Critical Care

Question 1

What information does an arterial line give?

Answer 1

provides systolic, diastolic, and mean arterial pressure information (also allows for blood draw access)

Question 2

t/f, an arterial line in the neck or radial artery limits a patient’s mobility

Answer 2

false, can have full mobility unless it is in the groin- which can limit it

Question 3

What does MAP tell us and what range is not good?

Answer 3

reflects the tissue perfusion pressure (avg pressure tending to push blood through the circulatory system), less than 60 may indicate inadequate tissue perfusion

Question 4

Which veins can a central line be inserted into and what information does it give us?

Answer 4

subclavian or jugular vein (femoral sometimes as well), allows for continuous monitoring of central venous pressure or right arterial pressure-> assesses cardiac function and intravascular fluid status

Question 5

t/f, a PICC line is used instead of a central line when a pt requires prolonged stay

Answer 5

true, a PICC line is used instead and inserted into a peripheral vein and its tip ends up in the distal SUPERIOR VENA CAVA

Question 6

a low central venous pressure (CVP) may indicate ____

Answer 6

hypovolemia/dehydration

Question 7

Which catheter is being shown in the picture?

Answer 7

pulmonary artery catheter/ swan ganz catheter

Question 8

Which catheter would give you the best information about the pressures of the heart atria and heart O2, resistance and pacing of atria and ventricles?

Answer 8

pulmonary artery catheter/swan ganz catheter

Question 9

t/f, the pressure of the pulmonary veins, capillaries, and artery are equal to the pressure at the end of diastole

Answer 9

true, since the pulmonary venous system has no valves, LAP reflects value of LVEDP

Question 10

What term describes the outflow or venous pressure for the pulmonary circulation?

Answer 10

pulmonary capillary wedge pressure (LAP)

Question 11

pulmonary artery end diastolic pressure is essentially equal to the LVEDP which is normally LESS THAN ____ mmHg

Answer 11

12mmHg

Question 12

What are some reasons we would measure pulmonary capillary wedge pressure?

Answer 12

assess severity of L ventricular fxn
assess mitral and aortic valve dysfxn
assess and treat pulmonary edema
assess pulmonary HTN
assess and treat hypovolemic state

Question 13

in patients with brain injury, a high ICP correlates with low ___ ___ ____

Answer 13

cerebral perfusion pressure

Question 14

What is the normal ICP for adults, children (based on this lecture slide)

Answer 14

adults: 0-10 mmHg
children under 5: 0-5 mmHg

Question 15

t/f, you can mobilize a patient with an intraaortic balloon pump

Answer 15

false, mobility is contraindicated until it is removed (no hip flexion in leg with catheter as well)

Question 16

What does an intraaortic balloon pump help improve?

Answer 16

helps improve blood flow to the myocardium

Question 17

Which types of patients would be on ecmo (4)?

Answer 17

those with lungs that can’t provide enough oxygen to the body even when given extra oxygen
whose lungs can’t get rid of CO2 even with help from mechanical ventilator
heart can’t pump enough blood to the body
those waiting for organ transplant

Question 18

What is the name of the heart pump used to maintain blood flow in babies and small children with serious heart failure?

Answer 18

Berlin Heart

Question 19

What is one of the main side effects that affects up to 80% of mechanically ventilated ICU patients?

Answer 19

delirium

Question 20

What are some of the warning signs for post-intensive care syndrome?

Answer 20

mm weakness or problems with balance
problems with thinking and memory
severe anxiety
depression
nightmares

Question 21

What are three rehab interventions you can do in the ICU?

Answer 21

cognitive stimulation, in-bed cycling, early mobility

Question 22

When should you stop early mobility in the ICU?

Answer 22

Question 23

What are some PT keys to treatment in the acute care setting?

Answer 23

check the placement of all femoral catheters before and after treatment- includes all femoral arterial lines, venous lines, ECMO cannulas