Unit 2 Outline

Question 1

What is the nurse’s role in maintaining ventricular-assistive devices (VADs)?

Answer 1

The nurse’s role includes patient assessment, device monitoring, patient education, maintenance of equipment, emergency preparedness, documentation, collaboration, and psychosocial support.

Question 2

What is Acute Coronary Syndrome (ACS)?

Answer 2

ACS is an umbrella term for conditions associated with sudden, reduced blood flow to the heart, primarily caused by coronary artery disease.

Question 3

What are the characteristics of Acute Coronary Syndrome (ACS)?

Answer 3

Includes unstable angina, NSTEMI, and STEMI. Symptoms include chest pain, shortness of breath, sweating, nausea, and lightheadedness.

Question 4

What is Myocardial Infarction (MI)?

Answer 4

MI is a type of ACS that refers to the death of heart muscle tissue due to prolonged ischemia.

Question 5

What are the symptoms of Myocardial Infarction (MI)?

Answer 5

Symptoms are similar to ACS but often more severe and persistent, including ‘crushing’ chest pain.

Question 6

What is Heart Failure (HF)?

Answer 6

HF is a chronic condition where the heart cannot pump sufficiently to maintain blood flow to meet the body’s needs.

Question 7

What are the types of Heart Failure (HF)?

Answer 7

Types include systolic heart failure (HFrEF) and diastolic heart failure (HFpEF).

Question 8

What is Acute Respiratory Distress Syndrome (ARDS)?

Answer 8

ARDS is an acute inflammatory response in the lungs leading to increased permeability of the alveolar-capillary membrane, resulting in pulmonary edema and respiratory failure.

Question 9

What are the clinical features of ARDS?

Answer 9

Symptoms include sudden onset of dyspnea, tachypnea, and hypoxemia, with physical examination showing use of accessory muscles for breathing and cyanosis.

Question 10

What are the diagnostic criteria for ARDS?

Answer 10

The Berlin Definition categorizes ARDS based on the degree of hypoxemia: mild, moderate, and severe.

Question 11

What is the interpretation process for arterial blood gas (ABG) results?

Answer 11

Interpretation involves assessing pH, analyzing PaCO2, evaluating HCO3-, and checking PaO2 and SaO2.

Question 12

What are common nursing problems for clients on mechanical ventilation?

Answer 12

Common problems include impaired gas exchange, risk of ventilator-associated pneumonia, sedation and anxiety, barotrauma, infection, immobility, nutritional deficiencies, and psychosocial issues.

Question 13

What are the characteristics of a Nasal Cannula?

Answer 13

A lightweight device delivering 1 to 6 L/min, providing 24% to 44% oxygen concentration. It’s comfortable and allows for oral communication.

Question 14

What are the characteristics of a Simple Face Mask?

Answer 14

Covers the nose and mouth, delivering 5 to 10 L/min with 40% to 60% oxygen concentration. It can be uncomfortable for long-term use.

Question 15

What is a Venturi Mask?

Answer 15

A mask with interchangeable adapters for precise oxygen control, delivering 24% to 50% oxygen concentration at 4 to 15 L/min.

Question 16

What is a Non-Rebreather Mask (NRB)?

Answer 16

A mask with a reservoir bag and one-way valves that prevent exhaled air from entering the bag, providing high concentrations of oxygen.

Question 17

What is the oxygen flow rate for a Non-Rebreather Mask (NRB)?

Answer 17

Delivers high concentrations of oxygen, typically > 90% when properly fitted and used at a flow rate of 10 to 15 L/min.

Question 18

What are the indications for using a Non-Rebreather Mask (NRB)?

Answer 18

Used for patients with severe hypoxemia or respiratory distress, such as in cases of pneumonia or acute respiratory failure.

Question 19

What are the advantages of using a Non-Rebreather Mask (NRB)?

Answer 19

Provides a high concentration of oxygen, useful in emergencies.

Question 20

What are the disadvantages of using a Non-Rebreather Mask (NRB)?

Answer 20

Can be uncomfortable; prolonged use may lead to CO2 retention if not monitored.

Question 21

What is the description of a High-Flow Nasal Cannula (HFNC)?

Answer 21

A specialized nasal cannula system that delivers heated and humidified oxygen at high flow rates.

Question 22

What is the oxygen flow rate for a High-Flow Nasal Cannula (HFNC)?

Answer 22

Delivers up to 60 L/min, providing accurate and adjustable oxygen concentrations (21% to 100%).

Question 23

What are the indications for using a High-Flow Nasal Cannula (HFNC)?

Answer 23

Used for patients with moderate to severe respiratory distress, especially in conditions like pneumonia, asthma exacerbations, or post-extubation.

Question 24

What are the advantages of using a High-Flow Nasal Cannula (HFNC)?

Answer 24

Enhances comfort, provides humidification, and can improve oxygenation without the need for invasive ventilation.

Question 25

What are the disadvantages of using a High-Flow Nasal Cannula (HFNC)?

Answer 25

Requires careful monitoring; not universally available in all settings.

Question 26

What is the description of a Tracheostomy Collar?

Answer 26

A device that fits over a tracheostomy tube, delivering oxygen directly to the airway.

Question 27

What are the indications for using a Tracheostomy Collar?

Answer 27

Used for patients with tracheostomy needing supplemental oxygen.

Question 28

What are the advantages of using a Tracheostomy Collar?

Answer 28

Allows for oxygen delivery while maintaining airway patency.

Question 29

What are the disadvantages of using a Tracheostomy Collar?

Answer 29

Requires careful monitoring to ensure proper fit and function.

Question 30

What is the nurse's role in titrating critical drips?

Answer 30

Conduct a thorough assessment of the patient's baseline vital signs, laboratory values, and clinical status before initiating any critical drip.

Question 31

What should a nurse continuously monitor when titrating critical drips?

Answer 31

Regularly monitor vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation) and other relevant parameters.

Question 32

What is the treatment for Sinus Bradycardia?

Answer 32

Asymptomatic: Monitor and evaluate for underlying causes. Symptomatic: Administer atropine (0.5 mg IV every 3-5 minutes, up to 3 mg total) or consider transcutaneous pacing if unstable.

Question 33

What is the treatment for Ventricular Fibrillation (VFib)?

Answer 33

Start CPR and defibrillation (shock) as soon as possible. Administer epinephrine (1 mg IV every 3-5 minutes) after the second shock.

Question 34

What is the normal range for Hemoglobin (Hgb)?

Answer 34

12-16 g/dL (women), 14-18 g/dL (men).

Question 35

What does a low White Blood Cell Count (WBC) indicate?

Answer 35

Leukopenia (increased risk of infection).

Question 36

What is the normal range for Sodium (Na+)?

Answer 36

135-145 mEq/L.

Question 37

What is the nurse's role in the ventilator care bundle?

Answer 37

Maintain the patient’s head of bed elevation at 30-45 degrees to reduce the risk of aspiration.

Question 38

What is the purpose of daily sedation vacations in ventilator care?

Answer 38

To evaluate the patient’s readiness for extubation and adjust sedation protocols based on patient responses.

Question 39

What should a nurse monitor for in patients receiving anticoagulants?

Answer 39

Monitor patients closely to ensure therapeutic levels are maintained.

Question 40

What is the purpose of regular interdisciplinary rounds in patient care?

Answer 40

Regular interdisciplinary rounds facilitate communication and adherence to the care bundle.

Question 41

How can patient and family engagement improve care?

Answer 41

Educating patients and their families about the ventilator care bundle and involving them in the care process can enhance adherence to protocols and improve patient comfort.

Question 42

What is Continuous Quality Improvement (CQI) in healthcare?

Answer 42

CQI involves reviewing cases of VAP, identifying contributing factors, and implementing corrective actions to foster a culture of safety and continuous improvement.

Question 43

What are vital signs?

Answer 43

Vital signs include heart rate, blood pressure, respiratory rate, temperature, and oxygen saturation, providing essential information about a patient's physiological status.

Question 44

Why is monitoring vital signs important during medication titration?

Answer 44

Monitoring vital signs is crucial for detecting changes in patient condition, guiding medication adjustments, and ensuring patient safety.

Question 45

What is the nurse's role in baseline assessment of vital signs?

Answer 45

Nurses establish baseline vital signs prior to medication therapy and document them accurately in the patient’s medical record.

Question 46

How often should vital signs be monitored during medication titration?

Answer 46

The frequency of vital sign checks should be based on the patient’s condition, the medication being titrated, and institutional protocols.

Question 47

What is telemetry monitoring?

Answer 47

Telemetry monitoring is used for patients on continuous cardiac medications to monitor heart rate and rhythm continuously.

Question 48

How should nurses interpret vital signs?

Answer 48

Nurses should analyze vital sign trends and understand normal ranges, which may vary based on age, comorbidities, and specific patient populations.

Question 49

What are titration protocols?

Answer 49

Titration protocols involve following established guidelines for adjusting medication doses based on vital sign thresholds.

Question 50

How can nurses educate patients about vital sign monitoring?

Answer 50

Nurses should inform patients about the importance of vital sign monitoring, potential side effects, and what symptoms to report.

Question 51

What is the importance of documentation and reporting in vital sign monitoring?

Answer 51

Accurate record-keeping and prompt reporting of concerning changes in vital signs facilitate effective communication among the healthcare team.

Question 52

What should nurses do in case of critical changes in vital signs?

Answer 52

Nurses should recognize critical changes that may indicate adverse reactions and know the institution's emergency protocols to initiate appropriate interventions.