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

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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 learn best by people quizzing me. Anyone willing to ask me a question or 2?

Specializes in Cardiothoracic ICU.

i think rap and pap would be elevated and the wedge would be elevated but not reflect left atrial preload correctly?

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Specializes in critical care, PACU.
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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Specializes in critical care, PACU.
i think rap and pap would be elevated and the wedge would be elevated but not reflect left atrial preload correctly?

You are correct in that the RAP and PAP would be elevated because of the pulmonary hypertension secondary to the PE and the relative RHF from the obstruction.

The PAOP would not be elevated in a non-diseased heart because of the obstructed blood flow in the pulmonary vascular system secondary to the clot. There may even be a preload deficit in the left side because of this.

Once again this is a "textbook case" straight from Pass CCRN

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Specializes in Cardiothoracic ICU.

what if the wedge was behind the clot?, wouldnt it have a high reading?

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Specializes in critical care, PACU.
what if the wedge was behind the clot?, wouldnt it have a high reading?

Probably, but I'm no expert on PE's so I'm just reporting straight from the book. Maybe someone else can shed some light on this?

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