Quiz Show

1
Quiz Show

• Question and Answer
• Samples and Techniques

2
Common means of sedation for patient receiving
mechanical ventilation

• Diprivan

3
A Primary safety nursing concern for patient with
ET tube

• Self Extubation

4
Once inserted, what is important for the initial
nurse to establish concerning the ET tube?

• Measurement of the tube (on the tube itself) at a
  specific point on the patient. 

• Ex 22 cm at the patient's lip.If this changes,
  we know the tube has moved.

5
Unless medically contraindicated, how should a
mechanically ventilated patient be positioned?

• Supine, HOB at 30

• to prevent aspiration supine doesnt mean you
  cannot turn the patient

6
What other intervention is almost always
administered with mechanical ventilation?

• OG or NG tube insertion

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Usually 6 - 10 mL/kg (ideal body weight)

• Tidal Volume

8
What is peep?

• Positive End-Expiratory Pressure

• The amount of residual pressure in the lungs at
  the end of expiration that keeps alveoli
  partially inflated so they are more easily
  inflated and perfused with the next breath

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What is Barotrauma?

• The PRESSURE of the air can cause damage to lungs
  / alveoli

• Patients with decreased pulmonary accommodation
  (emphysema) are at increased risk. Can lead to
  pneumothorax

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Nursing interventions to prevent VAP

• HOB elevated to 30 degrees. Use of an ET-tube
  with a suction port above the cuff. Proper and
  regular oral care. Oral suctioning prn. HAND
  WASHING and proper aseptic/clean technique as
  indicated

11
Proper oral care of a ventilated patient

• Mouth care every 2 hours. Brush Teeth every 12
  hours. Oralpharanygeal suction every 6 hours.
  Mouth moisterizer

12
Adverse effects of propofol

• HypotensionBradycardiaElevated triglyceride
  levels

13
What test is performed before paralyzing a
patient for Ventilation therapy?

• Train-of-Four (TOF) 

14
Anti-arrhythmic agent, Class III

• Amiodarone

• Is the only anti-arrhythmic to possess properties
  of all four anti-arrhythmics

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What do we use amiodarone for?

• Treatment of shock, V fib, pulseless V tach, A fib

16
It is important to measure this interval before
administering Amiodarone?

• Qt

17
How do you mix Amiodarone?

• 450 mg/250 ml D5W 

18
Amiodarone can be mixed in normal D5W?

• TRUE OR FALSE?

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Amiodarone adverse effects

• More common hypotension, neurologic effects,
  N/V, phebitis (central line recommended). Less
  common arrhythmias, flushing, edema, asystole,
  cardiac arrest, ataxia, headache

• AGAIN CENTRAL LINE RECOMMENDED!!!!

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Amiodarone Protocol

• 1 mg/min or 33.3cc/hr for 6 hours.then 0.5mg or
  16.7 cc/hr

21
Gold standard for achieving hemostasis for
patient with arterial sheath

• Manual Compression

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Frequency of Vitals Signs While You are Holding
Pressure

• Every 5 Minutes

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Pulling a Sheath Uses Aseptic Technique
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Amount of Time You Hold Pressure for
Interventional Cath

• 30 Minutes

25
 In general, patients with bronchospastic disease
should not receive

• Beta Blockers

• Due to the relative beta1 selectivity and
  titratability, esmolol HCl may be used with
  caution in patients with bronchospastic disease

26
For short term control of ventricular rate with a
short-acting agent is desirable

• Brevibloc, Esmolol

27
You have a patient post MI. He has a IABP and
swan in. CI is 1.8, PA 20/12, SVO2 is 56, SVR is
1534, BP IS 89/45, What additional info would you
like? What would you do next?

• What kind of MI? Inferior HR 55, CVP 5, Fluids

28
You are caring for a patient post AVR. His HR is
50. BP is 70/30. What would be your next step?
What pharmological interventions can you do?

• Epicardial Pacing, Dopamine, Epi, Atropine (If
  complete heartblock it probably wont work)

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Match the device to what it measures

• Stop Watch

• Distance

• Scale

• Temperature

• Thermometer

• Elapsed Time

• Speedometer

• Weight

• Odometer

• Rate of Travel