral perfusion pressure
(CPP) is poor?
Verified Answer -vasopressor: norepinephrine
What medication should you administer if a patient has increased ICP?
Verified Answer -osmotic diuretic: mannitol (will decrease cerebral
swelling)
What is the purpose of hyperventilation in a patient with increased ICP?
Verified Answer -keeps CO2 low (the use of an ambu bag will be the last
ditch effort)
What does the brain need a continuous supply of? (2)
Verified Answer -- oxygen
- glucose
How do you monitor oxygen and glucose levels in the brain?
Verified Answer -measured with a catheter
- brain tissue oxygen pressure
- PbtO2
(make sure nutritional status is satisfactory)
Why might patients get worse over a few days following a brain injury?
Verified Answer -secondary injury causing inflammation and cerebral
edema
