CC Concepts: Daily PE and Assessment

Question 1

True or False: The goal of an internist is monitoring, recording, and interpreting physiologic variables in critically ill animals to detect organ function and allow targeted, lifesaving intervention.

Answer 1

True

Question 2

Identify the abnormal breathing pattern associated with the following respiratory diagnoses.

• Dynamic airway collapse
• Pulmonary fibrosis
• Tracheal collapse
• Bronchitis
• Upper airway obstruction
• Nasopharyngeal mass
• Pulmonary parenchymal lesions/ diseases

Answer 2

Slow, deep breaths = Upper airway obstruction, dynamic airway collapse, bronchitis, or other obstructions to airflow

Increased inspiratory effort = Laryngeal disease, extrathoracic tracheal collapse/ obstruction

Increased expiratory effort = Intrathoracic airway collapse

Restrictive breathing pattern = pulmonary parenchymal disease or pulmonary fibrosis

Question 3

True or False: Bradycardia is an unusual finding in a critically ill patient.

Answer 3

True

This can be the result of hyperkalemia, neurological disease, conduction disturbances, or a side effect of analgesic or anesthetic drugs.

Question 4

What are possible differentials for the following mucous membrane colours?

• Pale/ white
• Red
• Cyanotic
• Yellow
• Brown

Answer 4

Pale/ white = anemia, vasoconstrictive response to shock

Red = vasodilation (SIRS, hyperthermia)

Cyanotic = severe hypoxemia (not evident without adequate Hb levels)

Yellow = hepatic disease, hemolysis

Brown = MetHb

Question 5

With a laterally recumbent patient, if the ________ _________ vein is distended, the limb can be elevated above the level of the heart. If the vein remains distended, it suggests elevated _______ ______ pressure.

Answer 5

Lateral saphenous; Central venous

Question 6

During auscultation of the upper and lower respiratory tract, what can be heard as an early indicator for fluid overload?

Answer 6

Stertor and wheezes in the upper airway, and quiet crackles in the lungs

Question 7

Crackles heard during auscultation can be associated with -?

Answer 7

Pneumonia, pulmonary edema, pulmonary hemorrhage, and small airway disease

Question 8

Decreased lung sounds can be associated with -?

Answer 8

Pulmonary consolidation, pneumothorax, or pleural effusion

Question 9

While patients with ______ can be aroused only with painful stimuli, it is often a sign of severe ________ or _________ derangements.

Answer 9

Stupor; neurologic; metabolic

Question 10

With a decrease or loss of gag reflux, what primary complication should be strictly monitored for?

Answer 10

Aspiration pneumonia

Question 11

Important considerations in the monitoring of critically ill patients include?

Answer 11

• TP, Albumin
• Glucose
• Electrolytes
• Oxygenation and ventilation
• RBC and Hb concentrations
• Blood pressure
• Renal function and urine output
• Nutrition
• TLC