NBRC Shock

Question 1

This class of drug can cause low urine output.
This vasopressor can also cause low urine output.

Answer 1

Ace Inhibitors

Low dose dopamine

Question 2

Remember that a drop in urine output is a symptom of another disease. A drop in urine out put less than ___ is a BIG DEAL on the test!

Answer 2

40 milliliters per hour

Question 3

If you give a fluid challenge to a patient, how much fluid are you giving?
What if they’re in sepsis? What kind of fluid?

Answer 3

500-1000 ml of crystalloid fluid

Sepsis: 300-500 ml of COLLOID fluid

Question 4

How do you treat thrombocytopenia?

Answer 4

Steroids, intravenous immunoglobulins. If no response, splenectomy.

Question 5

Bone marrow replacement or chemotherapy can cause this condition.

Answer 5

Thrombocytopenia

Question 6

Patients with an injury below __ may initially breathe adequately, but may eventually progress to ventilatory failure.
Clear C-spine using this test:

Answer 6

C-4

CT scan.

Question 7

In Rhabdomyolysis, skeletal muscle breaks down rapidly and breakdown products are released into the bloodstream. It’s really bad for the ___.

Answer 7

Kidneys

Question 8

If a patient has been trapped, consider this disease.

Answer 8

Rhabdomyolysis.

Question 9

On the test, if a patient came to the ICU with no fever and now they have a fever, consider this condition.
What should you do?

Answer 9

Sepsis.

Get blood cultures.

Question 10

What are the three most accurate places to take a patient’s temperature?

Answer 10

1. Intravascular space
2. Esophagus
3. Bladder

Question 11

These two types of methods for getting a patient’s temperature are not acceptable.

Answer 11

Axillary measurements

Chemial dot thermometers

Question 12

You should get 3-4 blood cultures on a sepsis patient. They shoudl all be done within ___ hours of admission. When should you get the first one?

Answer 12

Within 24 hrs of onset of fever.

Before starting antimicrobial therapy.

Question 13

If a sepsis patient does not have an IV, how do you get blood cultures? What if the patient does have an IV?

Answer 13

Venipuncture. But they have to be two seperate venipunctures.
If pt has an IV, one has to be by venipuncture and the other via IV.

Question 14

How much blood should be used for a blood culture?

Answer 14

10-20 mL.

Question 15

Before starting antimicrobial therapy, you should get this.

Answer 15

Cultures

Question 16

Name four common types of community acquired pneumonia.

Answer 16

S. Pneumoniae (Most common)
Legionella
Mycoplasma
Chlamydia

Question 17

What antibiotic is used to treat community acquired pneumonia? x3
Also, you should add what? x2

Answer 17

Ceftriaxone, cefotaxime, or ampicillin-sulbactam

Macrolyde (azithromycin) or a fluoroquinolone.

Question 18

What is used to treat MRSA?

Answer 18

Vancomycin

Question 19

Nosocomial infections are usually caused by (gram positive or gram negative) bacteria. Most commonly it’s ___ (type of bacteria).

Answer 19

Gram negative

Staph aureus.

Question 20

Treat nosocomial infections with ___ or ___.

Also, add ___ or ___.

Answer 20

Cephalosporins or carbapenem

Plus, add fluoroquinolone or aminoglycoside.

Question 21

What two bateria are associated with catheter related infections?
What is used to treat it?
One more thing that you should do:

Answer 21

Staphylococcus and Staph Aureus.
Treat with Nafcillin.
Remove the catheter.

Question 22

Use a PICC line if IV therapy is supposed to go for more than ___ days.

Answer 22

Six days.