CRITICAL CARE NURSING MIDTERM EXAM PASS GUARANTEED
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Course
Critical Care Paramedic
Institution
Critical Care Paramedic
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CRITICAL CARE NURSING MIDTERM EXAM PASS GUARANTEED
What are clinical signs that are indications for intubation? (5) - -ans--1) Shortened
speech
2) Use of accessory muscles
3) Subjective air hunger
4) Changes in mental status
5) RR >35
What are some laboratory findings that are indications for intubation? (8) - -ans--1)
PaO2/FiO2 < 250
2) PaCO2 >50
3) pH <7.25
4) Ve > 12 L/min
5) VC <15ml/kg
6) NIG <25cmH20
7) AaDO2 >350
8) VD > 0.6L
What are benefits of PEEP? (5) - -ans--1) Prevents distal airway collapse so that they
can partake in gas exchange
2) Lung recruitment
3) Decreases intrapulmonary shunt
4) Increases lung compliance
5) Allows FiO2 to be lower reducing O2 toxicity
What are some cardiac effects of PEEP? (3) - -ans--1) Reduces cardiac filling (reduced
venous return)
2) Reduces cardiac output
3) Increases CVP
What are uses of PEEP? (4) - -ans--1) Lower FIO2
2) Lung recruitment
3) Low volume vent (preventing opening and closing of alveoli)
4) COPD
What are inclusion criteria for ARDs? (6) - -ans--Acute respiratory distress syndrome
1) Acute onset (<7 days)
2) Predisposing condition
3) PaO2:FiO2 <200 (regardless of positive end-expiratory pressure)
4) Bilateral infiltrates
5) Pulmonary artery occlusion pressure <18mmHg
6) No clinical evidence of right heart failure
, What are parameters for mild, moderate and severe ARDs? - -ans--All defined by partial
pressure of oxygen in arterial blood/fraction of inspired oxygen (PaO2/FiO2)
Steroids/surfactant/antioxidants not proven to be effective
What are some risk factors for post op intubation? (2) - -ans--1) FEV 1 < 1L
2) VC <35%
What are parameters that are predictive of successful extubation? (8) - -ans--1)
Negative inspired pressure > 20-25cm H20
2) Tidal volume > 5-7mL/kg
3) Resp rate < 20
4) VC > 15ml/kg in adults, 10ml/kg in paediatrics
5) PEEP 5cm H20 or less
6) Ve 6-8 L/min (minute ventilation)
7) Absence of excessive secretions
8) GCS 14 or greater, hemodynamically stable
What optimization steps can be done prior to extubation? (11) - -ans--1) Withdraw
sedative drugs
2) Ensure patient psychologically ready
3) Minimize secretions
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