Critical Care Nursing Principles & Monitoring

Questions and Answers

What does professionalism in critical care nursing primarily emphasize?

Focusing solely on the technical aspects of treatment

Demonstrating accountability, respect, and integrity (correct)

Providing care under emergency situations only

Prioritizing speed over quality in patient care

What principle emphasizes the need to avoid intentional harm while treating patients?

Empathy

Efficacy

Non-maleficence (correct)

Fair allocation

How can efficiency impact critical care nursing?

By increasing the duration of patient hospitalization

By minimizing patient interaction during treatment

By reducing costs for hospitals and patients (correct)

By prioritizing emergency cases only

What is a key component of fair allocation in critical care nursing?

Providing equal treatment regardless of personal factors Signup and view all the answers

Which principle involves listening to patients' concerns and respecting their opinions?

Respect and care Signup and view all the answers

What defines a normal cardiac axis on an ECG?

QRS axis between -30° and +90° Signup and view all the answers

Which situation indicates left axis deviation (LAD)?

QRS axis less than -30° Signup and view all the answers

How many small boxes are equivalent to one big box on ECG paper?

25 Signup and view all the answers

What does the segment length between two specific points on an ECG indicate?

Segment Signup and view all the answers

What is the formula to determine heart rate using the 6 seconds method?

Count QRS complexes, multiply by 10 Signup and view all the answers

Which of the following methods can be used to determine the regularity of heart rhythms?

Caliper method Signup and view all the answers

What is the significance of analyzing P waves in an ECG?

Assesses atrial depolarization Signup and view all the answers

What heart rate is characteristic of sinus bradycardia?

60 bpm Signup and view all the answers

What does it mean if the interval between R waves is irregular?

Interval varies by greater than 0.06 seconds Signup and view all the answers

What do the vertical axis measurements on ECG paper represent?

Voltage in mV Signup and view all the answers

What does the QT interval represent in an ECG?

Time from the beginning of the QRS complex to the end of the T wave Signup and view all the answers

Where is the V4 electrode typically placed?

5th intercostal space under the breast in women Signup and view all the answers

Which lead records the electrical difference between the left leg and right arm electrodes?

Lead II Signup and view all the answers

What is the main function of augmented vector leads?

To provide a view of electrical activity in the frontal plane Signup and view all the answers

Which lead is positioned with the positive electrode on the right shoulder?

Lead aVR Signup and view all the answers

What do the chest leads (precordial leads) primarily provide?

A different view of electrical activity within the heart Signup and view all the answers

What does the cardiac axis represent?

Sum of depolarization vectors generated by cardiac myocytes Signup and view all the answers

Which aspect of the heart can an echocardiogram help to identify?

The size and possible thickening of heart chambers Signup and view all the answers

What is a necessary preparation step for a transesophageal echocardiogram?

Refraining from food for 8 hours Signup and view all the answers

Which of the following leads detects electrical activity between the left arm and left leg?

Lead III Signup and view all the answers

What method is NOT typically used to induce stress during a stress echocardiogram?

Injecting a radioactive tracer Signup and view all the answers

What characteristic of the Bruce Protocol is designed to evaluate heart performance?

Progressive increases in both speed and incline Signup and view all the answers

What advantage does transesophageal echocardiography have over transthoracic echocardiography?

It offers a better view of the heart Signup and view all the answers

Which measure indicates the maximum amount of oxygen usable during intense exercise?

VO2 max Signup and view all the answers

What is the purpose of applying gel during a transthoracic echocardiogram?

To enhance the ultrasound waves transmission Signup and view all the answers

Which of the following statements about MET is correct?

One MET is equivalent to consuming 3.5 mL of O2 per kg of body weight Signup and view all the answers

What might an echocardiogram reveal concerning the aorta?

Any abnormalities or issues with the aorta's structure Signup and view all the answers

What is an essential aspect of a stress echocardiogram’s function?

It evaluates heart behavior during stress Signup and view all the answers

What is the primary function of the sinoatrial (SA) node in the cardiac conduction system?

To initiate electrical impulses and generate the heart's normal rhythm Signup and view all the answers

Which hemodynamic monitoring method provides a non-invasive assessment of arterial oxygen saturation?

Pulse oximetry Signup and view all the answers

What does an increased 2,3 Diphosphoglycerate (DPG) level do to oxygen affinity in hemoglobin?

Decreases affinity for oxygen Signup and view all the answers

During which phase of the cardiac cycle does the QRS complex appear on the ECG?

Ventricular depolarization Signup and view all the answers

What is the typical heart rate if the atrioventricular (AV) node acts as the pacemaker?

40-60 bpm Signup and view all the answers

Which physiological characteristic allows myocardial cells to respond to an electrical impulse?

Excitability Signup and view all the answers

In the oxygen dissociation curve, what is indicated by a shift to the left?

Decrease in DPG levels Signup and view all the answers

What does the mean arterial pressure (MAP) represent in hemodynamic monitoring?

Average pressure in the systemic vasculature during cardiac cycles Signup and view all the answers

What is the role of oxyhemoglobin saturation measurements in clinical assessment?

To evaluate how effectively a patient is breathing Signup and view all the answers

What does the T wave on an ECG represent?

Ventricular repolarization Signup and view all the answers

What happens to a patient's arterial oxygenation if the PaO2 drops below 40 mmHg?

It reaches dangerous levels Signup and view all the answers

Which of the following is a feature of the cardiac conduction system?

Purkinje fibers conduct impulses to myocardial cells Signup and view all the answers

What does a decreased pH level do to the oxygen dissociation curve?

Shifts the curve to the right Signup and view all the answers

What characterizes the baseline of the ECG?

Represents the isoelectric line Signup and view all the answers

Study Notes

Principles of Critical Care Nursing

Fundamental truths guiding professional competencies, scientific knowledge, and empathy in nursing.
Efficiency in critical care reduces patient hospitalization time and treatment costs.
Care and medical interventions must align with patients' specific needs, including medication and life support.
Professionalism involves high-quality care, accountability, respect, and maintaining a positive work environment.
Safety and non-maleficence prioritize adherence to established protocols to minimize risks and avoid patient harm.
Emphasizes respecting patients’ concerns and promoting self-care to enhance quality of life, not just survival.
Advocates for fair treatment of all patients regardless of demographic factors, ensuring equitable use of medical resources.

Hemodynamic Monitoring

Non-invasive monitoring includes blood pressure (BP), pulse oximetry, and ECG.
Invasive methods utilize arterial lines, central venous catheters, and Swan Ganz catheters.
Blood pressure is expressed as systolic/diastolic (SBP/DBP) with Mean Arterial Pressure (MAP) indicating organ perfusion.
Elevated BP can indicate inadequate tissue perfusion; hypotension is commonly observed in shock.
Pulse oximetry measures arterial oxygenation through peripheral hemoglobin saturation.

Oxygen Dissociation Curve

Sigmoid-shaped curve illustrating the relationship between partial pressure of oxygen (PaO2) and oxygen saturation (SaO2).
Factors affecting the curve include pH, temperature, CO2 levels, and 2,3 DPG levels.
A left shift (increased pH, decreased CO2, decreased temperature) indicates higher affinity for oxygen, while a right shift (decreased pH, increased CO2, increased temperature) indicates lower affinity.

Cardiac Electrophysiology

The cardiac conduction system generates and transmits electrical impulses, prompting myocardial contraction.
SA node functions as the heart's pacemaker with a rate of 60-100 bpm, while the AV node has a rate of 40-60 bpm.
Purkinje fibers stimulate contraction, with the SA node being the primary pacemaker.
Physiological characteristics include automaticity, excitability, and conductivity of cardiac cells.

Electrocardiogram (ECG)

ECG records the heart's electrical activity, reflecting the state of cardiac health.
Key components: P wave (atrial depolarization), QRS complex (ventricular depolarization), and T wave (ventricular repolarization).
Auditory events on the ECG closely correlate with the mechanical contractility of the heart.

ECG Grids and Measurements

Time and voltage represented on an ECG grid; small boxes for timing and larger boxes for voltage.
Methods for heart rate determination include the 6-second method and counting large squares between R waves.

Dysrhythmias of Sinus Node

Sinus bradycardia features regular rhythm with a heart rate below 100 bpm.
Causes include increased metabolic demands and various shock states.
Treatment focuses on addressing underlying issues and may involve sedatives.

Echocardiogram Types and Procedures

Transthoracic echocardiography utilizes ultrasound waves for non-invasive examination of the heart.
Transesophageal echocardiography offers a clearer view, performed by guiding a tube through the esophagus after fasting.
Stress echocardiogram tests heart performance under stress through exercise or medications.

Metabolic Equivalent (MET)

One MET measures energy expenditure at rest (3.5 mL O2/kg/min).
Higher MET ratings indicate increased energy expenditure compared to rest; VO2 max assesses maximum oxygen utilization during intense exercise.
The Bruce Protocol involves maximal exercise testing to evaluate heart response to increasing physical demands.

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Description

Explore essential principles of critical care nursing along with hemodynamic monitoring techniques. This quiz covers professional competencies, patient safety, and both non-invasive and invasive monitoring methods. Enhance your understanding of the fundamental concepts that ensure effective and empathetic patient care in critical situations.