Chapter 2- Physical Exam and Daily Assessment of the Critically Ill Patient

Question 1

Physical Exam

Answer 1

• Airway/breathing
• Criculation (HR, MM color, CRT, venous distension, pulse quality)
• Auscultation
• Level of conciousness
• Temperature
• Hydration
• Abdominal palpation/GI assessment

S/H

Question 2

Monitoring/Laboratory Data

Answer 2

• Oncotic Pull/Total Protein/Albumin
• Glucose
• Electrolyte adn Acid-Base Balance
• Oxygenation/Ventilation
• RBC/Hgb
• BP
• Coagulation
• Renal function/UOP
• Immune status/AB/WBC
• Drug dosage/Metabolism
• Nutrition
• Nursing Care

S/H

Question 3

Kirby’s Rule of 20 for Monitoring the Critically Ill Patient

Answer 3

1. Fluid balance
2. Oncotic pull
3. Glucose
4. Electrolyte and Acid-base
5. Oxygenation and ventilation
6. Mentation
7. Perfusion and blood pressure
8. Heart rate, rhythm and contractility
9. Albumin levels
10. Coagulation
11. RBC and hemoglobin concentration
12. Renal function
13. Immune status, AB dosage and selection, WBC count
14. GI motility and mucosal ingetrity
15. Drug dosage and metabolism
16. Nutrition
17. Pain control
18. Nursing care and patient mobilization
19. Wound care and bandage change
20. TLC

S/H