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CRITICAL CARE ICU COMPETENCY QUESTIONS AND ANSWERS UPDATED
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CRITICAL CARE ICU COMPETENCY QUESTIONS AND ANSWERS UPDATED
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CRITICAL CARE ICU COMPETENCY QUESTIONSAND ANSWERS UPDATED 2024 - 2025
VersaCare,Bed,ANS,--
,blue,air,mattress,that,provides,pressure,relief,for,pts,with,*up,to,Stage,III,pressure,sores*
-->,air,fills,up,on,one,side,in,order,to,turn,the,pt,
-->,pressure,relief,primarily,to,UB,(staff,must,reposition,LB,in,order,to,provide,full,body,relief)
Total,Sport,Care,Bed,ANS,--,each,ICU,unit,owns,1-
2,total,sport,care,beds.,Include,*pink,air,mattress,that,provides,some,pressure,relief,to,the,pt,with,rotati
on,in,UB*
--
>,provides,pulmonary,care,to,pts,who,require,frequent,chest,physical,therapy,by,providing,*percussions/
vibrations,to,pt's,chest*
--
>,also,provides,option,of,*chair,egress*,with,stand,assist,to,allow,for,full,upright,seated,position,and,eas
e,with,standing
Portable,Monitors,ANS,-
In,the,CICU,,check,with,nursing,for,availability,of,a,portable,telemetry,unit,in,order,to,progress,a,pt,throu
gh,Phase,I,Cardiac,Rehab,staging.,Unless,they,have,transfer,orders,to,the,GPU,pts,should,be,monitored,d
uring,the,session,unless,otherwise,noted,by,nursing.,Travel,monitors/portable,tele,is,avail,on,all,ICU's,to,
advance,pts
Arterial,Line/Arterial,BP,(ABP),ANS,--
,arterial,line,is,a,thin,catheter,that,is,inserted,directly,into,the,artery,to,measure,real-time,BP
-,Inserted:
-->,Radial,art
-->,Femoral,art,at,the,groin:,*avoid,hip,flexion,beyond,90,to,prevent,kinking,of,the,catheter
-->,Brachial,art
-->,Axillary,art
-
,important,to,the,tx,of,your,pt:,Art,lines,are,dynamic,and,positional,changes,will,cause,fluctuations,in,the,
pressure,due,to,the,positional,nature,of,this,line
,-
,the,transducer,is,zeroed,or,calibrated,on,the,bedside,monitor,when,it,is,positioned,at,the,level,of,the,RA,
and,it,is,attached,to,the,pt's,upper,arm
-->,transducer,ABOVE,heart,=,*displays,drop,in,BP*
-->,transducer,BELOW,heart,=,*displays,elevation,of,BP*
-,monitor,alarms,are,set,for,acceptable,BP,ranges,for,each,specific,pt,while,pt,is,lying
-->,important,to,determine,if,alterations,are,d/t,movement,or,actual,changes,in,BP
-->,BP,should,return,to,baseline,once,activities,have,stopped,and,limb,is,returned,to,resting,position,
--
>,follow,the,same,guidelines,in,the,lab,values,competency,to,determine,whether,a,pt,is,appropriate,for,t
x
-,MAP,is,constantly,available,
-->,gives,you,an,indication,of,the,average,perfusion,pressure,across,the,entire,cardiac,cycle
-->,<60,may,not,be,good,for,tx
Central,Venous,Line,(CVP),ANS,--,used,to,measure,right,atrial,pressures,and,fluid,status
-,Inserted:,
-->,subclavian,vein
-->,internal,jugular,vein
-->,femoral,vein:,*avoid,hip,flexion,beyond,90,to,prevent,kinking,of,the,catheter
-,Norms:,*0-6*
-,very,positional,and,requires,transducer,to,be,at,the,level,of,the,RA
-,if,the,pt,does,not,have,enough,fluid,,the,CVP,will,be,LOW,
-,overloaded,with,fluid,,the,CVP,will,be,HIGH
-,position,sensitive,
-,repositioning,or,movement,of,pts,may,cause,PVCs,or,VPB,on,the,monitor
Swan,Ganz,Catheter,(PAPC),ANS,--
,pts,who,are,hemodynamically,unstable,and,need,cont.,monitoring,of,their,cardiac,output,,pulmonary,ar
tery,pressures,(systolic,and,diastolic),,pulmonary,capillary,wedge,pressures,(left,ventricular,end-
diastolic,pressure),,and,mixed,venous,saturation,will,have,a,Swan,Ganz/Pulmonary,Artery,Catheter.,The,l
ine,is,a,*large,yellow,catheter*,covered,by,corrugated,plastic,and,is,inserted,into,the,jugular,vein,or,subcl
,av,vein,,fed,through,the,SVC,,through,the,R,side,of,the,heart,and,rests,in,the,pulmonary,art.,(usually,locat
ed,on,pt's,right,side)
-
,may,be,too,sick,for,therapy,or,may,be,limited,to,ROM,only.,ROM,on,the,side,of,the,catheter,should,be,d
one,with,care,,*avoid,shoulder,ranges,greater,than,90,&,limiting,shoulder,external,rotation,to,no,greater
,than,45*
--
>,if,pt's,condition,warrants,mobilization,or,ambulation,,the,therapist,should,obtain,consent,from,the,phy
sician,prior,to,mobilizing,the,pt,w/,Swan,Ganz,catheter.,Disconnection,of,the,transducer,should,be,avoid
ed,,but,if,necessary,,done,only,by,nursing.,
-,norms,for,pulmonary,art,wedge,pressure,are,*5-15,mmHg*
--
>,if,the,pulmonary,art,wedge,pressure,reading,is,*>12,the,pt,SHOULD,NOT,be,placed,in,a,horizontal,posit
ion,to,limit,venous,return,which,increases,the,workload,on,the,ventricle
VIGILEO,ANS,--
,continuously,computes,stroke,volume,from,the,pt's,art,pressure,signal,to,determine,cardiac,output,thro
ugh,the,use,of,the,Flo,Trac,Sensor,
-->,the,Flo,Trac,Sensor,is,a,fancy,transducer,that,can,be,hooked,up,to,any,art,line,
-
,can,be,used,to,monitor,continuous,cardiac,output,(with,the,Flo,Trac),or,continuous,central,venous,oxyge
n,saturation
-,displays,key,hemodynamic,parameters,on,a,continuous,basis,(every,20s)
VIGILEO:,Stroke,Volume,,Cardiac,Output,,Cardiac,Index,,and,Stroke,Volume,Variation,ANS,--
,SV,,CO,,CI,should,all,increase,with,activity/exercise
--
>,if,pt's,SV,,CO,,CI,are,below,norms,,or,if,you,see,a,decrease,w/,activity/exercise,it,may,indicate,that,the,p
t's,heart,is,having,a,difficult,time,keeping,up,with,the,heart,and,body's,demand,for,O2,,and,it,may,not,be,
appropriate,for,tx.
-
,*Stroke,Volume*:,the,amount,of,blood,pumped,by,the,LV,of,the,heart,into,the,circulatory,system,in,one,
contraction.,Normally,,only,about,2/3,(66%),of,the,blood,in,the,ventricle,is,expelled,with,each,beat
-->,*60-100,mL/beat*
, -
,*Cardiac,Output*:,the,volume,of,blood,pumped,by,the,heart,into,the,circulatory,system,in,1,min.,*CO=,S
VxHR*,
-->,Norm:,4.7L,L/min
-->,*4.0-8.0,L/min*
-
,*Cardiac,Index*:,the,volume,of,blood,pumped,out,by,the,heart,in,relation,to,body,surface,area.,Shows,t
he,performance,of,the,heart,in,proportion,to,the,size,of,the,individual
-,*Stroke,Volume,Variation*:,a,naturally-
occurring,phenomenon,in,which,the,art,pulse,pressure,falls,during,inspiration,and,rise,during,expiration,
due,to,changes,in,intra-
thoracic,pressure.,Used,by,the,medical,team,to,determine,how,to,manage,the,pt's,fluid,status.,This,is,not
,typically,a,number,that,will,impact,your,therapy,session,
--
>,*Vigileo,numbers,can,be,found,in,EPIC,under,VS,complex,in,the,section,"Invasive,Hemodynamic,Monit
oring",
--
>,Vigileo,can,be,unplugged,from,the,wall,power,(the,new,ones,have,battery),but,do,not,unplug,from,the,
monitor,unless,RN,gives,you,the,okay,in,order,to,mobilize,the,pt.,It,will,need,to,be,recalibrated,and,will,n
ot,collect,data,while,unplugged,from,the,monitor
Central,Venous,Oxygen,Saturation,(ScvO2)/,Mixed,Venous,Oxygen,Saturation,(SvO2),ANS,--
,monitors,the,balance,between,oxygen,delivery,and,consumption,to,the,tissues.,Maintaining,this,balance
,to,the,tissue,is,essential,for,cellular,homeostasis,and,preventing,tissue,hypoxia,and,subsequent,organ,fai
lure,
-,ScvO2,and,SvO2,are,both,affected,by,CO,,Hgb,,SpO2,and,oxygen,consumption,(VO2)
-,*low,readings*,indicate,either,poor,oxygen,delivery,or,an,increase,in,consumption,
-
,*high,readings*,may,indicate,high,cardiac,output,(sepsis),or,the,body's,inability,to,use,the,oxygen,delive
red,to,the,tissues
*ScvO2*:,measured,in,the,SVC,by,a,CL,,and,measures,O2,content,in,blood,returning,from,the,UB,(will,be,
measured,and,displayed,on,the,Vigileo)
-,Norms:,*70-80%,and,runs,~5-10%,higher,than,SvO2*
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