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Test Bank for Priorities in Critical Care Nursing
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Test Bank for Priorities in Critical Care Nursing
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Test Bank for Priorities in Critical Care Nursing:Diagnosis and Management, 9th Edition by Linda D.
Urden, Kathleen M. Stacy,
What are clinical signs that are indications for intubation? (5) - ANSWER 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) - ANSWER
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) - ANSWER 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) - ANSWER 1) Reduces cardiac filling
(reduced venous return)
2) Reduces cardiac output
3) Increases CVP
What are uses of PEEP? (4) - ANSWER 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) - ANSWER 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? - ANSWER All defined
by partial pressure of oxygen in arterial blood/fraction of inspired oxygen
(PaO2/FiO2)
Mild - 300-201mmHg
Moderate - 200-101 mmHg
Severe - <100 mmHg
Use of weaning protocols for ventilation results in a decrease in the incidence of
what? - ANSWER Ventilator associated pneumonia
What is treatment of ARDs? (3) - ANSWER 1) Preventing iatrogenic lung
injury/barotrauma (Vt 7ml/kg, PIP <35cmH20, FiO2 <50%)
2) Reducing lung water (diuretics, PEEP)
3) Maintain tissue O2 (maintain cardiac output, hemoglobin)
Steroids/surfactant/antioxidants not proven to be effective
What are some risk factors for post op intubation? (2) - ANSWER 1) FEV 1 < 1L
2) VC <35%
What are parameters that are predictive of successful extubation? (8) - ANSWER
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) - ANSWER 1)
Withdraw sedative drugs
2) Ensure patient psychologically ready
3) Minimize secretions
4) Diuretics to clear pulmonary edema
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