nurs 471: quiz #1 UPDATED ACTUAL
Questions and CORRECT Answers
Complex patient: comorbidity, multimorbidity, substance abuse, etc.
Complex / Critical Care
"Direct delivery of medical care for a critically ill or injured patient. - CORRECT ANSWER - To
be considered critical an illness or injury must acutely impair one or more vital organ systems so that a
patient's survival is jeopardized."
"Critical care nursing is that specialty that deals specifically with human responses to life threatening
problems. - CORRECT ANSWER - A critical care nurse is a licensed professional nurse who is
responsible for ensuring that acutely and critically ill patients and their families receive optimal care."
Elements of Critical Illness or Injury
Patient survival is jeopardized
Unalterable, unstable, complex
Impairment of one or more vital organs
Care provided often within specialty unit
Often special personnel and equipment - CORRECT ANSWER - Levels of Care
I: most comprehensive ICU, teaching hospitals, special equipment, specialized doctors, nurses,
pharmacist, nutritionist, etc., example: Stanford, UCSF
II: comprehensive care for specific population, example: would be open heart surgery but not heart
transplant = transfer
III: able to stabilize critical patient but limited = transfer - CORRECT ANSWER - Open & Closed
Units ICU
Open: nursing, resp therapist, etc. but provider has patients throughout hospital, they rotate every month,
have patients in ICU and elsewhere
Closed: care is provided by dedicated team and doctor = cardiologist or pulmonologist, only patients are
in ICU, intensivist
,Complex care: one or more vital organ
Closed unit: intensivist
A lot of errors, pump errors - CORRECT ANSWER - Increasing Safety
Utilize patient constraints, weight, allergies
Install forcing functions or system level firewalls, scan wristbands, meds = force us to do the right thing
Avoid reliance of vigilance, checklists, standing orders
Organizational culture of safety: everyone on the same page for safety
Simplify & standardize key processes: checklists
Develop multidisciplinary approach: all a team, working together
Adequate appropriate competent staffing
Limit work hours - CORRECT ANSWER - Safety training: "Keep Me Safe: Universal Skills"
pay attention to detail, avoid errors = STAR
practice and accept a questioning attitude
communicate clearly
be accountable team member
Powerplans: evidence based
Protocols/guidelines
Clinical pathway (COVID) - CORRECT ANSWER - Methods
SBAR: used to handoff report
Two challenge rule: assertive communication
Speak Up
Collaboration
Collaborative Care MDR rounds ICU: everyone = nurse, doctor, dietitian, family discusses plan for shift,
day, and stay - CORRECT ANSWER - Synergy Care Model
Critical care nursing should be defined more by the needs of patients and those of their families than by
the environment in which care is delivered or the diagnosis of the patients
, Patient/family needs + Nurse competencies = Optimal patient outcomes
Patient characteristics, nurse competencies, patient and family outcomes, unit outcomes, system outcomes
- CORRECT ANSWER - Patient Needs: laughter
Stress & Worry from Patients
Being thirsty
Being in pain
Having tubes & lines in their body
Being unable to communicate
Being restricted by tubes/lines
Being unable to sleep
Being unable to be in control
Nurses response:
Communication = boards with pictures - CORRECT ANSWER - Comfort
Pain assessment and management
Sedation
Delirium assessment and prevention
Sleep
Nutrition
RASS: assessment goal to see if they need sedation or not
Goal is 0 = alert and calm or -1 = drowsy
Do not want to sedate them too much
plus = restless, agitated, combative
minus = sedation, unarousable - CORRECT ANSWER - Guiding Principles of Sedation
Used in the critical care setting to treat anxiety and agitation and to provide amnesia
Should be used only after "providing adequate analgesia and treating reversible physiologic causes"
Questions and CORRECT Answers
Complex patient: comorbidity, multimorbidity, substance abuse, etc.
Complex / Critical Care
"Direct delivery of medical care for a critically ill or injured patient. - CORRECT ANSWER - To
be considered critical an illness or injury must acutely impair one or more vital organ systems so that a
patient's survival is jeopardized."
"Critical care nursing is that specialty that deals specifically with human responses to life threatening
problems. - CORRECT ANSWER - A critical care nurse is a licensed professional nurse who is
responsible for ensuring that acutely and critically ill patients and their families receive optimal care."
Elements of Critical Illness or Injury
Patient survival is jeopardized
Unalterable, unstable, complex
Impairment of one or more vital organs
Care provided often within specialty unit
Often special personnel and equipment - CORRECT ANSWER - Levels of Care
I: most comprehensive ICU, teaching hospitals, special equipment, specialized doctors, nurses,
pharmacist, nutritionist, etc., example: Stanford, UCSF
II: comprehensive care for specific population, example: would be open heart surgery but not heart
transplant = transfer
III: able to stabilize critical patient but limited = transfer - CORRECT ANSWER - Open & Closed
Units ICU
Open: nursing, resp therapist, etc. but provider has patients throughout hospital, they rotate every month,
have patients in ICU and elsewhere
Closed: care is provided by dedicated team and doctor = cardiologist or pulmonologist, only patients are
in ICU, intensivist
,Complex care: one or more vital organ
Closed unit: intensivist
A lot of errors, pump errors - CORRECT ANSWER - Increasing Safety
Utilize patient constraints, weight, allergies
Install forcing functions or system level firewalls, scan wristbands, meds = force us to do the right thing
Avoid reliance of vigilance, checklists, standing orders
Organizational culture of safety: everyone on the same page for safety
Simplify & standardize key processes: checklists
Develop multidisciplinary approach: all a team, working together
Adequate appropriate competent staffing
Limit work hours - CORRECT ANSWER - Safety training: "Keep Me Safe: Universal Skills"
pay attention to detail, avoid errors = STAR
practice and accept a questioning attitude
communicate clearly
be accountable team member
Powerplans: evidence based
Protocols/guidelines
Clinical pathway (COVID) - CORRECT ANSWER - Methods
SBAR: used to handoff report
Two challenge rule: assertive communication
Speak Up
Collaboration
Collaborative Care MDR rounds ICU: everyone = nurse, doctor, dietitian, family discusses plan for shift,
day, and stay - CORRECT ANSWER - Synergy Care Model
Critical care nursing should be defined more by the needs of patients and those of their families than by
the environment in which care is delivered or the diagnosis of the patients
, Patient/family needs + Nurse competencies = Optimal patient outcomes
Patient characteristics, nurse competencies, patient and family outcomes, unit outcomes, system outcomes
- CORRECT ANSWER - Patient Needs: laughter
Stress & Worry from Patients
Being thirsty
Being in pain
Having tubes & lines in their body
Being unable to communicate
Being restricted by tubes/lines
Being unable to sleep
Being unable to be in control
Nurses response:
Communication = boards with pictures - CORRECT ANSWER - Comfort
Pain assessment and management
Sedation
Delirium assessment and prevention
Sleep
Nutrition
RASS: assessment goal to see if they need sedation or not
Goal is 0 = alert and calm or -1 = drowsy
Do not want to sedate them too much
plus = restless, agitated, combative
minus = sedation, unarousable - CORRECT ANSWER - Guiding Principles of Sedation
Used in the critical care setting to treat anxiety and agitation and to provide amnesia
Should be used only after "providing adequate analgesia and treating reversible physiologic causes"
