AACN Critical Care Exam 1
ABG exchange in hypoventilation - ANS-low RR, going hypercapnic!
High CO2, low bicarb -- keeping CO2
ABG modifications in hyperventilation - ANS-excessive bicarb, low CO2 -- blowing out CO2
Advanced Directive - ANS-Witnessed written report or oral statement wherein instructions
are given through someone to specific goals r/t healthcare conditions
Allow Natural Death (AND) - ANS-essentially similar to DNR however with out the negative
connotations
Alveoli - reason, what occurs when fluid fills them? - ANS-enables fuel alternate, while fluid
fills -- diffusion deficit --> bad gas alternate!
ARDS: diagnostic criteria - ANS-P/F ratio of </= 300
bilateral infiltrates on CXR
acute onset w/in 1w of initial insult
no evidence of L atrial hypertension as cause
ARDS: meds/tx - ANS-oxygenation - mechanical ventilation with high PEEP
sedation & comfort
therapeutic paralysis
F&E -- conservative! Don't want to overload
nutrition
prone positioning
ARDS: s/sx - ANS-respiratory distress that does not respond to O2 therapy!!
Early signs: initially alkalotic (breathing harder to compensate for O2), neurological
(restlessness, disorientation, decreased LOC), tachycardia
late signs: hypoxia, SOB, use of accessory muscles, central cyanosis, crackles, lungs are
hard to ventilate --> resp acidosis & metabolic acidosis r/t lactic acid buildup
ARDS: underlying patho - ANS-reasons: aspiration of gastric contents, pneumonia,
pulmonary contusion, multisystem trauma, sepsis
all direct insult to inflammatory reaction
**study diagram from magnificence*
Lung injury --> capillary membrane damage --> inflammatory mediators growing permeability
of surrounding tissues --> "leaky membranes"/influx of RBC, WBC, protein into alveoli -->
pulmonary edema --> diffusion disorder, hypoxia --> resp failure
lung injury --> alveolar membrane damage --> damage to pneumocytes --> decrease in
surfactant --> impaired compliance, alveoli disintegrate, atelectasis --> V/Q mismatch -->
resp failure
, autonomy - ANS-appreciate for man or woman and potential of the individual to make
selections with regard to their personal health and destiny (knowledgeable consent)
Beneficience - ANS-moves meant to gain the patient or others
BPS - if given pt state of affairs, be able to rating - ANS-Scores range from 3 (no ache) to 12
(maximum pain)
Facial Expression
- 1 Relaxed
- 2 partially tightened (brow reducing)
- three - completely tightened (eyelid remaining)
- 4 - grimacing
Upper Limb Movements:
- 1 - no movement
- 2 - partly bent
- three - absolutely bent with finger flexion
- 4 - permanently retracted
Compliance with mechanical ventilation
- 1 - tolerating movement
- 2 - coughing however tolerating ventilation maximum of the time
- three - fighting ventilator
- 4 - not able to manipulate air flow
brain loss of life - ANS-entire and irreversible cessation of mind feature
Causes for high strain alarms - ANS-vent is trying to force air in however it can not --
resulting from secretions, biting tube, kink in tube
Causes for low stress alarms - ANS-vent isn't meeting expected resistance -- air leak, apnea
alarm, detached from ventilator or pt self extubates
DNR - ANS-do now not resuscitate order
Explain the synergy model and understand how it's far utilized in exercise - ANS-- framework
that aligns patient wishes w nurse talents
- needs of affected person power nurse skills for patient care
hospice - ANS-Providing take care of terminally ill pts
How can nurses exceptional help the own family participants of patients and help them in
coping? - ANS-evaluate, plan, contain, speak, guide
own family-centered interventions
see if own family can help w care so that they experience extra in control
How is withdraw of care one of a kind from euthanasia? - ANS-minimum mortal misery,
agreed choices
ABG exchange in hypoventilation - ANS-low RR, going hypercapnic!
High CO2, low bicarb -- keeping CO2
ABG modifications in hyperventilation - ANS-excessive bicarb, low CO2 -- blowing out CO2
Advanced Directive - ANS-Witnessed written report or oral statement wherein instructions
are given through someone to specific goals r/t healthcare conditions
Allow Natural Death (AND) - ANS-essentially similar to DNR however with out the negative
connotations
Alveoli - reason, what occurs when fluid fills them? - ANS-enables fuel alternate, while fluid
fills -- diffusion deficit --> bad gas alternate!
ARDS: diagnostic criteria - ANS-P/F ratio of </= 300
bilateral infiltrates on CXR
acute onset w/in 1w of initial insult
no evidence of L atrial hypertension as cause
ARDS: meds/tx - ANS-oxygenation - mechanical ventilation with high PEEP
sedation & comfort
therapeutic paralysis
F&E -- conservative! Don't want to overload
nutrition
prone positioning
ARDS: s/sx - ANS-respiratory distress that does not respond to O2 therapy!!
Early signs: initially alkalotic (breathing harder to compensate for O2), neurological
(restlessness, disorientation, decreased LOC), tachycardia
late signs: hypoxia, SOB, use of accessory muscles, central cyanosis, crackles, lungs are
hard to ventilate --> resp acidosis & metabolic acidosis r/t lactic acid buildup
ARDS: underlying patho - ANS-reasons: aspiration of gastric contents, pneumonia,
pulmonary contusion, multisystem trauma, sepsis
all direct insult to inflammatory reaction
**study diagram from magnificence*
Lung injury --> capillary membrane damage --> inflammatory mediators growing permeability
of surrounding tissues --> "leaky membranes"/influx of RBC, WBC, protein into alveoli -->
pulmonary edema --> diffusion disorder, hypoxia --> resp failure
lung injury --> alveolar membrane damage --> damage to pneumocytes --> decrease in
surfactant --> impaired compliance, alveoli disintegrate, atelectasis --> V/Q mismatch -->
resp failure
, autonomy - ANS-appreciate for man or woman and potential of the individual to make
selections with regard to their personal health and destiny (knowledgeable consent)
Beneficience - ANS-moves meant to gain the patient or others
BPS - if given pt state of affairs, be able to rating - ANS-Scores range from 3 (no ache) to 12
(maximum pain)
Facial Expression
- 1 Relaxed
- 2 partially tightened (brow reducing)
- three - completely tightened (eyelid remaining)
- 4 - grimacing
Upper Limb Movements:
- 1 - no movement
- 2 - partly bent
- three - absolutely bent with finger flexion
- 4 - permanently retracted
Compliance with mechanical ventilation
- 1 - tolerating movement
- 2 - coughing however tolerating ventilation maximum of the time
- three - fighting ventilator
- 4 - not able to manipulate air flow
brain loss of life - ANS-entire and irreversible cessation of mind feature
Causes for high strain alarms - ANS-vent is trying to force air in however it can not --
resulting from secretions, biting tube, kink in tube
Causes for low stress alarms - ANS-vent isn't meeting expected resistance -- air leak, apnea
alarm, detached from ventilator or pt self extubates
DNR - ANS-do now not resuscitate order
Explain the synergy model and understand how it's far utilized in exercise - ANS-- framework
that aligns patient wishes w nurse talents
- needs of affected person power nurse skills for patient care
hospice - ANS-Providing take care of terminally ill pts
How can nurses exceptional help the own family participants of patients and help them in
coping? - ANS-evaluate, plan, contain, speak, guide
own family-centered interventions
see if own family can help w care so that they experience extra in control
How is withdraw of care one of a kind from euthanasia? - ANS-minimum mortal misery,
agreed choices
