CRITICAL CARE FINAL 2023 QUESTIONS AND ANSWERS ALREADY PASSED A+

1. What are the risk factors for stress-induced hyperglycemia? (DOPEGAME): 1. Diabetes 2. Obesity 3. Pancreatitis, cirrhosis 4. Exogenous catecholamines 5. Glucocorticoid therapy 6. Advanced age 7. Meds 8. Enteral/parenteral nutrition 2. What are the clinical manifestation of DKA? (6): 1. Dehydration 2. Polyuria 3. Polyphagia 4. Hyperventilation/Kussmaul's 5. Fruity odor to the breath 6. Flushed/Dry skin 3. What does the resuscitation of a traumatically injured patient involve? (2): 1. Reestablishing an effective circulatory volume 2. Stabilizing hemodynamic status 4. What is the primary survey of a traumatically injured patient?: A rapid evaluation designed to identify life-threatening injuries accurately, and provide simultaneous interventions 5. What is ABCDEFG of primary survey?: 1. Airway w/ cervical spine immobi- lization 2. Breathing and ventilation 3. Circulation w/ hemorrhage control 4. Disability or neuro status 5. Exposure/Environmental considerations 6. Full set of vitals 7. Get resuscitation adjuncts 6. What is the secondary survey of a traumatically injured patient?: Initiated after all life-threatening injuries have been identified and addressed. Includes patient and event history, and a head-to-toe assessment. 7. What is diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS)?: Both are endocrine emergencies caused by insulin deficiency and increased counterregulatory hormones 8. DKA is usually the initial indication of what condition?: Type 1 DM 9. Who is at increased risk for DKA?: Pregnant women with type 1 DM 10. In which patients is HHS more commonly seen?: Patients who have Type 2 DM or no prior history of DM 11. What are the presenting symptoms of DKA and HHS? (4): 1. Polydipsia (Increased thirst) 2. Polyuria 3. Dehydration 4. Polyphagia (increased hunger) 12. How does the onset of DKA differ from HHS?: The onset of DKA is quicker than HHS (1-2 days) HHS develops insidiously over a period of weeks to months. 13. How does the pathophysiology of DKA differ from HHS?: The pathophys- iology is similar, except that there are lower levels of fatty acids in HHS leading to a lack of ketosis 14. What cardiovascular changes may occur with kidney injury? (5): 1. HF 2. Pulmonary edema 3. Dysrhythmias 4. Peripheral edema 5. HTN 15. Why does acute kidney injury affect the cardiovascular system? (3): Fluid overload results in: 1. L&R ventricular dysfucntion 2. Electrolyte imbalance (hyperkalemia) 3. Sodium retention 16. What interventions are used to manage fluid overload in pts with AKI?: 1. Fluid restriction (600-1000 ml/day) 2. Accurate I&O - Daily weight 3. Diuretics 4. Sodium polystyrene sulfonate 5. Calcium gluconate 17. What hematological changes may occur with AKI?: Anemia due to de- creased erythropoietin secretion 18. How is anemia due to AKI treated? (3): 1. Iron supplements 2. Epoetin 3. Packed RBCs 19. What are the two important rules to follow when troubleshooting mechan- ical ventilation alarms?: 1. Never shut off alarms 2. Use a bag-valve device to manually ventilate the pt if unable to troubleshoot alarms quickly 20. What is the normal range of ICP?: 0-15 mm Hg 21. How should a patient with increased ICP be positioned? (2): 1. HOB elevated to 30 degrees2. Neutral midline head position 22. What is Cushing's triad? (3): A late sign of increased ICP that consists of: 1. Systolic HTN 2. Bradycardia 3. Decreased respirations 23. What are the two types of shock that can occur with a spinal cord injury?: 1. Spinal shock 2. Neurogenic shock 24. How does continuous mechanical ventilation (CMV) work?: The patient receives a set # of breaths and a set tidal volume. Ensures that patient receives adequate oxygenation regardless of effort. 25. What is the difference between CPAP and BiPAP?: CPAP provides a con- stant flow of air pressure. BiPAP lowers the amount of pressure during exhalation. 26. A patient is receiving 100% FiO2, but PaO2 is still less than 80 mm Hg. Which ventilator setting needs to be adjusted?: Increase PEEP to further expand the alveoli 27. What can be the causes of a low-pressure alarm on a ventilator? (3): 1. Disconnection of tubing 2. Pt biting through tubing 3. Equipment malfunction 28. What is the priority intervention when having difficulty troubleshooting ventilator alarms?: Provide the patient with oxygen using a bag-valve mask