Adult CCRN?

Specialties PICU

Published

I'm an adult ICU nurse but my goal is to get a job in a PICU. We found out tonight that the hospital is offering a CCRN review course coming up and if you pass CCRN they'll reimburse you the cost of the exam. I hadn't planned to take it until I was in the PICU and elligible to take the peds exam, but I'm thinking that if I pass I'll get it for free. Even though it's for adults, I would think there would still be benefit in getting the adult CCRN. Am I wrong? Would that look good on a resume for a PICU job? I'm thinking any education makes you a better nurse, right

Bryan

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Specializes in NICU, PICU, PCVICU and peds oncology.

Of course all education is good for something. And there is a lot of overlap between adult ICU and PICU... but. The reasons children are admitted to ICU are very different from the reasons adults are. Congenital heart defects and their treatment are not the same as MIs and aneurysms. There's a much larger respiratory component in kids and their reactions to drugs are quite different too. Adult ICU patients have a lot of life-style related comorbidities that kids don't so the knowledge base for the CCRN is very different from the peds CCRN. I have the study guide for the peds exam, so why don't I share a few of the questions and you can see how well you can answer them. That might help you decide which basket should hold your eggs...

- Which procedures would be most valuable in aiding management of a child requiring PEEP of 14cm H20?

a. ECMO therapy

b. placement of thoracostomy tube

c. placement of a pulmonary artery catheter

d. high frequency ventilation

- Two cardiac anomalies associated with Tetralogy of Fallot are:

a. VSD and pulmonary stenosis

b. PDA and interrupted aortic arch

c. atrial septal defect and patent foramen ovale

d. transposition of the great vessels and aortic stenosis

- When inhaled nitric oxide (iNO) is administered to infants with congenital heart disease complicated by pulmonary artery hypertension, the result is:

a. smooth muscle relaxation

b. pulmonary vasoconstriction

c. pulmonary vasodilation

d. systemic vasodilation

- An infant s/p PDA ligation would be assessed for which of the following:

a. phrenic nerve paralysis

b. decreased peristalsis

c. pulmonary embolism

d. pulmonary hypertension

- A 6 year old is admitted with hypotonia, diminished reflexes and papilledema. After extensive evaluation a diagnosis of astrocytoma is made. This type of tumor is usually located in the:

a. medulla

b. cerebellum

c. frontal lobe

d. lateral ventricles.

- The most important objective in caring for the patient with epiglottitis is to:

a. keep the child quiet and comfortable

b. administer racemic epinephrine

c. place the child in a supine position

d. administer antibiotics

So how did you do? Correct responses to follow...

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Specializes in Pediatrics, ER.

Please post the answers! I'm dying to know how I did!

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Specializes in NICU, PICU, PCVICU and peds oncology.

Can we wait until the OP has seen them??

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Specializes in Pediatrics, ER.

Oops, I thought this was from early this morning!!

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Specializes in Pediatrics, ER.

I'm going to post my letter answers. I'm confused on the rationale vs. wording on some of them. I hope someday when I work in a PICU it will all make sense.

1. C

2. A

3. C

4. D

5. B

6. A

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Specializes in NICU, PICU, PCVICU and peds oncology.

That's pretty good! 4/6 correct. Once dad2one has gotten up and had a chance to try his hand we'll discuss the answers here. See your PMs SarahBeth.

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Sorry to hold up the discussion. Worked night 6 out of 7 last night (3 on, 1 off, 3 on) and just woke up. I'll take a stab at the questions below..

- Which procedures would be most valuable in aiding management of a child requiring PEEP of 14cm H20?

I'm guessing HFOV because 14 is a lot of PEEP (at least it is for adults!) and I seem to recall that high PEEP is one of the indications for HFOV

- Two cardiac anomalies associated with Tetralogy of Fallot are:

a. VSD and pulmonary stenosis

- When inhaled nitric oxide (iNO) is administered to infants with congenital heart disease complicated by pulmonary artery hypertension, the result is:

OK, my brain is a little foggy from lack of sleep, but if I can reach back to Biochem...NO has some kind of effect on cGMP and causes smooth muscle relaxation, but that would seem to also cause vasodilation - and since you use this with PPH (right?) I would guess pulmonary vascular dilation. Not sure which one to pick...

- An infant s/p PDA ligation would be assessed for which of the following:

Given it's location, I'd say that nicking the phrenic nerve during the ligation might be a relative risk, so I'll pick a.

- A 6 year old is admitted with hypotonia, diminished reflexes and papilledema. After extensive evaluation a diagnosis of astrocytoma is made. This type of tumor is usually located in the:

We don't get much (if any) neuro surgery, so this is reaching back to nursing school. I want to say cerebellum...

- The most important objective in caring for the patient with epiglottitis is to:

Again, what I remember most about epiglottitis is to never visually inspect the throat unless you're prepared to intubate. My guess would be a...

This is all off the top of my head. How'd I do?

I realize the major differences between adult and peds ICU (the biggest part of why I want to work in the PICU is because of these differences). I've applied twice for a PICU job and both times it went to people with more experience. I don't know how to get more experience if I don't have much experience, so I'm looking for ways to set myself apart. I don't think that the Adult CCRN certification says I'd be a great PICU nurse, but I'm hoping that it might say that I've got more potential than the average applicant? Any other advice on how to beef up the resume would be appreciated. I did an externship in the NICU, so I've got a little experience with peds. I also shadowed in the PICU before nursing school and got a paper published on a research study I did in the PICU. I've also got PALS, ENPC, and STABLE certifications (our ICU rarely admits kids, so my manager thought it woud be good if someone knew what to do when it does happen!). I'm going back to finish my BSN this fall and at the end of it we've got to do a preceptorship. I think most people try to do theirs in whatever area they currently work in, but I'm going to try to do mine in the PICU to see if it helps get a foot in the door.

Bryan

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Specializes in NICU, PICU, PCVICU and peds oncology.

No worries Bryan... I knew you'd worked nights and were sleeping. For someone who just woke up you did very well... 100%. But quick - what are the other two anomalies associated with TOF?? No fair peeking... Those are basic PICU sorts of issues; I didn't use any of the more complex questions because of space... and I have tendinitis in my wrist so I didn't want to type that much!

Your game plan is a good one. The critical care background you already have will help, and maybe the CCRN will too. It does suggest a thirst for knowledge and a level of dedication to the field of critical care. The clinical practicum in PICU at the end of your degree could very well be your foot in the door. Best of luck, and please keep my updated.

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Displaced aorta (overriding I think is the proper term) and right ventricular hypertrophy.

When I shadowed in the PICU, I was with the team on rounds and we were talking about TOF. The attending asked one of the med students what the four characterstics of ToF were. He stumbled around for a few minutes before admitting he didn't know. So, the attending looks at me and says, "do you know by any chance, Mr. dad2one?" (of course I was dad2none back then :-) Luckily, I had just read it the night before and remebered the DROP mneumonic. I think everyone was surprised when I rattled off, "over riding aorta, ventricular septal defect, right ventricular hypertrophy, and pulmonary stenosis." It was pure luck at the time but I've never forgotten it!

Thanks for the encouragement. I'll keep you posted. And if you want to post more questions, we'll see if I can learn some more! :-)

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Specializes in NICU, PICU, PCVICU and peds oncology.

You're on! I'll post questions from current situations on my unit, no specific identifiers but real-world stuff.

Name 4 signs of increased intracranial pressure in infants.

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Specializes in Pediatrics, ER.

Agitation

Increased BP with decreased HR

Bulging fontanel

High pitched cry

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