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AH3 Exam 3 review Flashcards | StudBud
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AH3 Exam 3 review
AH3 Exam 3 review
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1
What is included in VAP bundle of care for intubated patients? SATA
perform oral hygiene q2h
pause tube feedings before repositioning
stress ulcer prophylaxis
maintain bed at 15 degrees
deep suction trachea once per shift
daily awakening trials
2
what late respiratory complications are a concern in the acute phase of burn treatment? select all
PE
TACO
ALI
ARDS
3
what degree burn presents with hyperesthesia, blisters, and edema?
4th
1st
2nd
3rd
4
what is the leading cause of coronary cardiogenic shock?
cardiomyopathy
hypocalcemia
LAD infarction
cardiac tamponade
5
what kind of distributive shock is happening when a pt has vasodilation due to a parasympathetic stimulation?
neurogenic
anaphylactic
septic
obstructive
6
if a pt weighs 75kg and had a burn BSA of 42% how much fluid should they approx. get in the first 8 hrs of treatment?
10,000 mL
4,000 mL
12,000 mL
6,000 mL
7
in relation to the end-tidal CO2 detector, what does the colors mean? SATA
yellow = oxygen present
yellow = CO2 present
purple = oxygen present
purple = CO2 present
8
in the refractory stage of shock what is happening? select all
supportive care is delivered
aggressive management is started
severe organ damage
pt is not responding to treatment
9
what are cardinal signs of carbon monoxide poisoning?
resp. acid.
burns around mouth
expectoration of carbon particles
low SpO2
10
In ARDS what is causing the inability of gas to exchange?
loss of fluid to pleural space
loss of surfactant
hyaline membranes forming
fluid in the alveoli
11
pt is presenting BP 91/55, HR 132, and RR 26 SpO2 87% following 3rd degree chem burns. what is first action?
start IV fluids
prepare for transfer to burn center
start pain medication
start vasoactive drugs
12
a pt was rapidly intubated. chest X-ray confirms ETT. after 45min the pt's BP 76/45, HR 138, O2 75%. what is a cause?
pulmonary embolism
aspiration
pulmonary edema
shunting
13
what is priority treatment interventions in septic shock?
antibiotics
vasoactive support
HR control
fluid resuscitation
14
pt is presenting with pain, peeling of the skin, the skin is reddended and blanches. what degree of burn is this?
3rd
4th
2nd
1st
15
what are common casues of anaphylactic shock? select all
insects
food
dander
meds
16
If the PEEP was increased on a vent. what could we see as a response to the increase in PEEP? SATA
decreased BP
increased BP
decreased CO
increased CO
17
what would be expected findings of a burn pt when assessing their urine? select all
urine may be amber
urine may be bright red
urine may be pink
urine may be dark / tea color
18
where do we measure the inserted depth of an ET tube that is placed every shift?
top of the throat
at the lip or teeth
the base of the pallet
the tip of the nose
19
what test should be done before insertion of an arterial line of the radial?
Fick's
Homan's
Chvostek's
Allen's
20
if a pt has a IABP inserted what are the main goals of this treatment? select all
increase UOP
decrease CO2
increase CO/CI
increase blood supply to coronaries
21
what does pulmonary artery (PA) pressure monitor?
left ventricle function
coronary occlusions
fluid status
dysrrhythmias
22
in cardiogenic shock what are the preferred treatments for increasing o2 supply and decreasing demand ? select all
CCRT
Plasmaphoresis
ECMO
IABP
23
what stage of shock presents with mottled skin, oliguria, MAPs <65, and lethargy?
progressive
refractory
compensatory
initiation
24
a pt presents with a burn of greater >30%, and labs are drawn, what would be expected findings? select all
increase platelets
increased HCT
hypernatremia
hyperkalemia
25
pt has burns to the back of head, both anterior arms, anterior trunk, and anterior left leg. what's the BSA?
45%
35.5%
40.5%
55%
26
What organism is most common in causing SIRS?
viral
fungal
gram (+) bacteria
gram (-) bacteria
27
if fluids are not started right away what will the burn/hypovolemic shock evolve into?
MODS
obstructive shock
cardiogenic shock
distributive shock
28
A pt has a hemothorax to the right side with trachea deviation. what is the goal of the chest tube placement?
allowing blood to drain
inserting a tube to the left side to equal pressure
to force more air into the pleural space
allowing air to escape
29
a pt has the following ABG - pH 7.33 CO 50 HCO3 21. what is your intervention?
coach to deep breathe and cough
apply 3L o2
use a flutter valve
notify respiratory therapy
30
pt states he had a skin graft after a burn and no longer has feeling to area. what degree of burn did the pt experience?
1st
2nd
4th
3rd
31
A pt arrives at the ED after an MVA. the pt has a paradoxical chest rise and fall. what is the suspected cause?
pneumothorax
PE
sternal rib fracture
flail chest
32
if a pt presents with temp of 102, HR 126, RR 22, and a 10% bands increase what is this a precursor to?
anaphylactic
sepsis
SIRS
neurogenic
33
the vent. setting SIMV is best characterized but which phrase?
delivers a set of pressure every breath
delivers a set amount of volume for every breath
the preferred setting used while a pt is paralyzed
the vent works with the pt by allowing the pt to spontaneously breathe
34
what meds would be anticipated to be ordered when a pt has decreased cardiac contractility? select all
catecholamines
beta blockers
inotropes
bronchodilators
35
if a pt presents with suspected inhalation burn injury what are we going to prioritize doing?
applying a NRB mask at 15L
preparing for intubation
placing pt on BiPaP
deep suctioning
36
What is the P/F ratio for the pt: pH 7.2, CO2 58, HCO3 14, PaO2 68, on FiO2 75% round to the nearest tenth
907
90.7
0.9
9.7
37
What does CVP monitor?
pressures of the left side of the heart
fluid status
systemic vascular resistance
pulmonary pressures
38
pt presents with an electrical injury and bone is exposed. what degree burn is this?
1st
2nd
3rd
4th
39
after successful intubation, the end-tidal CO2 detector color should do what?
change from purple to yellow
stay yellow
turn black
stay purple
40
What should you do if the vent alarms are ringing, the pt is in distress, and you cannot troubleshoot the issue?
disconnect the vent and manually ventilate
clamp the tube while you disconnect the vent
turn off the ventilator
remove the ET tube
41
neurogenic shock presents with what s/s? select all
HTN
dry warm skin
hyperglycemia
hypotension
42
which shock presents with hypovolemia s/s due to blood volume pooling in the peripheral vessels?
obstuctive
hypovolemic
cardiogenic
distributive
43
what happens if a chest tube becomes severed?
clamp the tube
place an occlusive dressing over the site
remove the tube and hold pressure
place the end of the tube in fluid to create a water seal
44
what type of shock presents with decrease venous return to the heart due to inadequate circulating volume?
hypovolemic
obstructive
neurogenic
septic
45
What anatomical area of the lungs is used to confirm the placement of an ET tube?
left lower lobe
trachea
carina
right bronchial branch
46
anaphylactic shock presents when what s/s occur? select all
resp. compromise
hypotension
increased UOP
skin/mucosal irritation
47
what are causes of obstrucive shock? select all
MI
cardiac tamponade
PE
tension pnuemothorax
48
What should we monitor for when we have a pt with an arterial line? select all
arterial dissection
arteriospasms
distal ischemia
cyanosis of the lips
49
what are inotropic medications? select all
dopamine
dobutamine
norepinephrine
anti-diuretic hormone
50
a pt is intubated awake alert and tolerating the vent well. they want to talk but can't. what can you use to help aid?
teach the pt morse code
use a vision board with pictures and phrases
ask the pt to blink once for yes, two for no
tell them they cannot speak and will have to wait until extubation
51
what acid-base imbalance is seen in the initial presentation of ARDS?
met. acid.
met. alk.
resp. alk.
resp. acid
52
in what phase does auto-diuresis and nutritional support begin for a burn pt?
emergent
acute
rehab
step-down
53
After a pt is extubated and becomes anxious and dyspneic with o2 sats 87%. What is the first intervention to perform?
Prepare to use noninvasive positive pressure ventilation
prepare to reintubate
increase the amount of o2 via nasal cannula to 8L
use the Ambu bag on the pt
54
if a pt presents with decreased afterload and is symptomatic what is the primary treatment?
vasocontrict
vasodilate
decrease BP
decrease hr
55
a pt presents with tracheal deviation to the right, lung sounds are absent, o2 sats are 78%. What is the cause?
myocardial infarction
pneumonia
pulmonary embolism
pneumothorax
56
what is ventilator synchrony?
when the pt is waking up from sedation
when the pt is compliant on the vent
when the pt bites the ET tube
when the pt fights the vent
57
what stage of shock presents with increase in lactic acid, decrease UOP, no bowel sounds, cool clammy skin?
refractory
initiation
compensatory
progressive
58
In hemodynamic monitoring, what does a Swan-Ganz catheter measure? select all
MAP
SVR
CO
PAWP