Critical Care Essentials Study Guide
Latest Updated
ow tidal volume, high peep, high O2, neuromuscular blocking agents, prone positioning,
ECMO - ANS-Pt has ARDS- what tx may be implemented to correct acidosis? -
PaO2/FIO2 ratio < 200 - ANS-ARDS- best diagnosis-
Respiratory acidosis - ANS-ABGs: pH: 7.26, CO2: 65, PO2: 54, HCO3: 22 ->
Reorientation, quiet environment, uninterrupted sleep, dark at HS, lights on in day, early
mobility - ANS-Help in preventing delirium:
drug used for hypotension - ANS-norepinephrine-
A-line, central line, PA cath/introducer - ANS-Pt is sedated on Fetanyl 100, Versed 4,
Riker-2; Pressure-regulated volume control; a new mode of ventilation that combines
the advantages of the decelerating inspiratory flow pattern of a pressure-control mode
with the ease of use of a volume-control mode (PRVC)- 24/240/100/16, HR- elevated.
What monitoring can be expected?
(CVVHDF)- Continuous veno-venous hemodiafiltration- uses replacement fluid and
dialysate. It combines the benefits of diffusion and convection for solute removal.
anticoag is needed to reduce the clotting of the blood in the blood tubing set and filter.
Gradual removal as opposed to HD which is harder on bp, bp 84/42 - ANS-Pt has a
creat- 3.1, K- 5.5, CVP- 20, crackles, bp- 84/42. What tx would be expected?
true - ANS-Pt maintained on 60/14 PEEP, Riker 1, TOF- 2/4 AND prone. On NMB.
Important to reorient pt->
Hypercapnia and delirium - ANS-Pt is difficult to arouse, speaking nonsensical words
and grunting. What could be happening?
Sedation interruption and spontaneous breathing trial - ANS-Two parts of the ICU
bundle to increase extubation success rates:
Before the family meeting and the actual death. Referral should be made within 60 min
of actual time of death - ANS-Pt O2 up to 6L- has been suctioned, continues with
hypoxia, cannot clear secretions, decreasing clinical status. When should a referral be
made to CORE?
, Adm Seroquel PO at HS. The deliriogenic meds should have already been stopped, do
not give Ativan- can make Delirium worse - ANS-Pt Intensive Care Delirium Screening
Checklist (ICDSC) is 6. What is a tx option?
on a treadmill sprinting - ANS-Myocardial O2 demand increases in a person who is:
Give something for pain/comfort, family would not want to see pt gasping for breath.
turn off alarms if family would like, turn off paralyzing agents, ask if any other family
members would like to come in. Pastoral Care - ANS-Transitioning to CMO and to
extubate. What needs to be done prior to extubation?
Anaphylactic - ANS-Pt was started on a new abx. bp- 64/24, hr- 132, CVP- 2, PAWP- 3,
SVR? What kind of shock is presenting?
The most common form of distributive shock. Antibodies respond to infection by
releasing cytokines, which causes dysregulation of the vascular causing insufficient
blood flow - ANS-Septic shock:
A less common form of shock. Caused by obstruction of blood flow leading to an
inadequate cardiac output despite normal intravascular volume and myocardial function.
- ANS-Obstructive Shock:
Restlessness, confusion, orthopnea, tachycardia, exertional dyspnea, fatigue, cyanosis,
nocturnal dyspnea, elevated pulmonary capillary wedge pressure, pulmonary
congestion: cough, crackles, wheezing, blood-tinged sputum, tachypnea - ANS-Left
sided heart failure:
a decrease in the intravascular blood volume to such and extent that effective tissue
perfusion cannot be maintained. - ANS-Hypovolemic shock:
Histamine release causing profound Immune Response, which leads to decreased
cardiac output and and cardiovascular collapse. - ANS-Anaphylactic Shock:
interstitial fibrosis restructuring - ANS-During a fibrotic phase of ARDs, the lungs exhibit:
Type 2 HFpEF (diastolic HF) EF >= 50-preserved EF, abnormality of heart muscle,
difficulty to stretch/fill in diastole. diastolic stiffness; pump okay. increased LVEDP, Low
LVEDV, low CO during exercise; HTN is the MAJOR CAUSE of diastolic HF - ANS-Left
sided heart failure 2 types:
Type 1 HFrEF (systolic HF) EF <40, impaired ventricular contractility during systole.
cardiac dilatation ;and reduction in SV, increased (LVEDP)- left ventricular end-diastolic
pressure, and decreased CO - ANS-Left sided heart failure, 2 types:
Insulin resistance, HTN, low HDL, increase in C Rx. proteins - ANS-Metabolic
Syndrome includes:
Latest Updated
ow tidal volume, high peep, high O2, neuromuscular blocking agents, prone positioning,
ECMO - ANS-Pt has ARDS- what tx may be implemented to correct acidosis? -
PaO2/FIO2 ratio < 200 - ANS-ARDS- best diagnosis-
Respiratory acidosis - ANS-ABGs: pH: 7.26, CO2: 65, PO2: 54, HCO3: 22 ->
Reorientation, quiet environment, uninterrupted sleep, dark at HS, lights on in day, early
mobility - ANS-Help in preventing delirium:
drug used for hypotension - ANS-norepinephrine-
A-line, central line, PA cath/introducer - ANS-Pt is sedated on Fetanyl 100, Versed 4,
Riker-2; Pressure-regulated volume control; a new mode of ventilation that combines
the advantages of the decelerating inspiratory flow pattern of a pressure-control mode
with the ease of use of a volume-control mode (PRVC)- 24/240/100/16, HR- elevated.
What monitoring can be expected?
(CVVHDF)- Continuous veno-venous hemodiafiltration- uses replacement fluid and
dialysate. It combines the benefits of diffusion and convection for solute removal.
anticoag is needed to reduce the clotting of the blood in the blood tubing set and filter.
Gradual removal as opposed to HD which is harder on bp, bp 84/42 - ANS-Pt has a
creat- 3.1, K- 5.5, CVP- 20, crackles, bp- 84/42. What tx would be expected?
true - ANS-Pt maintained on 60/14 PEEP, Riker 1, TOF- 2/4 AND prone. On NMB.
Important to reorient pt->
Hypercapnia and delirium - ANS-Pt is difficult to arouse, speaking nonsensical words
and grunting. What could be happening?
Sedation interruption and spontaneous breathing trial - ANS-Two parts of the ICU
bundle to increase extubation success rates:
Before the family meeting and the actual death. Referral should be made within 60 min
of actual time of death - ANS-Pt O2 up to 6L- has been suctioned, continues with
hypoxia, cannot clear secretions, decreasing clinical status. When should a referral be
made to CORE?
, Adm Seroquel PO at HS. The deliriogenic meds should have already been stopped, do
not give Ativan- can make Delirium worse - ANS-Pt Intensive Care Delirium Screening
Checklist (ICDSC) is 6. What is a tx option?
on a treadmill sprinting - ANS-Myocardial O2 demand increases in a person who is:
Give something for pain/comfort, family would not want to see pt gasping for breath.
turn off alarms if family would like, turn off paralyzing agents, ask if any other family
members would like to come in. Pastoral Care - ANS-Transitioning to CMO and to
extubate. What needs to be done prior to extubation?
Anaphylactic - ANS-Pt was started on a new abx. bp- 64/24, hr- 132, CVP- 2, PAWP- 3,
SVR? What kind of shock is presenting?
The most common form of distributive shock. Antibodies respond to infection by
releasing cytokines, which causes dysregulation of the vascular causing insufficient
blood flow - ANS-Septic shock:
A less common form of shock. Caused by obstruction of blood flow leading to an
inadequate cardiac output despite normal intravascular volume and myocardial function.
- ANS-Obstructive Shock:
Restlessness, confusion, orthopnea, tachycardia, exertional dyspnea, fatigue, cyanosis,
nocturnal dyspnea, elevated pulmonary capillary wedge pressure, pulmonary
congestion: cough, crackles, wheezing, blood-tinged sputum, tachypnea - ANS-Left
sided heart failure:
a decrease in the intravascular blood volume to such and extent that effective tissue
perfusion cannot be maintained. - ANS-Hypovolemic shock:
Histamine release causing profound Immune Response, which leads to decreased
cardiac output and and cardiovascular collapse. - ANS-Anaphylactic Shock:
interstitial fibrosis restructuring - ANS-During a fibrotic phase of ARDs, the lungs exhibit:
Type 2 HFpEF (diastolic HF) EF >= 50-preserved EF, abnormality of heart muscle,
difficulty to stretch/fill in diastole. diastolic stiffness; pump okay. increased LVEDP, Low
LVEDV, low CO during exercise; HTN is the MAJOR CAUSE of diastolic HF - ANS-Left
sided heart failure 2 types:
Type 1 HFrEF (systolic HF) EF <40, impaired ventricular contractility during systole.
cardiac dilatation ;and reduction in SV, increased (LVEDP)- left ventricular end-diastolic
pressure, and decreased CO - ANS-Left sided heart failure, 2 types:
Insulin resistance, HTN, low HDL, increase in C Rx. proteins - ANS-Metabolic
Syndrome includes:
