RRT Patient Evaluation

Question 1

If the ABG looks good but the patient looks and feels bad, think these three things in order.

Answer 1

CO poisoning
then Anemia
then Pulmonary Embolus

Question 2

When examining ABG’s, look at ___ first because that’s the most important thing.
If there’s an abnormal PCO2 but a normal pH and the patient is a COPD’er, should you make vent changes?

Answer 2

PCO2

No don’t make vent changes.

Question 3

A normal respiratory quotent (amount of CO2 produced) is ___.
A diet for COPD’ers should include foods high in ___. Alternatively you could also give them foods high in ___. Avoid foods high in ___.

Answer 3

0.8
Best: Fats
Second best: Proteins
Avoid: Carbohydrates (Produces most CO2 to digest.)

Question 4

If you have an emergency, don’t seek to prove it. Instead, ___ and ___.

Answer 4

Suspect and treat.

Question 5

In pulmonary embolus patients, give ___. Also give analgesics to relieve ___. To maintain circulation, give ___ or ___. ALso give thrombolytic agents such as ___ or ___.

Answer 5

Low dose heparin
Chest Pain
Digitalis or Digoxin
Urokinase or streptokinase
(NPS)

Question 6

To treat pulmonary embolus, give ___% FiO2. Get an ___ and ___ test, as well as a spiral CT.

Answer 6

100%

ABG and coagulation test (NPS)

Question 7

What four drugs can you give for TB?

Answer 7

INH, Rifampin, Ethambutol, and Streptomycin. (NPS)

Question 8

HIV patients may have ___. You will have to order a ___ to test for this because it can’t grow outside the body.

Answer 8

Pneumocystis Carinii / Jerovecii.

Bronchoscopy

Question 9

Burn victims, smoke inhalation victims, and CO poisoning victims: Intubate these patients. Also consider ___ for severe cases. Set FiO2 at ___. Upstairs these patients should have a ___ room. Patient may require ___ to clear mucus plugs and evaluate airway.

Answer 9

Hyperbaric chamber
100%
Isolation
Bronchoscopy

Question 10

Cold water drowning victims should be reheated with ___. Also a heated lavage of gastric intrathoracic pericardial and peritoneal spaces may be considered. To not reheat hypothermia patients faster than ___.

Answer 10

Heated IV solutions

No faster than a few degrees per hour

Question 11

What patients should get an ELISA test?

Answer 11

Suspected HIV patients

Question 12

Any reading with a “v”, such as CvO2, is associated with ___. (Not venous or flow)

Answer 12

Cardiac output

Question 13

Swan-Ganz is inserted through a ___ with the baloon (Inflated or deflated). Then it’s advanced through the ___ and into the ___. When the Swan-Ganz reaches ___, it’s in the correct position.

Answer 13

Central vein
Deflated
Inferior Vena Cava
R Atrium
50 cm

Question 14

The best location for a Swan-Ganz catheter is in the ___ with the balloon deflated. The Swan-Ganz will now detect ___. When the balloon is inflated, it will detect ___.

Answer 14

Pulmonary Artery
PAP
Wedge Pressure

Question 15

Mixed blood samples are best drawn from the ___. When getting a mixed blood sample, the balloon should be (inflated or deflated).

Answer 15

Pulmonary Artery.

Deflated

Question 16

When ___ cm of catheter is inserted, you should read pressures from the ___. If not, the catheter is probably curled up in the ___. If this happens, (inflate or deflate) the balloon and withdraw it.

Answer 16

50
Pulmonary Artery
Heart (R atrium or R ventricle)
Deflate

Question 17

The waveform seen from a Swan-Ganz looks tall with a little notch on top. This indicates the catheter is in the ___.
If it’s tall with no notch, the catheter is in the ___.
If it’s short with no notch and pressures are low, you’re in the ___.
If they’re around 10-15 with no notch, you should ___.

Answer 17

Pulmonary Artery
Right ventricle
Right atrium
Pull it back a little bit.

Question 18

If there is movement of the PA catheter, the first thing you want to do is check the ___.

Answer 18

PAP waveform