Critical Care Jeopardy
What are complications from portal hypertension?
Hepatorenal syndrome, hepatic encephalopathy, and hemorrhagic shock
What is thrombus formation?
Hypercoagulability, injury to the vascular endothelium, and venous stasis place the patient at risk for this problem seen in critical care
What are potential complications of hemodialysis?
Hypotension and hypothermia
What is Bundles?
ICU care that prevents central line associated bloodstream infections, prevents ventilator associated pneumonia, and treats sever sepsis
What is the most sensitive indicator of an increased ICP?
Level of consciousness
What are signs and symptoms of cardiac tamponade?
Muffled heart sounds, JVD, and tachycardia. It is a life threatening condition
Signs of hypocalcemia?
Muscle cramps, hyperreflexia, irritability, and a prolonged QT interval. Can be seen in acute pancreatitis
What is frequently monitored in the ICU as surrogate to determine fluid volume status? A standard central line is needed to monitor it.
Central venous pressure
A patient has COPD and has this blood gas representation: pH 7.35, CO2 58, and HCO3 30. What metabolic state are they in?
Compensated respiratory acidosis
What is the classic sign of the manifestation of pancreatic hemorrhage due to acute pancreatitis?
Cullen's sign
What are the signs of left sided heart failure?
Dyspnea, SOB, orthopnea, and low urine output
What is the primary goal to treat hypovolemic shock?
To restore circulating volume
What is heparin?
A drug that inactivates thrombin and is commonly used in DVT prophylaxis
What is neurogenic shock?
A form of vasodilatory shock from spinal cord injury
When should you hold Metformin?
24 hours before and 48 hours after a percutaneous cardiac intervention (PCI). It can worsen renal function if not held
What is Albuterol?
A bronchodilator frequently administered to asthmatics
What are benzodiazepines?
A class of medication that can cause respiratory depression, hypotension, and can worsen delirium and is not recommended for long-term sedation in the ICU
What is endotracheal suction?
A common nursing intervention that should be performed when appropriately indicated. While performing this procedure, if you notice the patient to develop bradycardia, stop and hyperoxygenate the patient
What is magnesium sulfate?
A medication used to treat Torsades de Pointes and Status Asthmaticus. It is also indicated when serum value gets below 1
What is sinus bradycardia?
A rhythm that has P waves with every QRS and has a rate less than 60. Patients would be initially treated with atropine 0.5 mg IV push
What is a portacaval shunt?
A surgical procedure that helps decrease portal venous pressure and ultimately reducing the chance of bleeding from esophageal varices
What is indicated for ventricular tachycardia?
A synchronized cardioversion at 50-100 joules. It is a wide-complex rhythm when the patient has a pulse and is symptomatic
What findings occur form pulmonary embolism?
A thromboembolic condition. Signs - acute right sided heart strain, elevated A-a O2 gradient, and tachycardia
What is flail chest?
A traumatic injury where paradoxical chest movement is seen
What is Dopamine?
A vasopressor drug that has different effects at stratified doses of 2-5, 5-10, and 10-20 mcg/kg/min. Some people refer to the 2-5 range as the "renal dose"
What disease process of the lungs does not respond to oxygen administration and is caused by inflammatory/immune response?
ARDS
What is compartment syndrome?
Acute disease process that is common in patients with extremity fractures and monitored with frequent neurovascular checks. It is assessed for by using the 5 Ps
What are interventions for supraventricular tachycardia?
Administer adenosine 6 mg with an IV flush and observe the monitor for conversion of this rhythm
What is one of the three factors contributing to stroke volume and represented by the mean arterial pressure (MAP)?
Afterload
How is Rhabdomyolysis treated?
Aggressive volume administration
What is Hyerosmolar Nonketotic Syndrome?
An endocrine condition that causes an altered level of consciousness, a decreased respiratory rate and hypotension. Unlike DKA because it has no association with production of ketone bodies
What is diabetes insipidus?
An endocrine disorder where ADH production is shut down. Can cause hypovolemic shock
What is ADH?
An endocrine hormone that is responsible for increased water reabsorption at the distal convoluted tubule
What is Atrial Fibrillation?
An irregular rhythm, has no discernible P wave and has variable rates
What are complications of PCI?
Bleeding at the insertion site, absent pulse in the right lower extremity, reocclusion of the culprit coronary artery
What do you do if you see v-tach on the monitor?
Call for help and start CPR. Defibrillation is indicated as soon as possible
What are the hallmark signs of distributive shock?
Capillary pooling of blood and low blood pressure
What deficiency is seen in patients with chronic renal disease?
Erythropoietin deficiency
What is Rapid Sequence Intubation (RSI)?
Etomidate and Succinylcholine should be administered to result in sedation and paralysis
What is shock?
Inadequate tissue perfusion
What is the leading cause of death in burn patients?
Infection
What should be considered for removal each day in the ICU?
Invasive lines
What is TPA?
It is given in a STEMI when PCI is not available. Bleeding is a significant complication
What are the signs of respiratory failure?
Patient is only able to speak in one or two word sentences, the patient seems drowsy, the patient cannot lie supine, and breath sounds are diminished
What is the classic finding in pulmonary edema?
Pink frothy sputum
What are signs and symptoms of diabetic ketoacidosis?
Polyuria, signs of dehydration, altered LOC, kussmaul's breathing, tachycardia and possible hypotension Hypokalemia can be a complication during treatment
What are the nursing interventions associated with esophageal varices and/or portal hypertension?
Portal venous pressure reduction, assessment for possible alcohol withdrawal, and administration of vasopressin 0.2 units/min
What are the locations of acute renal failure and/or acute kidney injury?
Pre-renal, intra-renal, and post-renal
Hypocalcemia may develop from what chronic disease condition?
Renal failure
What can happen in severe electrical burns? Renal failure can then occur from this disease process if not medically managed
Rhabdomyolysis
What endocrine syndrome can result from head and lung problems?
SIADH
What on the ECG represents acute injury to the cardiac muscle?
ST elevation
What is an AED?
The device used by bystanders or healthcare providers with little to no training if an unresponsive patient is found
What is decerebrate posturing?
The form of posturing representative of brain stem involvement and has poor prognostic indication
What is cardiogenic shock?
The form of shock due to the inability of the heart to pump blood forward
What is septic shock?
The form of shock where microorganisms enter the body and stimulate the inflammatory/immune system
What measurement of the abdominal aortic aneurysm determines risk for rupture?
The length
Which organ is responsible for producing blood clotting factors?
The liver
How is the amount of fluid resuscitation determined of a burn patient? Patient will receive crystalloids (usually lactated ringers)
The percent burned, patient's weight, and 4 mL
What is infection and rejection?
The two most significant complications to monitor for in the heart transplant patient
What are the interventions for anaphylactic shock?
Treatment with epinephrine and Benadryl. Follow up prevention and teaching will save a life with this acute disease
What is Cushing's Triad?
Widening pulse pressure, irregular breathing, and bradycardia. Seen in patients nearing brain herniation
