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cardiopulm jd > CPPT In ICU > Flashcards

CPPT In ICU Flashcards

1
Q

Green (ECG) normal values

A

60-90 bpm

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2
Q

Red: BP and (MAP- mean arterial pressure) normal values

A

120/80 mmHg and MAP is between 60-110, normal is 92

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3
Q

CVP (Central venous pressure) normal values

A

2-8 cmH2O or 2-6 mmHg

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4
Q

Blue- Intracranial pressure normal values

A

0-15 mmHg, can treat up to 20 mmHg, if 19, talk to nurse

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5
Q

Purple- SpO2- normal values

A

97-98

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6
Q

Endotracheal tube can be inserted by what two ways?

A

Oral and nasal

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7
Q

3 classifications of tracheostomy tubes

A

Cuffed and cuffless
Fenestrated and nonfenestrated
Metal and plastic

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8
Q

ET-T is used for short or long term management?

A

Short

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9
Q

Where are trachs inserted?

A

Below vocal cords

Btw third and fourth tracheal rings at sternal notch

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10
Q

What should the cuff pressure on the trach be?

A

Below 25 cmH2O

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11
Q

Trach patients should have what kind of motion done?

A

C/S ROM and prone positioning

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12
Q

Where are chest tubes inserted for fluid?

A

Btw fourth and fifth intercostal space at the midaxillary line for fluid (low)

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13
Q

Where are the chest tubes inserted for a pneumothorax?

A

IN the second intercostal space at the midclavicular line (high)

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14
Q

Where should the drainage container be placed for patients with a chest tube?

A

Upright and below the level of the chest connecting the tubes to an under water seal drainage system and applying suction

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15
Q

3 compartments of drainage containers

A

Under water seal drainage
A collection chamber for air or fluid
A suction chamber

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16
Q

In the 3 compartments of the drainage containers, where is it okay to see bubbles?

A

The suction chamber

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17
Q

True or false: patients connected to an under water seal drainage can be mobilized and ambulated?

A

True

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18
Q

Can percussion and vibration be performed with chest tubes?

A

Yes

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19
Q

ROM of what body part is necessary with breathing exercises for people with chest tubes?

A

Shoulder ROM

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20
Q

Orange hair syndrome

A

Patient need 2-4x amount of normal pain meds to feel relief

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21
Q

An spO2 of 90% corresponds to a PaO2 of ….

A

60 mmHg

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22
Q

Below 90% of SpO2 is a problem, and this can occur…

A

Dysrhythmias

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23
Q

At what SpO2 and PaO2 do most dysrhythmias occur?

A

SpO2- 85% and PaO2 of 50 mmHg

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24
Q

HDM-A Line: Peripheral Arterial Catheters: What artery is this usually put into?

A

Radial artery

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25
Q

HDM-A Line: Peripheral Arterial Catheters: What two things are the catheter connected to?

A

A flush device and transducer

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26
Q

HDM-A Line: Peripheral Arterial Catheters: Where should the transducer be placed?

A

At the level of the right atrium

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27
Q

HDM-A Line: Peripheral Arterial Catheters: What will the pressure readings be if the transducer is below the right atrium?

A

Falsely high

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28
Q

HDM-A Line: Peripheral Arterial Catheters: What will the pressure readings be if the transducer is above the right atrium?

A

Falsely low

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29
Q

HDM-A Line: Peripheral Arterial Catheters: What is one thing you should not change without notifying the nurse?

A

The height of the bed

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30
Q

This kind of line has a loop along thumb and the wrist is bandaged

A

A line

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31
Q

Central Venous Pressure (CVP) catheters: are placed where?

A

Directly into the heart (right atrium)

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32
Q

Central Venous Pressure (CVP) catheters: This is an important tool to assess…

A

Right atrial pressure
Right ventricular function
Systemic fluid status

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33
Q

Central Venous Pressure (CVP) catheters: Directly reflects ______
Indirectly reflects _______

A

Directly: right atrial pressure
Indirectly: right ventricular end diastolic pressure

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34
Q

Central Venous Pressure (CVP) catheters: If the right ventricle is failing, what will rise?

A

CVP

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35
Q

Central Venous Pressure (CVP) catheters: The waveform fluctuates with inspiration
_______ with spontaneous inspiration
_______ with positive pressure respiration

A

Decreases

Increases

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36
Q

Swan Ganz: How is it inserted

A

Through the right atrium, right ventricle, and then passed into the pulmonary artery

37
Q

Swan Ganz: What three things can be calculated?

A

Preload
Contractile state
Afterload

38
Q

Pulmonary Artery Catheters: During balloon inflation, the pulmonary artery wedge pressure is calculated and the wave is _____

A

Dampened

39
Q

Pulmonary Artery Catheters: Pulmonary artery wedge pressure is indicative of…

A

Left atrial and left ventricular end diastolic pressures

40
Q

Pulmonary Artery Catheters: The balloon should NOT be inflated for more than ___ seconds

A

15

41
Q

What side of the brain are ICP devices placed on?

A

Injured side of the brain

42
Q

Two different types of neurological monitoring devices:

A

EVD (external ventricular drain) and Bolt

43
Q

What two things does the (external ventricular drain) drain?

A

Spinal fluid and CSF

44
Q

For someone on Bolt or EVD, how should the bed be set up?

A

Head of bed MUST be elevated

45
Q

What kind of wave demonstrates sudden increases in ICP with peaks of 50-100 mmHg

A

Alpha wave

46
Q

What kind of wave is a saw tooth pattern, correlates with respiratory changes and occurs decreasing brain compliance

A

Beta wave

47
Q

Cerebral perfusion pressure is the drive pressure of….

A

Blood to the brain

48
Q

How can CPP be calculated?

A

MAP-ICP=CPP

49
Q

What value do we want CPP to be?

A

> 60 mmHg

50
Q

Can put a patient in trendelenberg if ICP is _____ and CPP is ____

A

<25 mmHg

>50 mmHg

51
Q

MAP= formula

A

((2 x DBP) + SBP) / 3

52
Q

CVP mean number is…

A

0-8 mmHg

53
Q

Pulmonary artery values:
Systolic:
End diastolic:
Mean

A

15-32 mmHg
4-13 mmHg
9-19 mmHg

54
Q

Normal mean range for pulmonary artery wedge pressure is…

A

4-12 mmHg

55
Q

Peripherally Inserted Central Catheter (PICC Line): Infusion of what?

A

Meds, nutrition, fluids, or blood products

56
Q

Peripherally Inserted Central Catheter (PICC Line): What is the placement?

A

Under fluoroscopic guidance, catheter is inserted percutaneously into a vein in antecubital fossa.
The tip of the Cather is moved into the superior vena cava and right atrium and goes right into the heart

57
Q

Peripherally Inserted Central Catheter (PICC Line): What is important about blood pressure?

A

Cannot take blood pressure in extremity with PICC line

58
Q

Peripherally Inserted Central Catheter (PICC Line): Can you ambulate with patient?

A

Yes

59
Q

TLC (Tri Lumen Catheter): Infusion of…

A

Meds, nutrition and blood products

Allows blood withdrawal

60
Q

TLC (Tri Lumen Catheter): Placement?

A

Inserted percutaneously into the superior vena cava through the subclavian, external jugular, or internal jugular vein or into the femoral vein of the LE

61
Q

TLC (Tri Lumen Catheter): What needs to be ruled out before giving therapy?

A

A pneumothorax

62
Q

TLC (Tri Lumen Catheter): When do you need to calcify orders for transfer training OOB with MD?

A

When they have a femoral catheter placement

63
Q

Implantable Port: Infusion of…

What population usually gets these?

A

Drugs, TPN, blood products and other fluids; typically in patients with cancer

64
Q

Implantable port: placement?

A

Percutaneous placement into super vena cava or right atrium via subclavian or internal jug vein
Portal place over 3rd and 4th ribs

65
Q

Temp pacemaker: Placement

A

Pacing wire is inserted transvenously through subclavian or IJ vein into right atrium, right ventricle or both

66
Q

Temp pacemaker: Wire is ____ and device is ____

A

Internal

External

67
Q

Temp pacemaker: What is a contraindication for people with a temp pacemaker?

A

Shoulder flexion/abduction ROM- typically for 1 month min

68
Q

Hemo Catheter: Permits access for _____

A

Urgent dialysis/acute renal failure

69
Q

Hemo Catheter: If you are on a hemo catheter, you are usually on this kind of machine as well

A

Dialysis

70
Q

Hemo Catheter: Placement

A

Catheter is inserted percutaneously into subclavian, IJ, or femoral vein; sutured into place

71
Q

Mechanical ventilation: If you RR is this value, you may be intubated

A

RR >30

72
Q

Mechanical ventilation: May be intubated if PaCO2 >50 mmHg with pH<7.25

A

True

73
Q

What is the 50/50 rule?

A

MV is indicated if a patient’s PaO2 falls below 50 mmHg and the PaCO2 rises above 50 mmHg

74
Q

Mechanical ventilation: Most commonly used modes of MV are…

A

Assist-control

Continuous mandatory ventilation

75
Q

CMV (continuous mandatory ventilation) means that the vent is doing ______ of the work

A

100%

76
Q

SIMV: means that the patient is doing _____ of the work

A

Less than 100%

77
Q

PEER (positive end expiratory pressure) means that…

A

The patient is breathing on their own

The higher the PEEP, the more support pt needs (want PEEP to come down)

78
Q

When the breath is patient triggered, it is referred to…

A

IMV

79
Q

When the breath is delivered by the vent, it is termed

A

SIMV

80
Q

Do you do PT if a patient is on a vent and is beating weaned on SBT?

A

NOOOOOO

81
Q

High pressure alarm is probably because…

A

A/W is blocked, sputum, coughing (needs to be suctioned)

82
Q

Low pressure alarm means:

A

Disconnected from vent, likely pt pops off vent

83
Q

4 indications of CPPT in the ICU

A

Retained secretions
Acute atelectasis or infiltrate
Decrease in PaO2 or SpO2 as a result of secretion retention
Prophylactic use

84
Q

4 things that the efficacy of CPPT is determined by:

A

Decrease in pulmonary infection incidence
Improvement in the PFT
Decrease duration of mechanical ventilation
Prevention of tracheostomies

85
Q

Activities in the ICU including CPPT can increase metabolic rate by ____%

A

35%

86
Q

What FEV1% is needed for patient to have an effective cough?

A

60%

87
Q

Do manual techniques increase the ICP?

A

No, it is not a contraindication

88
Q

It appears that the increase in VO2 and VCO2 that occurs with manual techniques returns to baseline in how many minutes?

A

15 minutes

89
Q

When doing manual techniques, out of these measures what increases and what decreases? HR, BP, RR, O2

A

HR, BP, and RR increase
O2 decrease

All return to baseline in 15 min or better after PT

cardiopulm jd (12 decks)

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