ICU Equipment Flashcards by Jasmine Lelliott

What equipment might be seen in an ICU?

pulse ox
capnography
doppler and oscillometric non-invasive blood pressure
invasive blood pressure, arterial catheters via trasnducers onto monitor
central venous pressure via central line, haemodynamic presure
multiparameters
glucometer
lactate monitor
microscope
biochemistry and haematology machine
centrifuge
syringe drivers and infusion pumps

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Why might you use a lactate monitor?

if you do not own a blood gas analysis machine

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What parameters will you find on a blood gas reading?

pH
PaO2/PvO2
PaCO2/PvCO2
BE
HCO3
anion gap

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What is Pao2/PvO2 measuring?

partial pressure of oxygen dissolved in plasma

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What is PaCO2/PvCO2 measuring?

partial pressures of carbon dioxdie dissolved in plasam

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What is BE on a blood gas analysis?

base excess or deficit, H ions needed to return the pH back to normal

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What is HCO3 measuring?

bicarbonate (buffer)

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What is anion gap measuring?

unmeasured anions in the blood e.g ketones, uric acid, ethylene glycol

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What is the normal range for pH?

7.35-7.45

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What is the normal range for PaO2?

80-100mmHg

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What is the normal range for PaCO2?

35-45mmHg

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What is the normal range for HCO3?

21-24

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What is the normal range for BE (base excess)?

+2 or -2mEq

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What is the normal range for anion gap for dogs and cats?

dogs = 12-24mEq/L
cats = 13-27mEq/L

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What can an increase in lactate cause?

emtabolic acidosis

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What pH will you get with metabolic acidosis?

<7.35

What pH will you get with metabolic alkalosis?

> 7.45

What is it called when metabolic aklkalosis causes a pH of >7.45?

alkalaemia

What is it called when metabolic acidosis causes a pH of <7.35?

acidaemia

What compensatory factors occur with metabolic acidosis?

pH within normal limits but HCO3 is very low and PaCO2 is also low

What compensatory factors occur with metabolic alkalosis?

pH within normal limits but HCO3 very high and PaCO2 also high

What happens if the PaCO2 is >45mmHg?

respiratory acidosis

What happens if PaCO2 is <35mmHg?

respiratory alkalosis

What happens if the body is in respiratory alkalosis?

hypoventilation to retiain CO2 to bring pH down

What happens if the body is in respiratory acidosis?

body with hyperventilate to get rid of CO2

If a patient has a blood gas of pH - 7.063 PaCO2 - 106.7mmHg HCO3 - 28.4 BE - 4.2 what causes this?

Aacidaemia and primary resporatory acidosis with partial metabolic acidosis

If a patient has a blood gas of pH- 7.202 PaCO2 - 19.8mmHg HCO3 - 7.4mEq/L BE - 18.5 what causes this?

acidaemia, respiratory alkalosis, metabolic acidosis with compensatory respiratory alkalosis

If a patient has this blood gas analysis pH - 7.49 PaCO2 - 47mmHG HCO3 - 34.8mEq/L BE- 10.2 what causes this?

alkalemia, respiratory acidosis, metabolic alkalosis and compensatory respiratory acidosis

What conditions can cause metabolic acidosis?

diarrhoea, diabetic ketoacidosis, renal failure, addisons disease, lactic acidosis (sepsis)

What conditions can cause metabolic alkalosis?

vomiting (loss of H ions),hypoalbuminaemia (weak acid), upper GI obstruction (vomiting)

What is the rule of 20?

lists the critical parameters to be checked in critical patients

What is included in the rule of 20?

- fluid balancce - oncotic pull/albumin - glucose - electrolytes and acid base - oxygenation and ventilation - levels of consciousbess/mentation - blood pressure - heart rate, rhythm and contractibility - temperature - coagulation - RBC and Hb - renal function - immune status - GI motility - drug doses/drug metabolism - nutrition - pain control - patient mobilisation/care - wound care - TLC

How wouldyou nurse a ventilation patient?

-eye care - dry eye - mouth care - ulcers, lack of moisture - airway - humidification - physio and positioning - lines, drains,tubes - urination/defaecation - drugs - treatment of underlying conditions - record keeping - acid base, blood gases and electrolytes

How would you monitor a patient with head and neck trauma who is un-responsive?

- fluid balance - glucose and electrolyte monotoring - ventilation/oxygenation - mentation/coma score NIBP monitor for cushings reflex - HR and ECG monitor bradycardia - parenteral nutrition - coagulation checks - mannitol/hypertonic saline - u-catheter RBC

What causes a cushings reflex?

raised intracranial pressure

What nursing care would you provide for a head and neck trauma patient?

turning every 4 hours, eye care, oral care, wound management, TLC

What is the rule of 20 for a BOAS patient presenting as cyanotic/dyspnoeic and anxious?

- fluid balance - high flow oxygen therpay - glucose and electrolytes - temperature - venilation/oxygenation - PaO2/PaCO2 - BP - HR and ECG - drugs - nutrition - parenteral