Most serious form of heat stress, resulting in the failure of the hypothalamic thermoregulatory processes
Leading to altered mentation, absence of perspiration, and circulatory collapse
What core temp. is considered to be hypothermia?
What is considered life-threatening?
<35 C
Life threatening: <30 C
How can a pt. look from moderate hypothermia to severe hypothermia?
Moderate s/s:
- Bradycardia and bradypnea
- BP hard to get (use doppler)
- rigidity
- Shivering disappears at temp 86 F
Severe s/s:
- Bradycardia
- Vfib -> Asystole
List tx for hypothermia
Manage ABCs
Rewarm pt.
Correct dehydration and acidosis
Treat cardiac dysrhythmias
Difference between passive and active rewarming?
Passive: move pt. to warm, dry place, remove damp clothing; place warm blanket
Active: body to body contact, fluid or air filled warming blankets, radiant heat lamps
- Invasive: peritoneal, gastric, or colonic lavage with warmed fluids
At what core temp should you d/c core temp? F/C
Rewarming should be d/c at 95F/35C
List initial tx for animal/human bites
Initial: clean with copious irrigation, debridement, tetanus and analgesics
- abx
How many injections are given for the rabies prophylaxis?
Initial injection IG
Five series vaccine injection: 0, 3, 7, 14, 28
(half injected into wound, half IM)
What's the hour limit you can perform gastric lavage after poison ingestion?
List 3 contraindications
2 hours
Contraindications:
1. caustic agents
2. co-ingested sharp objects
3. nontoxic
Contraindications of activated charcoal.
When can you give an antidote when also giving charcoal?
1. diminished bowel sounds
2. Paralytic ileus
3. ingestion of substance poorly absorbed by charcoal
Do not give antidote immediately before, with, or shoftly after charcoal
What is the indication of Cathartics (Sorbitol)
To be given with first dose of charcoal to stimulate intestinal motility
whole-bowel irrigation
Fill in: Hemodialysis / hemoperfusion is used with poisonings and is reserved for __a__.
Severe acidosis
When are chelating agents used?
During an Iron overdose
This organization is the largest specialty nursing in the world who care for acute and critically ill patients.
They manage and certifies/renews processes for most critical care nurses
AACN: american association of critical care nurses
What are each acronym?
CCRN
CCRN-E
PCCN
CMC
CSC
CNML
ACNPC
CCNS
CCRN: Critical Care RN
CCRN-E: Adult tele, ICU, CCRN
PCCN: progressive care nursing cert
CMC: cardiac medicine subspecialty
CNML: clinical nurse manager and leader
ACNPC: Acute Care NP Cert
CCNS: Critical care clinical nurse specialist
List the 4 reasons for admission to the ICU
1. Physiologically unstable
2. risk for serious complications
3. Need for invasive interventions and frequent assessment
4. require intensive and complicated nursing support
What is DOPE
Troubleshooting mechanical ventilation
D: Dispalced Tube
O: Obstruction
P: Pneumothorax
E: Equipment failure
What is the purpose of the CRRT?
For continuous renal replacement therapy
Large volumes of fluid replacement
What is the purpose of Hemodynamic Monitoring?
List the 4 tests that can be done
It is the measurement of pressure, flow, and oxygenation within the cardiovascular system
Tests include:
1. ARt line: for continuous invasive BP monitor
2. CVP: right atrial pressure (preload)
3. Pulmonary artery: intracardiac pressure and CO
4. SVO2 and ScVO2: tissue oxygenation
Match the purpose Hemodynamic Monitoring test: Art line
A.
Match the purpose Hemodynamic Monitoring test: CVP
B.
Match the purpose Hemodynamic Monitoring test: Pulmonary artery
C.
Match the purpose Hemodynamic Monitoring test: SVO2 and ScVO2
C.
List normal values of each (oxygen extraction)
SVO2%
SaO2%
CO (L/min)
VO2 (mL/min) *VO2 max is the maximum rate of oxygen consumption measured during incremental exercise
SVO2%: 60-80%
SaO2%: 95-98%
CO (L/min): 4-8 L/min
VO2 (mL/min): 225-275 mL/min
Select all that apply: Which of these causes high-pressure alarms
a. Kinks in tubing
b. Secretions, coughing, gagging
c. resp. arrest
d. Ventilator disconnection
e. Water in tubing
f. Oversedation
g. Bronchospasm
h. Loss of airway
a. Kinks in tubing
b. Secretions, coughing, gagging
c. resp. arrest
d. Ventilator disconnection
e. Water in tubing
f. Oversedation
g. Bronchospasm
h. Loss of airway
Select all that apply: Which of these causes Apnea Alarm
a. Kinks in tubing
b. Secretions, coughing, gagging
c. resp. arrest
d. Ventilator disconnection
e. Water in tubing
f. Oversedation
g. Bronchospasm
h. Loss of airway
a. Kinks in tubing
b. Secretions, coughing, gagging
c. resp. arrest
d. Ventilator disconnection
e. Water in tubing
f. Oversedation
g. Bronchospasm
h. Loss of airway
Select all that apply: Which of these cause low-pressure alarms
a. Kinks in tubing
b. Secretions, coughing, gagging
c. resp. arrest
d. Ventilator disconnection
e. Water in tubing
f. Oversedation
g. Bronchospasm
h. Loss of airway
