Exam 1 Blueprint

Question 1

ABG Interpretation

Answer 1

🔸 Fully Compensated
- pH (Normal)
- HCo3 (Abnormal)
- PaCo2 (Abnormal)

🔸 Partially Compensated
- pH (Abnormal)
- HCo3 (Abnormal)
- PaCo2 (Abnormal)

🔸 Uncompensated
- pH (Abnormal)
- HCo3 or PaCo2 (Abnormal)
- Only one of the (HCo3 or PaCo2) will be abnormal

Question 1

ARDS interventions & monitoring

Answer 1

🔸 ARDS
➤ Acute Respiratory Distress Syndrome

🔸 Signs & symptoms
* Tachycardia
* Dyspnea
* Retractions
* Hypoxia
* Tachypnea
* ↓ Pulmonary compliance
* White lungs

🔸 Monitoring
* ABGs (↓Po2, ↑ Dyspnea)

🔸 Early Interventions
- Raise the HOB
- Auscultate the lungs
- Provide suction of thick secretions
- Apply supplemental O2
- Call the HCP

🔸 Management
- Identify & treat the underlaying cause
- Intubation, mechanical ventilation with PEEP to keep alveoli open
- Treat hypovolemia to keep hemodynamically stable
- Place the pt of Prone position for better oxygenation
- frequent repositioning to prevent pressure ulcers
- Nutritional support (enteral feeding)
- Reduce anxiety (sedation, paralysis)
- Supportive care

Question 2

Pneumothorax signs & symptoms

Answer 2

• Tachycardia
• Dyspnea
• Retractions
• Hypoxia
• Tachypnea

Question 3

Chest tube assessment

Answer 3

🔸 Normal findings
- Gentle bubbling

🔸 Abnormal findings
- Rapid bubbling ( Air leak)
- Intermittent rapid bubbling (Happens when the pt coughs, should return back to normal)

🔸 Uses of Chest Tubes
* removes air, fluid, blood from the pleural space
* Prevents air & fluids from reentering the pleural space
* Reestablishes proper pressures after an injury or trauma

🔸 Management of a Chest Tube drainage system
- Ensure the dressing around the chest tube is tight and intact
- Assess for difficulty breathing
- Assess breathing effectiveness by pulse oximeter
- Auscultate each lung for breath sound
- Check the alignment of trachea
- Check tube insertion site for puffiness or crackling (signs of emphysema)
- Observe site for signs of infection and excessive bleeding
- Check to see if tube “eyelets are visible
- Assess for pain and administer pain meds
- Assist the Pt to deep breath, cough, perform maximal inhalations and the use of incentive spirometry
- Reposition the pt who report a “burning pain in the chest

Question 4

Tension pneumothorax signs & symptoms

Answer 4

🔸 Tension Pneumothorax
➤ It allows air entering the pleural space to be TRAPPED, hence creating a :-
* Positive pressure
* Tension
- This is a medical emergency

🔸 Signs & symptoms
* Diverted trachea from midline

Question 5

Assessment of intubated pt.

Question 6

Safety of ventilated pt

Question 7

Pulmonary edema interventions

Answer 7

🔸 Pulmonary edema
➤ Occurs when fluid occupies the lungs & Alveoli space compromising gaseous exchange

🔸 Interventions
* Minimize extertion and stress
* Give O2 through a Nonrebreather
* Give medications:-
- Diuretics (Furosemide)
- Vasodilator (Nitroglycerin)

Question 8

Chest trauma interventions & monitoring

Question 9

Chest trauma signs & symptoms

Question 10

Rhythm interpretation & interventions

Question 11

Shockable rhythms

Question 12

Endocarditis signs & symptoms

Question 13

Valve disfunction assessment

Question 14

MI recognition & interventions

Question 15

Heart cath assessment & safety

Question 16

Mean Arterial Pressure (MAP)

Question 17

Pacemaker assessment & pt education

Question 18

CABG assessment & complications

Question 19

Cardiomyopathy indications