FCCS test with correct Answers

DIRECT Methodology - ANSWER-Detection Intervention Reassessment Effective Communication Teamwork ____ is the greatest contribution to diagnosis. - ANSWER-History ____ is the single most important indicator of critical illness. - ANSWER-Tachypnea Kussmall Breathing (or change in depth of respiration) usually indicates - ANSWER-Metabolic acidosis Cheyne-Stokes Respiration (or periodic breathing with apnea or hypopnea usually indicates - ANSWER-Severe brainstem injury or cardiac dysfunction Biot Respiration (or ataxic breathing) usually indicates - ANSWER-Severe neuronal damage ____ is one of the most important indicators of critical illness. - ANSWER-Metabolic acidosis ____ is one of the most useful tests in an acutely ill patient. - ANSWER-ABG An acute deterioration may seem to occur more abruptly in: young or elderly? - ANSWER-Young What are the two most important predictors of risk in a critically ill patient? - ANSWER-Tachypnea and Metabolic acidosis Oropharyngeal airway is not used if ____. - ANSWER-Airway reflexes are intact Nasopharyngeal airway is contraindicated in patient with ____ and ____. - ANSWER-Suspected basilar skull fracture or coagulopathy ____ is the most common cause of airway obstruction. - ANSWER-Tongue SOAP ME (Airway Mneumonic) - ANSWER-Suction Oxygen Airways Position Monitoring/Medications Equipment Airway Evaluation - ANSWER-Neck Mobility External Face Mouth Tongue and Pharynx Jaw After tracheal intubation, significant alterations in hemodynamics should be anticipated. - ANSWER-Hypertension and Tachycardia Although, you can also have Hypotension and decreased CO due to reduced venous return associated with positive airway pressure. Maximum dose of Lidocaine in airway: - ANSWER-4 mg/kg (Max: 300 mg) Depolarizing Neuromuscular Blockers - ANSWER-Succinylcholine Non-depolarizing Neuromuscular Blockers - ANSWER-Vecuronium Rocuronium Cisatracurium Dosage of Succinylcholine - ANSWER-1-1.5 mg/kg IV bolus Dosage of Vecuronium - ANSWER-0.1-0.3 mg/kg IV bolus Dosage of Rocuronium - ANSWER-0.6-1 mg/kg IV bolus Reversal agent of Fentanyl - ANSWER-Naloxone Reversal agent of Midazolam - ANSWER-Flumazenil Dose of Etomidate - ANSWER-0.1-0.3 mg/kg IV bolus SE of Etomidate - ANSWER-Myoclonus and Trismus Reversal agent of Etomidate - ANSWER-None What induction agent may reduce elevation of intracranial pressure during laryngoscopy? - ANSWER-Lidocaine Max dose of Lidocaine - ANSWER-Do not excede 4 mg/kg because can cause neurotoxicity (seizures) Induction Dose of Ketamine - ANSWER-1-4 mg/kg IV bolus Ketamine has no adverse cardiovascular effects except in: - ANSWER-Severe CHF What induction agent may increase intracranial pressure? - ANSWER-Ketamine Induction Dose of Propofol - ANSWER-1-2 mg/kg IV bolus SE of Propofol - ANSWER-Severe hypotension in volume-depleted patients Compressions (in CPR) should be performed at least ____/min at a depth of ____ inches for maximal blood flow. - ANSWER-100/min and 2 inches During CPR, you should provide ____ breaths over ____ second each. - ANSWER-2 breaths over 1 second each. Ratio of compressions to ventilation in CPR - ANSWER-30:2 Monophasic Defibrillator Level - ANSWER-360 Joules Biphasic Defibrillator Level - ANSWER-200 Joules During CPR, ventilations should not exceed ____ to ____ breaths per minute. - ANSWER-8 to 10 breaths per minute Target Temperature Management after CPR - ANSWER-32'C (89.6'F) to 36'C (96.8'F) for 24 hours To improve neurological outcome and reduce mortality! Detection of or a rapid increase in end-tidal CO2 is often the earliest indication of ____. - ANSWER-Return of Spontaneous Circulation (ROSC) What is the Goal PCO2 during CPR? - ANSWER-Normocapnia (PCO2 38-42 mmHg)` Closed chest compressions produce approximately ____ of normal cardiac output. - ANSWER-One-third Consider Target Temperature Management in patients with initial rhythm of ____ and ____. - ANSWER-Ventricular Fibrillation and Pulseless Ventricular Tachycardia Adverse Effects of Target Temperature Management - ANSWER-Neurologic: Shiveringterm-46 Cardiac: Dysrhythmias Renal: Diuresis and Potassium Shifts Platelets: Coagulopathy Skin: Frostbite Altered Drug Metabolism Side Effects of Target Temperature Management - ANSWER-Coagulopathy Increased Risk of Infection Arrhythmias Hyperglycemis Tension Pneumothorax typically have ____ and/or ____. - ANSWER-hypotension and/or PEA Treatment for Tension Pneumothorax - ANSWER-Needle Thoracostomy - 16 ot 18 gauge catheter through the anterior chest wall in the second intercostal space at the midclavicular line. Define Acute Respiratory Failure - ANSWER-Inability of the respiratory system to meet the oxygenation, ventilation, or metabolic requirements of the patient Define Hypoxemic Respiratory Failure - ANSWER-PaO2 50 TO 60 mmHg Define Hypercapnic Respiratory Failure - ANSWER-PaCO2 50 mmHg COPD (ARF) - ANSWER-Mixed Pneumonia (ARF) - ANSWER-Hypoxemic Acute Respiratory Distress Syndrome (ARF) - ANSWER-Hypoxemic Traumatic Brain Injury (ARF) - ANSWER-Hypercapnic Overdose (ARF) - ANSWER-Hypercapnic Decompensated CHF (ARF) - ANSWER-Hypoxemic What type of ARF responds to oxygen? - ANSWER-Hypoxemic How can you monitor patient's condition with Hypoxic Respiratory Failure? - ANSWER-P:F Ratio What causes Hypercapnic Respiratory Failure? - ANSWER-Excess CO2 production or decreased effective alveolar ventilation Alveolar Minute Ventilation - ANSWER-VA = (VT-VD) x f Hypercapnea occurs from either decreased VT and/or f or increased VD. Occurs when patient is unable to sustain minute ventilation Low-flow Nasal Cannula (Flow/Oxygen) - ANSWER-Low-flow, Low-oxygen High-flow Nasal Cannula (Flow/Oxygen) - ANSWER-Hight-flow, High-oxygen Venturi Mask (Flow/Oxygen) - ANSWER-High-flow, Con