Anyone have any good critical care questions to quiz me on? - page 2

Hey all you expert critical care nurses! I am going to be taking the BKAT 8. I took it once before. Not sure how prepared I am for it again...I have a little bit of experience in CC, but I think I... Read More

  1. by   ProgressiveActivist
    The surgeon would notified of the need for pt to go back to the OR and get set up for a bedside sternotomy to scoop out the clots.
  2. by   Biffbradford
    Anybody think a CXR would be a good idea too?
  3. by   ProgressiveActivist
    and an echo
  4. by   Creamsoda
    Milk the chest tubes, now.
  5. by   CarlieChicRN
    Pericardiocentesis? Increase chest tube suction?
  6. by   CVmursenary
    fluid bolus as far as i know. This should elevate a lowering bp by increasing preload.
  7. by   angelique777
    I liked all these great answers!!! It had me thinking. Thanks for sharing, wish there where more like this !!!!!
  8. by   fiveofpeep
    Ohh please let's keep this going. I'm studying for the CCRN and this is a fun way to do it. I'll go next...

    In a vented patient, how would you anticipate the vent settings be changed for the following
    1. PaO2 is 55
    2. Pa02 is 120
    3. CO2 is 30
    4. CO2 is 55


    Hint to help you remember for testing: you change TV and/or RR when there is an abnormality in ___ and change FiO2 and/or PEEP when there is an abnormality in ____
    Last edit by fiveofpeep on Jan 6, '12 : Reason: weird formatting
  9. by   fiveofpeep
    i just came up with another one for my study buddy and thought i'd share...

    in a patient with pulmonary embolus the rap/cvp would be (increase/decrease/normal), the pap would be (increase/decrease/normal), and the paop would be (increase/decrease/normal)
  10. by   PetERNurse
    The answer to these depends on what the current vent settings are and full assessment of ABG taking disease process into account.
  11. by   PetERNurse
    CVP, PAP, and wedge will all be elevated.
  12. by   CVmursenary
    i think rap and pap would be elevated and the wedge would be elevated but not reflect left atrial preload correctly?
  13. by   fiveofpeep
    Quote from PetERNurse
    The answer to these depends on what the current vent settings are and full assessment of ABG taking disease process into account.
    Keep it simple. This is straight from the Pass CCRN book without elaboration.

    As a general rule if oxygen is altered you can change the FiO2 and/or PEEP to correct it. If the CO2 is altered you can change the TV and/or RR.

    Remember, this is all very general. I just liked how they laid it out that way because it helped me keep it straight better.

    So for low oxygen you could increase the FiO2 and/or PEEP (obviously depending on what it was before and if the patient is at risk for barotrauma)

    If oxygen is high you could decrease FiO2 and/or come down on the PEEP if you need to.

    If CO2 is low you can decrease the TV and/or RR to prevent less blowing off of CO2

    If CO2 is high you can increase the TV and/or RR to increase CO2 elimination.

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