Critical Care Jeopardy

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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


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