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Critical Care Class > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

common causes of upper GI bleeds

A 
gastric and duodenal ulcers
esophageal varices
erosive gastritis
esophagitis
Mallory-Weiss tears
angiomas of stomach or small bowel
aortoenteric fistulas
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2
Q

common causes of lower GI bleeds

A

colonic angioma
diverticular
internal hemorrhoids

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3
Q

difference between upper and lower GI bleed

A

upper: above duodenal junction; vomit bright, dark, or coffee ground blood, black tarry stool
lower: colon, rectum, anus - rectal passage of red/maroon/bloody stool

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4
Q

most appropriate intervention for patient with large amounts of vomiting

A

NGT and upper endoscopy

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5
Q

how to stabilize pt with acute, critical GI bleed

A

replace volume loss with crystalloids and blood to stabilize hemodynamics

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6
Q

calculate blood replacement

A

each gram lost = 1 unit given

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7
Q

considerations when deciding how many units of blood to give during acute GI bleed resuscitation

A

hemodilution from fluid replacement

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8
Q

when to see results from PRBC

A

48-72 hours for intra- and extravascular equilibrium

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9
Q

Hep A route of infection

A

oral-fecal, contaminated food

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10
Q

Hep A Sx

A 
fever
malaise
anorexia
nausea
abd discomfort
jaundice
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11
Q

Hep B route of infection

A

blood + body fluid

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12
Q

Hep B Sx

A 
jaundice
fatigue
loss of appetite
nausea
GI upset
dark urine
clay-colored stool
joint pain
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13
Q

Hep C route of infection

A

blood and body fluid

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14
Q

Hep C Sx

A

80% w/o Sx

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15
Q

etiology of acute pancreatitis

A 
iatrogenic, idiopathic
infectious (HIV, mumps)
gallstones
genetics
ETOH
trauma
steroids
autoimmune, anesthesia
scorpion, snake bites
hyperlipid, hypoCa, hypothermia
ERCP
drugs
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16
Q

Trousseau’s sign and Chvostek’s sign present with what electrolyte disturbance

A

hypocalcemia

17
Q

abnormal labs with acute pancreatitis

A

high: amylase, lipase, BG, triglycerides, LFTs, BUN/Creat, Hct, WBC, bili
low: albumin, calcium (binds to free fatty acid complexes, intracellular translocation)

18
Q

ACLS adaptations for pregnancy

A

A - jaw thrust d/t larynx displacement
B - 18-22 breaths/min to maintain resp alkalosis
C - higher on chest
D - displace uterus left to improve circulation

deliver fetus after 4-5 min
remove fetal monitor before defib
increase pressure to paddles

19
Q

benefits of enteral over parenteral feeding

A

prevent:
intestinal lumen atrophy
bacterial translocation
development of sepsis from bowel flora

20
Q

care of thrombocytopenic pt

A

limit invasive procedures
no rectal meds, temps
electric razors only
bowel regimen to decrease straining

21
Q

define prerenal AKI

A

decreased perfusion to kidneys w/o damage to renal tubules

22
Q

cause of prerenal AKI

A

hypovolemia
altered PVR (sepsis)
decreased CO
meds

23
Q

treat prerenal AKI

A 
restore renal perfusion via:
fluids
pressors
eliminate problem beds
hemodynamic stability goal
24
Q

define intrarenal AKI

A

decreased perfusion to kidneys d/t damage to kidney

25
Q

cause of intrarenal AKI

A

prolonged hypotension or drugs toxic to tubular cells

26
Q

treat intrarenal AKI

A

immunosuppressive or cytotoxic meds

confirm with renal biopsy d/t risk/benefit

27
Q

define post renal AKI

A

obstruction of urinary flow (hydronephrosis)

28
Q

cause of postrenal AKI

A

prostatic hypertrophy, other tumors

29
Q

treat postrenal AKI

A

relieve obstruction

30
Q

labs to send during stroke

A

CBC
electrolytes
glucose
PT/PTT

31
Q

ischemic stroke supportive care

A 
ABCs
IV normal saline
supine
normoglycemia
normothermia
aspirin
DVT prophylaxis
dysphagia screen
don't treat BP unless MAP>140
stroke unit
32
Q

define delirium

A

disturbance of consciousness characterized by acute onset and fluctuating course of impaired cognitive functioning

33
Q

define cerebral auto-regulation

A
  1. body’s ability to maintain adequate BP to brain
  2. cerebral circulation has capacity to maintain blood flow at constant level during changes in BP
  3. adequate cerebral blood flow is maintained by constriction/dilation of cerebral vessels in response to changes
34
Q

ICP and CPP goals in patient with head trauma/injury

A

ICP > 20

CPP > 60

35
Q

what happens when CPP drops?

A

cerebral ischemia

36
Q

early signs of elevated ICP

A

confusion, agitation
headache
N/V

37
Q

late signs of elevated ICP

A

puipillary changes
papilloedema
loss of motor fxn
cardiovascular vital sign changes (Cushings traid - HTN, bradycardia, irreg resps)

38
Q

interventions of unstable pregnant patient

A

left lateral position or manually displace uterus
100% O2 via non-rebreather
fluid bolus

Critical Care Class (1 decks)

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