BKAT Critical Care Review questions with verified answers, Exams of Nursing

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BKAT Critical Care Review questions with verified answers Normal Central Venous Pressure (CVP) range - ANSWER: ➡ 2-8 mmHg Normal Pulmonary Artery Occlusion Pressure (PAOP) range - ANSWER: ➡ 6-12 mmHg Normal Pulmonary Artery Systolic (PAS) range - ANSWER: ➡ 20-30 mmHg Normal Pulmonary Artery Diastolic (PAD) range - ANSWER: ➡ 5-15 mmHg Normal Pulmonary Artery Mean (PAM) - ANSWER: ➡ 11-20 mmHg Normal Systemic Vascular Resistance (SVR) range - ANSWER: ➡ 800-1200 mmHg Preload - ANSWER: ➡ volume left in the left ventricle at the end of diastole What is preload affected by? - ANSWER: ➡ venous return to the heart, atrial kick, total volume, and ventricular compliance What drugs can affect preload? - ANSWER: ➡ Furosemide and nitroglycerin Afterload - ANSWER: ➡ Amount of pressure heart has to overcome to pump blood out What drugs may affect afterload? - ANSWER: ➡ Vasoconstricters and vasodilators Contractility - ANSWER: ➡ the contractile force of the heart, how much will it take to move the preload out against the afterload What is the appropriate hold time after pulling an arterial line? - ANSWER: ➡ 5-10 min What part of the heart does the PAOP affect? - ANSWER: ➡ Left ventricle What part of the heart does the CVP affect? - ANSWER: ➡ Right ventricle What does it mean when the PAOP is elevated? - ANSWER: ➡ Increased left ventricular end diastolic pressure that could be indicative of left ventricular dysfunction or failure What does it mean if CVP is elevated? - ANSWER: ➡ Fluid overload or decreased compliance (such as with ARDS and COPD) Difference between stable and unstable angina - ANSWER: ➡ Stable angina: pain happens with certain activities but then goes away with rest. Unstable angina: chest pain can occur at rest, becomes more sever or frequent, or lasts longer ECG changes with an acute MI? - ANSWER: ➡ ST elevation or depression ECG changes with hyperkalemia - ANSWER: ➡ Peaked T waves What conditions may cause elevated cardiac enzymes? - ANSWER: ➡ Trauma, acute MI, CABG, and pericarditis What is the goal of treatment with cariogenic shock? - ANSWER: ➡ to increase cardiac output What are the effects of nitroprusside (Nipride) and dobutamine (Dobutrex) on preload, afterload, and contractility? - ANSWER: ➡ They both increase cardiac output, heart rate, and contractility Appropriate pressure for suctioning is - ANSWER: ➡ 120 mmHg Causes of decreased breath sounds - ANSWER: ➡ Pneumonia, heart failure, pleural effusion, and increased chest wall thickness Nursing action to check for proper ETT placement - ANSWER: ➡ Listen to bilateral breath sounds Most common reason for development of PE following trauma with multiple long bone fractures - ANSWER: ➡ Fat emboli What is the most important nursing action in relation to cervical spine injury? - ANSWER: ➡ Respiratory impairment is the most common complication of CSI, so need to protect airway, maintain adequate respirations, and keep spine straight Earliest sign of increased ICP - ANSWER: ➡ Headache and vomiting Drug frequently used to decrease ICP - ANSWER: ➡ Mannitol How many hours can lapse between onset of stroke symptoms and administration of tPA? - ANSWER: ➡ Up to 4.5 hours Most important part of neurological assessment - ANSWER: ➡ Evaluation of LOC Signs of diabetes insipidus in a post operative craniotomy patient - ANSWER: ➡ Extreme thirst and urine output >1000 mL What anti-seizure medication should never be mixed with D5W and why? - ANSWER: ➡ Dilantin because it causes crystallization Signs and symptoms of DKA - ANSWER: ➡ Frequent urination, extreme thirst, elevated glucose, elevated urine ketones, nausea and/or vomiting, abdominal pain, confusion, and fruity-smelling breath Signs and symptoms of hypoglycemia - ANSWER: ➡ Shakiness, dizziness, hunger, irritability, anxiety, and headache Treatment for DKA - ANSWER: ➡ IV fluids and correction of potassium of </= 3.3 before insulin, administration of 0.1 unit/kg bolus of insulin, and insulin infusion at 0.1 units/kg/hr Peak action time of regular insulin - ANSWER: ➡ 2-4 hours Peak action time of NPH insulin - ANSWER: ➡ 8-14 hours What is cortisone? - ANSWER: ➡ A synthetic form a cortisol for replacement of cortisol, a hormone produced in then adrenal gland Normal BUN ranges - ANSWER: ➡ 7-20 Normal creatinine range - ANSWER: ➡ 0.5-1.3 Normal potassium range - ANSWER: ➡ 3.5-5 Normal urine specific gravity range - ANSWER: ➡ 1.003-1.030 Adequate urine output level - ANSWER: ➡ At least 0.5 mL/kg/hr Is medication that is excreted through the kidneys increased or decreased in dosage for patients in acute renal failure? - ANSWER: ➡ Decreased Recommended renal diet - ANSWER: ➡ Low Na+, low phosphorus, and low protein Sudden development of dyspnea and tachycardia in acute renal failure patients in most indicative of what? - ANSWER: ➡ Fluid overload Low intermittent suction is used with OGT and NGT to do what? - ANSWER: ➡ Decompress the stomach and prevent vomiting Best way to confirm OGT/NGT placement - ANSWER: ➡ X-ray "Coffee ground" NGT aspirate may indicate what? - ANSWER: ➡ Bleeding that has occurred in the recent past and become partially digested Signs and symptoms of blood transfusion reactions - ANSWER: ➡ Back pain, dark urine, chills, fainting, dizziness, fever, flank pain, skin flushing, and shortness of breath Most important treatment in burn patients with 24 hours following airway securment - ANSWER: ➡ IV fluid resuscitation Why should a hypothermic patient not be rapidly re-warmed? - ANSWER: ➡ Rebound increased ICP True or false: A medical power of attorney gives the person the right to make all medical decisions for the patient while in critical care? - ANSWER: ➡ False ACLS rhythms that amiodarone is used to treat - ANSWER: ➡ V-fib and pulseless v- tach Amiodarone dosage for ACLS - ANSWER: ➡ 300 mg Signs and symptoms of cyanide toxicity - ANSWER: ➡ Mental status changes, tachycardia, seizure, a need for an increase in dose, and unexplained metabolic acidosis