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Cardioresp > Intro to ICU > Flashcards

Intro to ICU Flashcards

1
Q

What are the most common causes of being in the ICU?

A

-Respiratory Failure requiring mechanical ventilation, pneumonia, ARDS, Flu

  • Renal Failure
  • Metabolic dysfunction
  • Infection > sepsis
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2
Q

What does ARDS stand for?

A

Acute respiratory distress syndrome

> fluid build up in alveoli

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3
Q

List 3 common surgical reasons to be in the ICU.

A

1) post-op pain causing difficulty breathing
2) Hypoxemia
3) Complex surgeries

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4
Q

Describe Guillain-Barre syndrome

A

The immune system attacks the PNS, can lead to rapid on set of numbness, weakness and paralysis. As a result breathing muscles are not working and mechanical ventilation is required.

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5
Q

List non-surgical reasons to be in the ICU.

A
  • Trauma to the chest area, rib fractures
  • Hemothorax or Pneumothorax
  • Hemothorax Blood in the chest cavity (Pleural space)
  • Pneumothorax air in the chest cavity
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6
Q

Describe the role of vasopressors post-op

A

Vasopressors help to increase blood pressure

  • low blood pressure can also be a problem
  • Remain in ICU to monitor drugs and blood pressure
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7
Q

What is the difference between an arterial line vs central line?

A

Arterial line are inserted into arteries and are used to obtain samples for ABGs

Central lines provide nutrients, fluids, and medication to the patients and are inserted into a large vein in the arm,

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8
Q

What does PICC stand for?

A

Peripherally Inserted Central Catheter.

  • long term IV
  • typically used for children
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9
Q

What does PIV stand for?

A

Peripheral IV

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10
Q

What is Vascathater used for?

A

Carry blood from the body to a dialysis machine

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11
Q

What is vac dressing used for?

A

negative pressure wound therapy

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12
Q

Why are PTs in the ICU and what is ICUAW?

A

ICU acquired weakness

  • clinically detected weakness in patients who spend prolonged periods of time in the ICU
  • makes it hard for patients to recovery
  • myopathy, neuromyopathy, polyneuropathy
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13
Q

What is the respiratory risk of immobility?

A
  • retained secretions
  • risk of atelectasis/ pulmonary embolism, pneumonia
  • dependant edema
  • decreased PaO2
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14
Q

How much strength is lost per day in the ICU?

A

3-11% per day

1 day in bed = 2 weeks in rehab

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15
Q

What are the 3 main risks of Immobility in the ICU?

A

1) Pressure ulcers
2) Skeletal - bone and muscle loss
3) Deliruim

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16
Q

What are the 3 types of delirium and which is the hardest to detect?

A

Hyper, hypo and mixed

- hypo is the hardest to detect and treat

17
Q

What are 3 ways delirium is similar to dementia?

A
  • confusion / loss of cognition
  • difficulty concentrating
  • memory
18
Q

List 5 improve outcomes for early mobility in the ICU

A
  • decreased ventilator days
  • decreased risk for pneumonia
  • decreased risk of pressure ulcers
  • decreased LOS
  • Increased physical function at discharge
19
Q

What are 3 ways delirium is different from dementia?

A

Delirium

  • abrupt onset,
  • duration days to weeks
  • Reversible

Dementia

  • gradual onset
  • months to years
  • usually unreversible
20
Q

What are the steps of the early mobility ABCDEF bundle?

A 
(A)Assess, prevent and manage pain
(B) Both Spontaneous awakening and breathing trial
(C) Choice of sedation
(D) Delirium
(E) Early Mobility
(F) Family empowerment and engagement
21
Q

What are the steps of PT assessment in the ICU

A
  • Review patient chart for diagnosis and symptoms
  • Review the current status of how the night went/mental state
  • Review test and lab results
  • determine mobility level
  • Review RAAS score
22
Q

Using the RAAS scale when is it safe to mobilize a patient?

A

Below -2 mobilizing is just patient positioning in the bed due to heavy sedation (PROM)

-1 to + 1, AROM, AAROM, Transfers, side of bed

23
Q

Describe PT assessment in the ICU and the areas involved

A

Cardio, neuro, and respiratory status

Vital signs, heart rate, BP

  • Are vitals high at rest before they start mobility or when they get moving?
  • Blood pressure is a way to measure perfusion, low = organs have low perfusion
    • Inotropes, vasopressors (Meds)

Respiratory Rate (15-20), Blood gasses, breath sounds, observation of accessory muscle use, heavy breathing

- Breathing pattern (symmetrical lung expansion)
- Nasal prongs
- O2 saturation
- CXR
- Pulmonary f/n test
- FIOT (faction of inspired O2)

Neuro: LOC, sensation, LOC, delirium, cooperativeness, move, ability to follow directions

ROM/Strength, Bed mobility, skin integrity (pressure ulcers)

24
Q

Why is positioning important in the ICU?

A

Optimize V/Q

  • Reduce the risk of pressure ulcers
  • Prone can sometimes help improve oxygenation status and hypoxia

During prone positioning, ventilation is improved due to changes in pleural pressure (PPL) and the amount of lung atelectasis present.

25
Q

What is the purpose of suctioning?

A

To remove excess secretions from the lungs

  • prevent infection
  • improve airway clearance
26
Q

What is a pulmonary shunt?

A

the alveoli of the lungs are perfused with blood as normal, but ventilation (the supply of air) fails to supply the perfused region.

In other words, the ventilation/perfusion ratio (the ratio of air reaching the alveoli to blood perfusing them) is zero.

A pulmonary shunt often occurs when the alveoli fill with fluid, causing parts of the lung to be unventilated although they are still perfused.

27
Q

What are the four primary reasons for employing endotracheal intubation?

A

1) Upper airway obstruction
2) Inability to protect the lower airways from aspiration
3) Inability to clear secretions from the lower airways
4) Need for positive-pressure mechanical ventilatory assistance

28
Q

What is the cardiovascular risk of immobility?

A
  • decreased cardiac conditioning (0.9% per day)
  • decreased venous return and stroke volume
  • increased HR to maintain resting VO2
  • Risk of DVT

Cardioresp (6 decks)

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