Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Nursing May Exam > Intensive care nursing > Flashcards

Intensive care nursing Flashcards

1
Q

define critical care nursing

A

field of nursing focusing on care of critically ill patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are potential causes of life threatening illness?

A

surgery
illness
injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

list patients in need of critical CCN

A 
CV unstable
respiratory distress
neurological disease
multiple trauma
systemic disease
extensive wounds
electrolyte imbalances
sepsis
neonates and adolescents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the aim of triage for critical patients?

A

quickly assess patient to determine order of treatment for patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe the steps of triage for critical patients

A

assess 3 MBS
if fail any of MBS assessments need immediate attention
usually takes place in reception with owner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the 3 MBS?

A

neurological
CV
respiratory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what should you make sure to communicate with owners of critical patients during triage?

A

introduce self and what you will do
ask patients temperament
if stable keep with owner, if not take for treatment and explain someone will be out soon to explain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is assessed in the quick assessment of triaging critical patients?

A 
HR
pulse quality
RR and effort
bleeding
pain
mentation
ambulation
seizure signs
MM
CRT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are considerations when monitoring critical patients?

A

tailor to individual
monitoring equipment can be unreliable
trends more important than results

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when do patients need constant monitoring?

A

critical patients

patients likely to deteriorate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which patients should be monitored every 15-30 minutes?

A

GA recovery

starting blood transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which patients should be monitored every 1-2 hours?

A

hypoglycaemic patients
if monitoring RR
when need medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

which patients are monitored every 4-6 hours?

A

stable patients but may deteriorate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

which pulse points are used most for cats and dogs?

A

dogs- femoral and dorsal pedal

cats- femoral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how is pulse assessed?

A

feel rate and quality

listen for deficits as indicate arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is suggested by weak and thready, bounding or snappy pulses?

A

weak or thready- low systolic BP
bounding- sepsis
snappy- anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what needs considering when assessing patients heart rates?

A

pain
stress
drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

state normal heart rate for dogs large and small

A

60-100bpm- large

100-140bpm- small

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

state HR when tachycardic in dogs

A

over 140 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

state HR when bradycardic in dogs

A

less than 60bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

state normal HR in cats

A

14-180bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

state HR when tachycardic in cats

A

over 180-200bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

state HR when bradycardic on cats

A

less than 120bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are normal systolic, diastolic and MAP in dogs?

A

systolic- 110-160mmHg
diastolic- 55-110mmHg
MAP- 100mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what are normal systolic, diastolic and MAP in cats?
systolic- 120-170mmHg diastolic- 70-120mmHg MAP- 130mmHg
26
what BP are classed as hypotensive?
less than 100mmHg systolic and 60mmHg MAP
27
what BP are classed as hypertensive?
over 170-200mmHg systolic and 120mmHd MAP
28
how do you respond to hypotension?
give IVFT bolus and vasopressors to cause vasoconstriction
29
how do you manage hypertension?
give antihypertensive drugs such as amlodipine | investigate cause
30
how does doppler measure BP?
sound waves detect arterial blood flow
31
how does oscillometric BP work?
machine reads BPs
32
what is the benefit of arterial BP measurement?
continuous monitoring of systolic, diastolic and MAP
33
what colour are normal MM?
pink
34
what do red/hyperaemic MM suggest?
sepsis
35
what colour are MM from CO toxicity?
bright red
36
what do white MM suggest?
anaemia | shock
37
what do cyanotic MM suggest?
hypoxia | hypoxaemia
38
what colour do MM go from paracetamol toxicity?
brown
39
what causes icteric MM?
liver disease
40
what causes petechia in MM?
coagulopathy
41
what do dry MM suggest?
dehydration
42
what is normal CRT?
1-2 seconds
43
define CRT
amount of time for colour to return to capillary bed after digital pressure applied
44
what is shown by CRT?
peripheral perfusion
45
what causes prolonged CRT?
shock hypoperfusion vasoconstriction
46
what causes rapid CRT?
sepsis | vasodilation
47
what is the purpose of ECG?
measure electrical activity of the heart
48
what conditions can make patients prone to cardiac arrhythmias?
GDV | sepsis
49
what are examples of heart abnormalities from auscultation?
murmurs gallops pulse deficits
50
state normal RR for dogs
18-36brpm
51
state normal RR for cats
20-30brpm
52
what is considered bradypnoeic?
less than 15brpm
53
what is considered tachypnoeic?
over 45-60brpm
54
what can cause bradypnoea?
drugs hypocapnia CNS disease hypothermia
55
what can cause tachypnoea?
``` hypoxia hypercapnia pain hyperthermia pyrexia stress metabolic acidosis ```
56
define apnoea
absence of ventilatory effort
57
what can cause apnoea?
respiratory or cardiac arrest drug overdose neurological complications
58
what is seen for normal respiratory effort?
gentle chest movement | minimal abdominal movement
59
what signs indicate dyspnoea?
increased chest and abdominal muscle movement orthopnoea open mouth breathing
60
what can cause dyspnoea?
airway obstruction pleural space disease pulmonary parenchymal disease upper airway disease
61
what are signs of reduced respiratory effort?
reduced chest and abdominal muscle movement
62
what is the danger of reduced respiratory effort?
high risk of cardiac and pulmonary arrest
63
what can cause reduced respiratory effort?
head injury spinal cord injury tetanus end stage respiratory failure
64
define stridor
dry noise on breathing
65
define stertor
wet noise/snore on breathing
66
what should you listen for when auscultating lungs?
``` noise on inspiration noise on expiration stridor stertor decreased lung sounds abnormal lung sounds ```
67
how should you auscultate lungs?
symmetrically divide each lung into dorsal, middle and ventral portions and move cranial to caudal compare each side
68
what is suggested by decreased lung sounds?
pneumothorax | pleural effusion
69
what is the purpose of pulse oximetry?
measures oxygenation of blood
70
what are advantages and disadvantages of pulse oximetry?
adv- non-invasive, continuous monitoring | disadv- doesn't measure tissue perfusion or ventilation
71
where do you place pulse oximetery?
tongue lip ear inguinal fold
72
state normal ETCO2
35-42mmHg
73
state hypercapnic ETCO2
over 50mmHg
74
state hypocapnic ETCO2
less than 30mmHg
75
what makes ETCO2 an indirect assessment of ventilation?
ETCO2 is roughly 1-4mmHg less than arterial PaCO2
76
what is the advantage of capnography?
non-invasive
77
what does capnography measure?
ETCO2
78
what can affect capnography trace?
``` system leaks ETT kink sensor obstruction airway obstruction apnoea ```
79
what is normal PP oxygen?
80-100mmHg
80
state mild and severe values for hypoxaemia
mild- 70-80mmHg | severe- less than 60mmHg
81
what does PP oxygen show?
ability to oxygenate blood
82
what does PP CO2 show?
ability to ventilate and perform gas exchange in alveoli
83
state normal PP CO2
35-45mmHg
84
what is hypocapnia PP CO2?
less than 35mmHg
85
what is hypercapnia PP CO2?
over 45mmHg
86
what are considerations when giving oxygen therapy?
minimise stress minimal restraint be prepared for decompensation and intubation
87
what are examples of non-invasive oxygen provision?
flow by oxygen cage nasal prongs
88
what are examples of invasive oxygen provision?
nasal catheters trans-tracheal endotracheal ventilation
89
state how mentation is classed as
``` normal obtunded stuporous comatose hyper-excitable ```
90
define hyper-excitable
excessive reaction to stimuli
91
what can cause reduced mentation?
shock hypoperfusion hypoxaemia primary neurological disease
92
list cranial nerve function assessment
PLR pupil size and symmetry oculocephalic reflexes menace reflex
93
what should be seen in PLR?
both pupils responding bilaterally, rapidly and consensually
94
what are examples of abnormal pupil size and symmetry?
anisocoria miosis mydriasis
95
define anisocoria
different sized pupils
96
define miosis
constricted pupils
97
define mydriasis
dilated pupils
98
what is meant by oculocephalic reflex?
tracking response of eyes when head moved side to side
99
what should be seen in menace reflex?
reflex blinking in response to rapid approach to an object
100
what is nystagmus?
eyes make repetitive, uncontrolled movements | can be horizontal, vertical or rotational
101
define strabismus
one or both eyes deviated from normal position
102
what are signs of increased ICP?
absent PLR | pupil changes
103
describe the modified GCS
3 sections scored out of 6 then totalled | lower the score the worse prognosis
104
what are the 3 sections in modified GCS?
motor activity- gait, ambulation brainstem reflexes- PLR, oculocephalic reflex, pupil size level of consciousness- response to stimuli
105
when should you alert clinician regarding modified GCS?
if deteriorate 2 or more since last check
106
what is meant by the cushings reflex?
hypertension and bradycardia as a result of increased ICP
107
what patients are at risk of ICP?
head trauma seizures meningoencephalitis
108
how should you manage patients with high ICP?
raise head and thorax 15-30 degrees sternal recumbency to aid ventilation oxygen avoid increasing ICP
109
how can you avoid increasing ICP?
no jugular samples | avoid stimulations to sneeze, gag, vomit
110
what should you do if patient seizes?
note length and type
111
how should you manage seizure patients?
``` cool if hyperthermic have seizure plan on door of kennel keep meds accessible keep in padded kennel give oxygen before and after seizure elevate head and thorax when safe ```
112
what needs to be closely observed in patients with lesions to cervical region?
respiratory function
113
how should you manage spinal trauma patients?
transport on spinal board minimise movement keep flat
114
what are nursing considerations for patients with decreased conciousness?
monitor gag reflex, regurgitation may need to intubate physiotherapy hygiene
115
list features of critical care wards triage station
``` ECG portable monitoring equipment exam table BP machine oxygen portable ultrasound consumables ```
116
list features of high dependency area
``` oxygen monitoring equipment observation charts heat sources pumps for meds moveable trolley for access to patient ventilator anaesthetic machine patient easily accessible ```
117
what are features of emergency crash station?
``` easily accessible wheels to allow moving crash table always clear stocked and checked regularly and after use clearly labelled draws of contents ```
118
list some equipment found on crash trolleys
``` ETT and equipment for intubation suction IV consumables pre-drawn saline for flush chest drain equipment IO equipment ECG ambu bag defibrillator essential drugs capnography ```
119
what are some essential drugs used in crashes?
adrenaline atropine reversal agents dosage charts
120
what are some features to make feline friendly areas?
glass doors to see through but reduce noise windows blocked at bottom to prevent seeing dogs away from dogs in quiet area separate oxygen cages
121
what are features of nursing station in critical care ward?
able to see whole room patient records easily accessible easy computer access list of important contact numbers
122
what is the reason for having a lab in critical care ward?
quick diagnosis | use out of hours
123
what tends to be found in labs in critical care wards?
``` blood gas/electrolyte machine centrifuge haematology biochemistry coagulation times microscope SNAP tests ```
124
what is measured in minimum database?
PCV TS blood gas analysis- ventilation, acid base, electrolytes, lactate, oxygenation blood glucose
125
what tests are in extended database?
``` biochemistry haematology urinalysis coagulation profile blood typing and cross matching SNAP tests ```
126
what needs to be considered when choosing kennel for patient?
size walk in top or bottom oxygen kennel
127
when are patients placed in incubators?
neonates | if cant maintain temperature
128
where do critical patients tend to be kept in the ward?
in cot or trolley
129
what are some considerations of patient accommodation in critical care ward?
``` access to nursing and observation access to oxygen temperament visibility barrier nursing recumbency places to hide for cats ```
130
list considerations for patient environment in critical care wards
``` calm and quiet dim light reduced traffic for infection and noise control signs on doors cats separate clean and tidy easy access to consumables access to monitoring equipment ```
131
what tends to be found on hospital sheets?
``` patient and owner details date problem list notify if list tubes, drains, IV lines IVFT and meds information clinical notes weight- admit and daily food intake clinician notes temperament resus status ```
132
what measures are in place for infection control?
``` hand hygiene wiping equipment before and after use gloves prevent HAI barrier nursing ```
133
what patients should be barrier nursed?
wounds potential infectious disease compromised immune system
134
what measures are in place to maintain patient hygiene in hospital?
``` eye lube oral hygiene monitor excretions prevent and treat urine scalding monitor bladder for expression and catheterisation keep on vet bed clean and dry patient if soiled tail bandages ```
135
how do you manage hypothermia?
``` incubator bubble wrap heat mats blankets vet bed warm IVFT ```
136
when do and dont you actively cool hyperthermic patients?
if over 40 degrees unless pyrexic as helps fight infection
137
when do you stop actively cooling hyperthermic patients?
at 39.6 degrees as continue to cool and risk hypothermia
138
how can you cool hyperthermic patients?
air con ice under bedding cooling mats tepid bath
139
what consideration is needed for hyperthermic patients?
oxygen needed as higher consumption
140
how are lines, tubes and drains managed?
``` checked 2x daily remove as soon as no longer needed treat aseptically label and colour code monitor production from drains ```
141
what are the aims of physiotherapy?
``` decrease complications improve circulation allow muscle and tendon relaxation aid pain management reduce inflammation promote recovery ```
142
when is physiotherapy indicated?
``` pressure sores muscle contraction pulmonary secretions build up muscular weakness atrophy joint stiffness limb swelling pain boredom ```
143
when is physiotherapy contraindicated?
``` unstable patients unstable fractures spinal injury head trauma blood disorders very stressed very painful ```
144
what is the importance of providing nutrition to patients in hospital?
enterocytes in GIT need constant direct supply of nutrients after 3 days of none cells start to die creating weakness in GIT barrier so increased permeability which can lead to bacteria and endotoxins entering systemic circulation
145
why is it important to try to get early enteral nutrition in critical patients once stable?
may have been anorexic before hospital
146
what needs to be considered when introducing food to patients in hospital?
refeeding syndrome
147
list examples of enteral feeding tubes
``` NO NG oesophagostomy percutaneous endoscopic gastrotomy jejunostomy ```
148
why do PEG tubes need to be left for minimum 10 days after placement?
allow adhesions to form to reduce risk of peritonitis
149
how are patients fed through J tube?
CRI of jejunal diet only
150
what is meant by parenteral nutrition?
nutrients given directly into patients blood as CRI avoiding GIT
151
what is the negatives of parenteral nutrition?
less balanced | more expensiv
152
when is parenteral nutrition used?
non-functioning GIT unconscious severe neuro deficits
153
how is TPN given?
via central line or peripheral central catheter
154
what is PPN?
40-70% nutrient given parenterally
155
what are considerations for parenteral nutrition?
strict aseptic technique as sepsis risk TPN can cause thromboembolisms new bag and giving set every 24 hours
156
how can stress be minimised in hospitalised patients?
``` TLC bonding sedation to allow rest steady for nervous patients reassurance air diffusers hiding spots ```
157
how is hypovolaemia managed?
observe compensation mechanisms fluid bolus of 5-20ml/kg over 10-20 minutes reassess after each bolus
158
how is hydration monitored in hospitalised patients?
assess hydration daily update fluid plan regularly plan for ongoing losses and maintenance
159
what is normal UOP?
1-2ml/kg/hr
160
how is UOP monitored?
``` monitor ins and outs assess tissue perfusion closed system IDUC weigh bedding weigh patients for rapid changes ```
161
how are IDUC managed?
aseptic handling clean 2x daily lower than patient but not on floor prevent patient interference
162
how can you provide TLC to hospitalised patients?
``` bond with patient quiet time grooming affection toys time out of kennel hand feeding owner visits ```
163
why are nursing care plans used for critical patients?
standardise care so all needs covered and problems highlighted
164
what are the stages of nursing care plans?
assessment planning implementation evaluation

Clinical Nursing May Exam (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions