Critical Care Flashcards
(152 cards)
1
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Q: What is critical care nursing?
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A: Critical care nursing involves the specialized care of patients with life-threatening conditions, requiring comprehensive and continuous monitoring and treatment.
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Q: What are the three components of circulation?
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A: Blood vessels, the heart, and blood.
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Q: What was one of the first specialized critical care units developed?
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A: The first specialized ICU was the respiratory ICU.
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Q: How did World War II impact the development of critical care units?
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A: WWII led to the creation of shock wards for critically injured patients, which later evolved into ICUs.
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Q: What is a key element of critical care nursing regarding patient monitoring?
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A: Monitoring the physiological functions of critically ill patients and ensuring safety and quality of care.
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Q: What is the primary goal of holistic critical care nursing?
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A: To provide care that considers the patient’s body, mind, and spirit as interconnected and inseparable.
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Q: What is beneficence in critical care nursing?
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A: The ethical principle of doing good and preventing harm to patients.
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Q: How do critical care nurses manage crisis situations?
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A: They use their clinical judgment, problem identification skills, and crisis management techniques to stabilize and support patients.
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Q: How is hypovolemic shock treated in critical care?
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A: Treatment involves fluid resuscitation, controlling bleeding, and restoring blood volume.
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Q: What are common conditions managed in critical care settings?
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A: Respiratory failure, cardiac arrest, shock (neurogenic, cardiogenic, septic), and severe trauma.
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Q: What is the protocol for managing diabetic ketoacidosis (DKA) in critical care?
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A: Treatment includes insulin administration, fluid resuscitation, electrolyte monitoring, and addressing the underlying cause.
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Q: What interventions are used in managing cardiogenic shock?
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A: Interventions include inotropes, vasopressors, mechanical support, and addressing the underlying cardiac condition.
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Q: What role do vasopressors play in critical care?
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A: Vasopressors are used to raise blood pressure in patients with shock, improving tissue perfusion.
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Q: What is the purpose of CPAP in critical care?
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A: CPAP (Continuous Positive Airway Pressure) provides a constant flow of air to keep the airways open, often used in patients with sleep apnea or respiratory distress.
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Q: How do nurses manage patients on mechanical ventilation?
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A: They monitor respiratory status, ensure proper ventilator settings, perform suctioning, and prevent ventilator-associated complications.
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Q: What is the role of critical care nurses in family presence during resuscitation?
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A: They support the family, facilitate communication, and provide a compassionate environment during resuscitation efforts.
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Q: What are the goals of managing dysrhythmias in critically ill patients?
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A: To stabilize the heart rhythm, maintain cardiac output, and prevent complications such as stroke or cardiac arrest.
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Q: What is anaphylactic shock and how is it managed in critical care?
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A: Anaphylactic shock is a severe allergic reaction managed with epinephrine, antihistamines, corticosteroids, and airway support.
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Q: What is the protocol for managing septic shock?
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A: Early recognition, aggressive fluid resuscitation, antibiotics, vasopressors, and source control of infection.
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Q: How is neurogenic shock treated?
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A: Treatment includes stabilizing the spine, maintaining blood pressure, and managing bradycardia.
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Q: What are the components of the ABCs in CPR?
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A: Airway, Breathing, and Circulation.
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Q: What is the significance of fluid resuscitation in critical care?
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A: It restores intravascular volume, improves cardiac output, and enhances tissue perfusion in shock states.
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Q: How is cultural diversity addressed in critical care?
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A: Through cultural competence, sensitivity to lifestyle differences, and incorporating cultural needs into care plans.
18
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Q: What are the signs and symptoms of shock in critically ill patients?
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A: Hypotension, tachycardia, cold and clammy skin, decreased urine output, and altered mental status.
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Q: What is the role of antihistamines in critical care?
A: They are used to treat allergic reactions, including anaphylaxis, by blocking histamine receptors.
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Q: How are blood transfusions managed in critical care settings?
A: By ensuring blood type compatibility, monitoring for reactions, and maintaining proper documentation and patient consent.
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Q: How is ventilator-associated pneumonia (VAP) prevented?
A: By maintaining proper hygiene, oral care, elevating the head of the bed, and using appropriate ventilator settings.
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Q: What are the main challenges in managing critically ill pediatric patients?
A: Challenges include differences in anatomy and physiology, medication dosing, and the need for specialized equipment.
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Q: What are the main challenges in managing critically ill pediatric patients?
A: Fluid management, infection control, pain management, and wound care.
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Q: What are the indications for tracheostomy in critical care?
A: Indications include prolonged mechanical ventilation, airway obstruction, and secretion management.
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Q: How is pain managed in critically ill adults?
A: Through regular pain assessments, appropriate use of analgesics, and non-pharmacological interventions.
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Q: What are the roles of respiratory therapists in critical care?
A: They manage ventilators, provide breathing treatments, perform pulmonary hygiene, and assist with airway management.
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Q: How is hyperglycemia managed in critically ill patients?
A: With insulin therapy, regular glucose monitoring, and adjusting nutrition and medications.
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Q: How is cardiac catheterization used in critical care?
A: For diagnostic purposes and interventions like angioplasty or stent placement in patients with cardiac conditions.
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Q: What is the purpose of thrombolytics in stroke and cardiac care?
A: To dissolve blood clots and restore blood flow in conditions like ischemic stroke and myocardial infarction.
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Q: What are the primary goals of nutritional support in critical care?
A: To meet the caloric and protein needs of critically ill patients, support healing, and prevent malnutrition.
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Q: How is acute kidney injury managed in critical care?
A: By managing fluid balance, avoiding nephrotoxic drugs, and using renal replacement therapy if necessary.
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Q: What interventions are used to prevent pressure ulcers in immobile patients?
A: Regular repositioning, use of pressure-relieving devices, and skin assessments.
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Q: How is end-of-life care managed in critical care settings?
A: Through palliative care approaches, discussing goals of care, and respecting patient and family wishes.
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Q: What are common signs of sepsis in critical care patients?
A: Fever, increased heart rate, elevated respiratory rate, and signs of organ dysfunction.
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Q: How do critical care nurses manage fluid and electrolyte imbalances?
A: By monitoring laboratory values, adjusting IV fluids, and managing medications that affect fluid balance.
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Q: What are the roles of nephrology nurses in critical care?
A: Managing patients with kidney conditions, dialysis, and monitoring for complications related to renal failure.
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Q: How is quality improvement implemented in critical care units?
A: Through data monitoring, implementing evidence-based practices, and ongoing evaluation of care processes.
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Q: How are multidrug-resistant organisms managed in critical care?
A: By using strict infection control measures, isolating patients, and using appropriate antibiotics.
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Q: How is bronchodilation achieved in critical care patients?
A: Through the use of bronchodilators like albuterol, epinephrine, or anticholinergics.
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Q: How do critical care nurses manage hyperactive delirium?
A: By assessing the underlying cause, using medications like antipsychotics, and creating a calm environment.
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Q: What interventions are used for patients with trauma injuries?
A: Stabilization, pain management, surgical interventions, and continuous monitoring.
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Q: What are common complications of immobility in critical care patients?
A: Pressure ulcers, muscle atrophy, deep vein thrombosis, and respiratory complications.
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Q: How is acute respiratory distress syndrome (ARDS) managed?
A: With supportive care, mechanical ventilation, prone positioning, and managing the underlying cause.
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Q: What is the purpose of guided imagery in critical care?
A: To reduce stress, anxiety, and pain through mental visualization techniques.
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Q: What is the impact of psychosocial issues on healing in critical care?
A: Psychosocial issues can affect recovery, stress levels, and overall patient outcomes.
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Q: What are the signs of ineffective coping in critical care patients?
A: Anxiety, depression, refusal of care, and lack of participation in treatment plans.
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Q: How do critical care nurses manage the risk of delirium?
A: Through regular assessment, minimizing sedatives, and promoting sleep and orientation.
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Q: What is the importance of effective communication in critical care?
A: It ensures clear understanding among the care team, patient, and family, reducing errors and enhancing care.
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Q: How are anticoagulants used in critical care?
A: To prevent clot formation in conditions like deep vein thrombosis, atrial fibrillation, and during mechanical ventilation.
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Q: What are the primary objectives of critical care nursing?
A: To stabilize patients, prevent complications, promote recovery, and provide support to patients and their families.
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What is the main goal of Critical Care?
To support organ function and treat life-threatening conditions in patients requiring intensive monitoring.
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What are the common causes of respiratory failure?
Pneumonia, ARDS, COPD, trauma, and neuromuscular disorders.
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What is the PaO2/FiO2 ratio indicative of ARDS?
A ratio less than 300 mmHg is indicative of ARDS.
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What are the key features of septic shock?
Persistent hypotension requiring vasopressors to maintain MAP ≥65 mmHg and serum lactate >2 mmol/L despite adequate fluid resuscitation.
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What is the first-line treatment for septic shock?
Early administration of broad-spectrum antibiotics and aggressive fluid resuscitation.
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Define Multiple Organ Dysfunction Syndrome (MODS).
Progressive dysfunction of two or more organ systems due to an uncontrolled inflammatory response to a severe illness or injury.
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What are the criteria for Systemic Inflammatory Response Syndrome (SIRS)?
Two or more of the following: temperature >38°C or <36°C, heart rate >90 bpm, respiratory rate >20 breaths/min, or abnormal white blood cell count.
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List the common types of shock.
Hypovolemic, cardiogenic, obstructive, and distributive shock.
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What are the hallmarks of cardiogenic shock?
Decreased cardiac output and increased systemic vascular resistance.
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What is the function of vasopressors in shock management?
To increase blood pressure by vasoconstriction and improving cardiac output.
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Name an example of a commonly used vasopressor in shock.
Norepinephrine.
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: What is the importance of maintaining Mean Arterial Pressure (MAP) in critically ill patients?
To ensure adequate organ perfusion, typically keeping MAP ≥65 mmHg.
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What are the components of the Glasgow Coma Scale (GCS)?
Eye opening, verbal response, and motor response.
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What is the most common cause of hospital-acquired infection in ICU patients?
Ventilator-associated pneumonia (VAP).
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What is the function of a central venous catheter (CVC)?
To deliver medications, fluids, blood products, and parenteral nutrition, and to monitor central venous pressure.
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What is the normal range for central venous pressure (CVP)?
2-6 mmHg.
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What is a key intervention for managing increased intracranial pressure (ICP)?
Elevating the head of the bed to 30 degrees and ensuring adequate sedation and analgesia.
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What is the Monro-Kellie doctrine?
It explains that the cranial cavity has a fixed volume, and an increase in one of its components (brain tissue, blood, CSF) must be compensated by a decrease in another to maintain normal ICP.
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What is the Cushing's Triad and what does it indicate?
Cushing's Triad consists of hypertension, bradycardia, and irregular respirations, indicating increased intracranial pressure and potential brain herniation.
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What are the initial management steps for a patient with traumatic brain injury (TBI)?
Stabilization of the airway, breathing, and circulation (ABCs), followed by neuroimaging and ICP monitoring.
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What is the role of sedation in patients with elevated intracranial pressure (ICP)?
Sedation reduces metabolic demand and prevents agitation, which can lower ICP.
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What is permissive hypotension, and when is it used?
Permissive hypotension is a strategy where blood pressure is kept lower than normal to reduce the risk of bleeding in trauma patients, especially those with uncontrolled hemorrhage.
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What is Disseminated Intravascular Coagulation (DIC)?
A condition where small blood clots develop throughout the bloodstream, leading to organ damage and increased risk of bleeding.
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What are the common triggers for DIC in critical care?
Sepsis, trauma, malignancy, and obstetric complications.
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What is the treatment approach for DIC?
Treat the underlying cause, supportive care, and sometimes blood product transfusion like platelets or fresh frozen plasma.
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What is a common complication of mechanical ventilation?
Ventilator-associated pneumonia (VAP), caused by bacteria entering the lungs through the endotracheal tube.
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What are preventive strategies for Ventilator-Associated Pneumonia (VAP)?
Elevating the head of the bed, daily sedation vacations, oral hygiene with chlorhexidine, and using subglottic suctioning.
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What is the ABCDE bundle in critical care?
A bundle of interventions that stands for Awakening, Breathing coordination, Delirium monitoring, Early mobility, and Exercise.
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What is the goal of early mobilization in the ICU?
To reduce the risk of muscle atrophy, delirium, and ICU-acquired weakness.
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What are the signs of acute delirium in ICU patients?
Confusion, agitation, hallucinations, and altered consciousness.
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What are some risk factors for ICU delirium?
Advanced age, pre-existing cognitive impairment, use of sedatives, and prolonged ICU stay.
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How is delirium managed in the ICU?
Through minimizing sedative use, ensuring proper sleep-wake cycles, and using antipsychotics if necessary.
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What is the role of enteral nutrition in critically ill patients?
To provide essential nutrients directly into the gastrointestinal tract, helping to maintain gut function and reduce infection risks.
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What are the indications for parenteral nutrition in critically ill patients?
When enteral feeding is contraindicated or insufficient, such as in cases of severe bowel injury or prolonged ileus.
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What is the difference between total and partial parenteral nutrition?
Total parenteral nutrition (TPN) provides all daily nutritional needs intravenously, while partial parenteral nutrition (PPN) supplements some enteral nutrition.
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What is the significance of glycemic control in critically ill patients?
Maintaining tight glucose control helps prevent hyperglycemia-related complications like infection and impaired wound healing.
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What is the target blood glucose range in critically ill patients according to current guidelines?
140-180 mg/dL.
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What are the potential complications of overfeeding in critically ill patients?
Hyperglycemia, fatty liver, increased CO2 production, and electrolyte imbalances.
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Define Acute Coronary Syndrome (ACS).
A range of conditions associated with sudden, reduced blood flow to the heart, including unstable angina and myocardial infarction.
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What is the primary treatment for STEMI (ST-Elevation Myocardial Infarction)?
Immediate reperfusion therapy, either through percutaneous coronary intervention (PCI) or thrombolytic therapy.
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What is the difference between NSTEMI and STEMI?
NSTEMI involves a non-ST elevation myocardial infarction, typically less severe than STEMI, which presents with ST-segment elevation on ECG.
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What are the first-line drugs used in the management of ACS?
Antiplatelets (aspirin), nitrates, beta-blockers, and anticoagulants.
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What is the function of beta-blockers in myocardial infarction treatment?
Beta-blockers reduce heart rate, myocardial oxygen demand, and blood pressure, helping to limit heart damage.
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Define Heparin-Induced Thrombocytopenia (HIT).
A rare but serious immune-mediated reaction to heparin causing low platelet counts and increased risk of thrombosis.
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How is Heparin-Induced Thrombocytopenia (HIT) managed?
Stop all heparin products and start alternative anticoagulation, such as direct thrombin inhibitors (e.g., argatroban).
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What is the common side effect of prolonged corticosteroid use in critically ill patients?
Immunosuppression, hyperglycemia, muscle weakness, and osteoporosis.
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What is the role of corticosteroids in septic shock?
Corticosteroids may be used in patients with septic shock unresponsive to fluids and vasopressors, especially in adrenal insufficiency.
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What is the most common cause of acute liver failure in the ICU?
Acetaminophen overdose.
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What is the primary treatment for acetaminophen overdose?
Administration of N-acetylcysteine (NAC) to prevent liver damage.
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What is the definition of cardiac tamponade?
A life-threatening condition where fluid accumulates in the pericardium, compressing the heart and limiting its ability to pump.
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What are the signs of cardiac tamponade?
Hypotension, distended neck veins, and muffled heart sounds (Beck's triad).
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How is cardiac tamponade treated?
Emergency pericardiocentesis to remove fluid from the pericardium.
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Define Pulmonary Embolism (PE).
A blockage in one of the pulmonary arteries in the lungs, typically caused by a blood clot that has traveled from the legs (deep vein thrombosis).
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What is the gold standard for diagnosing Pulmonary Embolism (PE)?
CT pulmonary angiography.
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What is the treatment for massive Pulmonary Embolism (PE)?
Thrombolytic therapy (e.g., tPA) or surgical embolectomy for life-threatening cases.
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What is the function of a Swan-Ganz catheter in critical care?
It measures pulmonary artery pressures, cardiac output, and other hemodynamic parameters to guide fluid management and vasopressor therapy.
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What are common complications associated with central venous catheter insertion?
Pneumothorax, infection, bleeding, and thrombosis.
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What are the three main types of burns?
Thermal burns, chemical burns, and electrical burns.
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How is the Rule of Nines applied in adults?
Head and neck: 9%, each arm: 9%, anterior trunk: 18%, posterior trunk: 18%, each leg: 18%, and genital area: 1%.
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How are burns classified based on depth?
Superficial (1st degree), partial-thickness (2nd degree), and full-thickness (3rd degree).
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What are the characteristics of a superficial (1st degree) burn?
Red, painful skin without blisters, typically involving the epidermis only.
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What are the characteristics of a partial-thickness (2nd degree) burn?
Blistered, red, and painful, involving both the epidermis and part of the dermis.
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What are the characteristics of a full-thickness (3rd degree) burn?
Charred or leathery skin, with damage to the entire epidermis and dermis, often painless due to nerve damage.
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What is the Parkland Formula for fluid resuscitation in burn patients?
4 mL of lactated Ringer's solution X kg of body weight X % of TBSA burned, administered in the first 24 hours.
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Why is fluid resuscitation critical in burn management?
To prevent burn shock, a type of hypovolemic shock caused by fluid loss from damaged skin and increased capillary permeability.
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What are the signs of inadequate fluid resuscitation in burn patients?
Hypotension, tachycardia, decreased urine output, and altered mental status.
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What is an escharotomy, and when is it performed?
A surgical procedure to relieve pressure by making incisions through burned tissue (eschar), often necessary in circumferential burns to restore circulation.
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What is the purpose of a fasciotomy in burn patients?
To relieve compartment syndrome by cutting the fascia to reduce pressure from swelling in deep tissue burns.
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What is carbon monoxide poisoning, and how is it related to burn injuries?
A common complication in fires, where carbon monoxide binds to hemoglobin, reducing oxygen delivery to tissues.
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What is the treatment for carbon monoxide poisoning in burn victims?
High-flow 100% oxygen therapy or hyperbaric oxygen therapy to displace carbon monoxide from hemoglobin.
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First Aid for Burns
Cool the burn with cool (not cold) water; cover with sterile cloth.
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Signs of Inhalation Injury
Singed nasal hairs, soot in the mouth, hoarse voice.
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Burn Complications
Hypovolemic shock, infection, contractures.
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Signs of Sepsis
Fever, chills, rapid heart rate, confusion, and low blood pressure.
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Common Causes of Sepsis
Bacterial infections, pneumonia, urinary tract infections (UTIs), and skin infections.
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Sepsis Management
Early antibiotics, IV fluids, oxygen, and monitoring of organ function.
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SIRS Criteria (Systemic Inflammatory Response Syndrome)
Body temperature >38°C or <36°C, heart rate >90 bpm, respiratory rate >20 breaths/min, white blood cell count >12,000/mm³ or <4,000/mm³.
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Prevention of Sepsis
Hand hygiene, timely treatment of infections, vaccination.
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Caused by a loss of blood or fluids (e.g., bleeding, burns, diarrhea).
Hypovolemic Shock
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Early Signs of Shock
Rapid heart rate, pale skin, cold and clammy skin, dizziness.
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Shock Management
Ensure airway, provide oxygen, IV fluids, medications (vasopressors).
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Complications of Shock
Organ failure, acidosis, death if not treated promptly.
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First Aid for Burns
Cool the burn under cool running water for at least 10 minutes.
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Pain Management for Burns
Use of analgesics like acetaminophen, NSAIDs, or opioids for severe burns
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Airway Management in Burns
Endotracheal intubation may be required for smoke inhalation or facial burns
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Initial Management of Sepsis
Rapid administration of broad-spectrum antibiotics within the first hour.
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Fluid Resuscitation in Sepsis
IV fluids, typically crystalloids (e.g., normal saline or lactated Ringer’s), to maintain blood pressure.
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Vasopressors in Septic Shock
Drugs like norepinephrine to raise blood pressure if fluids are not enough.
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Corticosteroids in Sepsis
Low-dose steroids like hydrocortisone may be used if blood pressure remains low despite treatment.
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Cardiogenic Shock Treatment
Use of inotropes (e.g., dobutamine) to strengthen heart contractions and improve blood flow.
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Septic Shock Treatment
Fluids, antibiotics, and vasopressors like norepinephrine.
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Neurogenic Shock Treatment
IV fluids and vasopressors (e.g., dopamine) to maintain blood pressure.
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Anaphylactic Shock Treatment
Epinephrine to reverse allergic reactions, along with antihistamines and steroids.
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Vasopressors in Shock
Drugs like dopamine, epinephrine, or norepinephrine used to constrict blood vessels and raise blood pressure.
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Monitoring in Shock
Continuous blood pressure, heart rate, urine output, and oxygen levels to assess response to treatment.
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Treating Acidosis in Shock
Sodium bicarbonate may be administered if severe metabolic acidosis occurs due to shock.
