Critical Care HESI

Question 1

Systemic Inflammatory Response Syndrome (SIRS)

Answer 1

Widespread inflammation that occurs in patients with various disorders

Most frequently associated with sepsis

Question 2

Multiple Organ Dysfunction Syndrome

Answer 2

Progressive dysfunction of two or more organ systems as result of widespread inflammation that is caused by an illness or injury

Common causes are sepsis or septic shock

Question 3

IV Fluid Therapy

Colloids

Answer 3

Normal human serum albumin

Rapidly expand intra vascular volume

Question 4

Types of Fluid Therapy
Isotonic
Crystalloids

Answer 4

Indicated for intravascular dehydration

Same osmolality as extra-cellular fluid

Question 5

Types of fluid therapy
Isotonic
Lactated Ringers

Answer 5

.9% NaCl in water with added K, Ca, Na, lactate buffers,

Used to replace body fluids, to provide bicarbonate to buffer body fluids

Question 6

Types of Fluid Therapy
Isotonic
NSS

Answer 6

.9 % NaCl in water

Raises plasma volume when RBC mass is adequate, replaces body fluids

Question 7

Blood Component Therapy

Type Specific Whole blood

Answer 7

Normal blood
Less viscous than packed red blood cells, can be administered quicker, low rate of transfusion reaction, takes a shorter time to prepare than crossmatched

Question 8

Blood Component Therapy

Packed Red Blood Cells

Answer 8

Red blood cells
Less danger of fluid overload
Used for Acute blood loss

Question 9

Blood Component Therapy

Platelets

Answer 9

Platelets that are pooled have 300ml a bag
One unit is for a single donor and has 200 ml
considerations: bag should be agitated periodically, nonfunctional in blood>72 hours old
Use: bleeding caused by thrombocytopenia, used in patients who receive 5000ml of. Blood in 24 hours

Question 10

Blood Component Therapy

Fresh Frozen Plasma

Answer 10

Definition: liquid portion of whole blood separated from cells and frozen
Considerations: albumin plasma expanders are now used more often
Use: replenishes clotting factors

Question 11

Blood Component Therapy

Albumin

Answer 11

Definition: prepared from plasma and is available in 5 % and 25% solutions
Considerations: albumin 25g/100ml is osmotically equal to 500ml of plasma
Use: hypovolemic shock, hypoalbuminemia, expands intravascular volume

Question 12

Hemodynamic Findings in the Kinds of Shock

Hypovolemic

Answer 12

RAP: decreased
Pulmonary artery pressure: N increased, decreased
Blood Pressure: decreased
Cardiac Output: decreased

Question 13

Hemodynamic Findings in the kinds of shock

Cardiogenic shock

Answer 13

RAP: increased
Pulmonary artery pressure: increased
Blood Pressure: decreased
Cardiac Output: decreased

Question 14

Neurogenic Shock Hemodynamic Parameters

Answer 14

RAP: decreased
PAP: N decreased
BP: decreased
CO:decreased

Question 15

Anaphylactic Shock Hemodynamic Findings

Answer 15

RAP: decreased
PAP: N decreased
BP:decreased
CO:decreased

Question 16

Septic Shock

Answer 16

Early                            late
BP:decreased           Decreased than increased
PAP: N decreased    Increased 
BP: decreased.         Decreased
CO: N increased.      Decrease

Question 17

Hemodynamic findings in early septic shock

Hyper dynamic, warm

Answer 17

Increased CO/CI
Decreased RAP/PAP/PCWP
Decreased SVR
Increased SVO2

Question 18

Hemodynamic findings for late septic shock

Cold,hypo dynamic

Answer 18

Decreased CO/CI
Variable RAP/PAP/PCWP
Variable SVR
Decreased SVO2

Question 19

Mild CO poisoning (11-20) manifestations

Answer 19

Headache, flushing, decreased visual acuity, decreased cerebral functioning, slight breathlessness
(Mostly neuro)

Question 20

Moderate CO poisoning (21-40) manifestations

Answer 20

Headache, nausea and vomiting, drowsiness, tinnitus and vertigo, confusion and stupor, pale to reddish-purple skin, decreased blood pressure, increased and irregular heart rate, decreased ST segment on electrocardiograph

Question 21

Severe CO Poisoning (41-60)

Answer 21

Coma, seizures, cardiopulmonary instability