ICU Management

Question 1

PT in the ICU: focus on?

Answer 1

Pulmonary care (secretion removal), early mobility (ROM, positioning, ther-ex, transfers, ambulation)

Question 2

Mechanical ventilation maintains __ for pts who cannot do so independently. Requires intubation with __, __, or __ (3 ways).

Answer 2

VE
ETT
NTT
tracheal

Question 3

Any contraindications to PT while on mechanical vent?

Answer 3

None- may ambulate using mechanical recusitator bag to maintain ventilation

Question 4

If ventilator tube movement from incision is suspected, what do you do? What if dislodged?

Answer 4

Nurse or respiratory therapist should check tube placement.

If dislodged, physician (often anesthesiologist) should replace tube

Question 5

Chest tubes- used for what?

Answer 5

Evacuate air or fluid trapped in intrapleural space

Question 6

Contraindications to PT with chest tube?

Answer 6

None- mobility only limited by length of tubing. Portable suction machines can be used for increased mobility

Question 7

If tube is dislodged during tx- what do you do?

Answer 7

Cover the defect and seek assistance

Question 8

IVs- any contraindications for PT? What to be aware of?

Answer 8

None- but be aware that UE should not be raised above level of IV medication for length of time or backflow of blood may occur

Question 9

Arterial line- where is it usually? How does it work?

Answer 9

Radial artery

Tubing connected to pressure pack that exceeds arterial pressure so line does not back up with blood

Question 10

Caution with ALine?

Answer 10

Maintain patency during moving. Lines may be capped off by nursing for short time to allow mobility. Length of tubing is only limitation for out of bed activity

Question 11

What do you do if ALine gets dislodged?

Answer 11

Immediate firm pressure applied to or above arterial insertion site to stop bleeding.

Question 12

Pt may have continuous electrocardiograph (ECG) with reported HR. BP reading may be periodic using ? Or continuous using transducer attached to ?

Answer 12

NIBP: non-invasive cuff
ABP: arterial line

Question 13

Continuous oxygen saturation (__) with pulse wave- __ is the percent saturation of O2 in arterial blood. Non invasive measurement that relates to PaO2 on S-shaped curve called _____. What are normal levels?

Answer 13

SaO2
SaO2
Oxyhemoglobin desaturation curve
90-100%

Question 14

Supplemental O2 increases ___ (up to 1) of pt’s environment. Supplemental O2 is indicated if PaO2 is ____ regardless of activity level. Monitor pt’s ____ to assure adequate oxygenation with increased activity.

Answer 14

FiO2
<55mmHg
SaO2

Question 15

Can PT prescribe supplemental O2 to pt?

Answer 15

No- Prescribed by physician since form of medication