ATI CRITICAL CARE PROCTORED EXAM
1.Before PFT's how long should a patient refrain from smoking? Using an inhaler?
smoking: 6-8 h
inhaler: 4-6 h
2. What test must you do before performing an arterial puncture?
Allen's test; patency of the ulnar artery- if blood returns to hand in 15s, then the
radial artery can be used for the puncture
3. How long should one apply pressure after an arterial puncture?
5 minutes (20 min if the patient is on anticoagulant therapy)
4. What are the normal ranges for ABG's?
(pH, PAO2, PACO2, HCO3, and SAO2)
pH: 7.35-7.45
PAO2: 80-100 mm Hg
PACO2: 35-45 mm Hg
HCO3: 21-28 mEq/L
SAO2: 95-100%
5.In what position should you place a patient if air embolism is expected?
,left side in trendelenburg
6. How long must a patient be NPO before a bronchoscopy?
4-8 hr
What types of medications might one administer prior to a bronchoscopy?
anxiolytics
atropine (to treat bradycardia)
viscous lidocaine
local anesthetic throat spray
What should you be monitoring a patient for after a bronchoscopy?
significant fever (mild is ok up to 24 hrs after the procedure), productive cough,
significant blood in sputum (small amounts are to be expected), hypoxemia,
laryngspasm
Prior to a thoracentesis what diagnostic procedure must be done?
CXR
What position should the patient be in for a thoracentesis?
sitting up over the bedside table
,What are possible complications of a thoracentesis? How do we tell patients to
identify pneumothorax?
mediastinal shifts
pneumothorax (deviated trachea, pain at the end of inhalation or exhalation,
affected side not moving with breath, increased HR, shallow respirations, nagging
cough, air hunger)
In what chest tube chamber (ONLY) should you see bubbling?
suction
What is excessive drainage from a chest tube?
more than 70 ml/hr
How should the nurse document for care following a chest tube? How often?
color and amount of drainage qh for 24h after insertion, then q8h
mark date, hour, and drainage level on the container at the end of each shift
What supplies should be kept at the side of a bed for a patient with a chest tube?
2 enclosed hemostats, sterile water, occlusive dressing
What should the nurse instruct the patient to do during chest tube removal?
valsalva maneuver
, What should the nurse do in the case that a chest tube is disconnected?
1. have the client exhale as much as they can to remove air from the pleural space
2. immerse the end of the chest tube in sterile water to restore the water seal
3. apply dry sterile gauze
What is the FiO2 and the flow rate for a nasal cannula? at what rate do we need to
administer humidification?
24-44%
1-6 L/min
humidification at 4 L/min
What is the FiO2 and the flow rate for a simple face mask?
40-60%
5-8 L/min (less than this causes the patient to rebreathe CO2)
What is the FiO2 and the flow rate for a partial rebreather mask?
40-75%
6-11 L/min
What is the FiO2 and the flow rate for a non-rebreather?
80-95%
10-15 L/min
1.Before PFT's how long should a patient refrain from smoking? Using an inhaler?
smoking: 6-8 h
inhaler: 4-6 h
2. What test must you do before performing an arterial puncture?
Allen's test; patency of the ulnar artery- if blood returns to hand in 15s, then the
radial artery can be used for the puncture
3. How long should one apply pressure after an arterial puncture?
5 minutes (20 min if the patient is on anticoagulant therapy)
4. What are the normal ranges for ABG's?
(pH, PAO2, PACO2, HCO3, and SAO2)
pH: 7.35-7.45
PAO2: 80-100 mm Hg
PACO2: 35-45 mm Hg
HCO3: 21-28 mEq/L
SAO2: 95-100%
5.In what position should you place a patient if air embolism is expected?
,left side in trendelenburg
6. How long must a patient be NPO before a bronchoscopy?
4-8 hr
What types of medications might one administer prior to a bronchoscopy?
anxiolytics
atropine (to treat bradycardia)
viscous lidocaine
local anesthetic throat spray
What should you be monitoring a patient for after a bronchoscopy?
significant fever (mild is ok up to 24 hrs after the procedure), productive cough,
significant blood in sputum (small amounts are to be expected), hypoxemia,
laryngspasm
Prior to a thoracentesis what diagnostic procedure must be done?
CXR
What position should the patient be in for a thoracentesis?
sitting up over the bedside table
,What are possible complications of a thoracentesis? How do we tell patients to
identify pneumothorax?
mediastinal shifts
pneumothorax (deviated trachea, pain at the end of inhalation or exhalation,
affected side not moving with breath, increased HR, shallow respirations, nagging
cough, air hunger)
In what chest tube chamber (ONLY) should you see bubbling?
suction
What is excessive drainage from a chest tube?
more than 70 ml/hr
How should the nurse document for care following a chest tube? How often?
color and amount of drainage qh for 24h after insertion, then q8h
mark date, hour, and drainage level on the container at the end of each shift
What supplies should be kept at the side of a bed for a patient with a chest tube?
2 enclosed hemostats, sterile water, occlusive dressing
What should the nurse instruct the patient to do during chest tube removal?
valsalva maneuver
, What should the nurse do in the case that a chest tube is disconnected?
1. have the client exhale as much as they can to remove air from the pleural space
2. immerse the end of the chest tube in sterile water to restore the water seal
3. apply dry sterile gauze
What is the FiO2 and the flow rate for a nasal cannula? at what rate do we need to
administer humidification?
24-44%
1-6 L/min
humidification at 4 L/min
What is the FiO2 and the flow rate for a simple face mask?
40-60%
5-8 L/min (less than this causes the patient to rebreathe CO2)
What is the FiO2 and the flow rate for a partial rebreather mask?
40-75%
6-11 L/min
What is the FiO2 and the flow rate for a non-rebreather?
80-95%
10-15 L/min
