Critical Care Patient Management Quiz

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Questions and Answers

What defines a patient classified as Level 2 in critical care?

  • Patient requires only basic observation and care in a normal ward.
  • Patient is in a life-threatening condition necessitating advanced respiratory support.
  • Patient is critically ill and in need of continuous observation and support in the ICU.
  • Patient requires assistance for a single failing organ system and needs more intervention than Level 1. (correct)

Which of the following responsibilities is NOT typically associated with an ODP in the transfer team?

  • Call for additional medical staff during the transfer. (correct)
  • Assist the anesthetist during patient transfer.
  • Communicate with the ICU regarding patient status.
  • Check and prepare monitoring and equipment.

What equipment is essential for the transfer of critically ill patients?

  • Portable monitoring and IV access. (correct)
  • Standardized clothing for the patient.
  • Dietary supplements and hydration packs.
  • Physical therapy equipment for rehabilitation.

In the context of handing over patient information during transfer, what does SBAR stand for?

<p>Situation, Background, Assessment, Recommendation. (C)</p> Signup and view all the answers

Which statement accurately describes the role of Level 3 critical care?

<p>Patients require advanced respiratory support and management for multi-organ failure. (B)</p> Signup and view all the answers

What does an increased HCO₃⁻ level indicate?

<p>Metabolic alkalosis (B)</p> Signup and view all the answers

Which statement regarding base excess (BE) is accurate?

<p>High BE may indicate primary metabolic concerns or compensated respiratory acidosis. (B)</p> Signup and view all the answers

In a scenario where both CO₂ and HCO₃⁻ levels are abnormal, what condition is most likely present?

<p>Mixed acid-base disorders (D)</p> Signup and view all the answers

What would be the expected respiratory compensation during an asthma attack?

<p>Rapid increase in ventilation rate (D)</p> Signup and view all the answers

If a patient has a pH of 7.47 and a normal HCO₃⁻ of 23, what is the likely condition?

<p>Respiratory alkalosis (A)</p> Signup and view all the answers

What is a defining characteristic of septic shock?

<p>Extreme response to infection leading to circulatory and metabolic dysfunction (C)</p> Signup and view all the answers

Which type of shock is primarily associated with the loss of blood volume?

<p>Hypovolemic shock (C)</p> Signup and view all the answers

What role does the renin-angiotensin-aldosterone system (RAAS) play in shock?

<p>It regulates arterial blood pressure (B)</p> Signup and view all the answers

What is the consequence of excessive white blood cell activity during sepsis?

<p>Systemic blood vessel dilation and permeability (B)</p> Signup and view all the answers

Which of the following describes the metabolic consequence of multiple organ failure (MOF)?

<p>Anaerobic metabolism leading to increased lactic acid (B)</p> Signup and view all the answers

What physiological risk is associated with decreased oxygen saturation?

<p>Risk of acidosis (A)</p> Signup and view all the answers

Which statement best describes the significance of the thyroid cartilage in airway management?

<p>It fully occludes the esophagus when compressed. (A)</p> Signup and view all the answers

Which reflex is primarily inhibited by general anesthesia during airway management?

<p>Gag reflex (D)</p> Signup and view all the answers

What role does the larynx play in the protection of the airway?

<p>It closes the glottis during swallowing. (B)</p> Signup and view all the answers

Why is the right main bronchus more likely to catch foreign objects compared to the left?

<p>It has a more vertical alignment and is shorter. (C)</p> Signup and view all the answers

During intubation, which anatomical landmark is associated with lifting the epiglottis?

<p>Vallecular space (A)</p> Signup and view all the answers

What is the primary neurological path involved in the pharyngeal reflex?

<p>Vagus nerve and glossopharyngeal nerve (A)</p> Signup and view all the answers

What is the purpose of the BURP maneuver in emergency airway care?

<p>To manipulate the thyroid cartilage for easier intubation. (C)</p> Signup and view all the answers

What occurs during metabolic acidosis in the context of decreased oxygen availability?

<p>Increase in bicarbonate levels due to excessive lactic acid (A)</p> Signup and view all the answers

Which muscle is primarily responsible for the contraction during inhalation?

<p>Diaphragm (A)</p> Signup and view all the answers

How does positive end-expiratory pressure (PEEP) enhance gas exchange?

<p>Prevents airway collapse during expiration (C)</p> Signup and view all the answers

What physiological condition can result from inadequate nearby space in the lung cavity?

<p>Bronchospasm and decreased lung volume (A)</p> Signup and view all the answers

What position is preferable for enhancing ventilation of the upper lung?

<p>Lateral position (D)</p> Signup and view all the answers

In respiratory health, the compliance of the lungs refers to what?

<p>The ease with which the lungs can expand (D)</p> Signup and view all the answers

Which statement about the effects of adrenaline on breathing resistance is accurate?

<p>Adrenaline acts as a bronchodilator at high doses (D)</p> Signup and view all the answers

What impact does an increase in surface area of the lungs have on pressure according to Boyle's Law?

<p>Decreases pressure within the lungs (C)</p> Signup and view all the answers

What is the initial treatment for laryngospasm in patients with COPD or asthma?

<p>Salbutamol 250mcg IV slowly (B)</p> Signup and view all the answers

Which emergency drug is indicated for severe bradycardia?

<p>Adrenaline (C)</p> Signup and view all the answers

In treating tachycardia, which medication is specifically used for supraventricular tachycardia (SVT)?

<p>Adenosine (A)</p> Signup and view all the answers

Which of the following treatments is not part of the immediate management for anaphylaxis?

<p>IV Salbutamol (D)</p> Signup and view all the answers

What is the primary medication used to treat malignant hyperthermia?

<p>Dantrolene (A)</p> Signup and view all the answers

In cases of hypotension, which of the following drugs is primarily used as an emergency treatment during cardiac arrest?

<p>Adrenaline (B)</p> Signup and view all the answers

Which condition is characterized by agitation, loss of consciousness, and cardiovascular collapse following local anaesthetic injection?

<p>Local Anaesthetic Toxicity (A)</p> Signup and view all the answers

What is a critical intervention in treating a patient experiencing a severe increase in body temperature and muscle rigidity?

<p>Immediate cooling (D)</p> Signup and view all the answers

Which part of the cardiac conduction system is primarily responsible for initiating the heartbeat?

<p>SA Node (B)</p> Signup and view all the answers

What occurs during the QRS complex of the cardiac cycle?

<p>Ventricular depolarization (A)</p> Signup and view all the answers

What is the primary role of the AV Node in the cardiac cycle?

<p>To conduct impulses to the ventricles (A)</p> Signup and view all the answers

Which phase of action potential is defined by sodium channels opening and sodium rushing into the cell?

<p>Phase 0 (B)</p> Signup and view all the answers

During which phase of the action potential does repolarization mainly occur?

<p>Phase 3 (D)</p> Signup and view all the answers

What is the primary state of a cardiac cell at rest?

<p>Polarized (C)</p> Signup and view all the answers

Which electrical activity corresponds to the T Wave in the cardiac rhythm?

<p>Ventricular repolarization (C)</p> Signup and view all the answers

What mechanism causes action potential phase 3 in cardiac cells?

<p>Closure of sodium channels and opening of potassium channels (B)</p> Signup and view all the answers

Which ion's concentration decreases inside the cell during depolarization?

<p>Potassium (C)</p> Signup and view all the answers

What is the significance of the PR interval in cardiac physiology?

<p>It represents the delay in the AV node (B)</p> Signup and view all the answers

Flashcards

Base Excess (BE)

A measure of the amount of acid or base needed to bring the blood's pH back to normal.

Respiratory Compensation

When the body tries to correct an abnormal pH by adjusting the respiratory system.

Metabolic Compensation

When the body attempts to adjust the pH by altering the levels of bicarbonate.

Alkalosis

A condition where the blood's pH is too high.

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Acidosis

A condition where the blood's pH is too low.

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Level 0 Critical Care

A patient whose needs can be met on a regular ward, without requiring specialized critical care.

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Level 1 Critical Care

A patient who is at risk of their condition deteriorating, requiring close monitoring and support from a critical care team, but can be managed on a general ward with advice and support from the critical care team.

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Level 2 Critical Care

Patients who require more frequent monitoring or intervention, often needing support for a single failing organ system. This level also includes patients who are recovering from intensive care (HDU).

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Level 3 Critical Care

This level involves patients requiring advanced respiratory support, including those with complex conditions involving multiple organ failure. This is the highest level of critical care, typically in an ICU setting.

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Transfer of Critically Ill

The process of transferring a critically ill patient from one care setting to another, often involving a dedicated team of healthcare professionals.

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Low Saturation = Acidosis Risk

Oxygen saturation levels dropping indicate a risk of acidosis, an imbalance in the body's acid-base balance.

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Oxygenation + Bag Mask Ventilation

The process of providing oxygen to the body through a mask and bag, often used in emergencies.

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Difficult Airway = BMV & Intubation Trouble

A difficult airway refers to a situation where securing an airway with a mask or endotracheal tube is challenging.

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Beavals Mask: Difficult Seal

Beavals are a type of mask used for ventilation, but getting a good seal on the patient's face can be problematic, especially when a patient has facial features that make a tight fit difficult.

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Cricoid Cartilage: Full Ring, Occludes Esophagus

The cricoid cartilage is ring-shaped and can completely block the esophagus when pressure is applied. This is often used to prevent aspiration (food or fluid entering the lungs) during emergency procedures.

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Airway Reflexes: Sensory Nerves & Motor Responses

Reflexes are involuntary actions triggered by sensory nerves that initiate motor responses. These reflexes protect the airway from foreign objects, but are suppressed during general anesthesia.

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Pharyngeal Reflex: Gagging & Sensory Nerves

The pharyngeal reflex, triggered by the vagus and glossopharyngeal nerves, causes muscle contractions in the throat to eliminate foreign objects. This reflex is closely related to vomiting, salivary, and cardiac centers in the brain.

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Laryngeal Reflex: Protecting the Trachea

The laryngeal reflex protects the trachea from foreign objects by closing the glottis (opening of the trachea). The reflex is triggered by sensory nerves in the larynx and hypopharynx, causing a spasm of the laryngeal muscles.

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What is shock?

A life-threatening condition where the body's circulatory system fails to deliver enough oxygen and nutrients to the tissues and organs.

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What is septic shock?

A type of shock caused by a severe infection where the body's immune response goes into overdrive.

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What is cardiogenic shock?

A type of shock where the heart is unable to pump blood effectively due to problems like arrhythmia or heart attack.

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What is SVR (Systemic Vascular Resistance)?

A measure of the size of arteries that blood passes through.

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What is MOF (Multiple Organ Failure)?

A condition affecting multiple organs when the body fails to deliver enough oxygen to cells due to shock, leading to cell death and organ dysfunction.

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Autorhythmic cells

Specialized cardiac cells that initiate and regulate the heart's rhythm.

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SA Node

The main pacemaker of the heart, located in the right atrium.

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AV Node

A group of autorhythmic cells located near the bottom of the right atrium.

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Cardiac Rhythm

The electrical activity of the heart, visualized on an ECG.

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P Wave

The part of the ECG that represents atrial depolarization.

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QRS Complex

The part of the ECG that represents ventricular depolarization.

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T Wave

The part of the ECG that represents ventricular repolarization.

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PR Interval

The time interval on the ECG representing the delay in the AV node.

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QT Interval

The time interval on the ECG representing the electrical activity of the ventricles.

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Polarized Cardiac Cell

The state of a cardiac cell when it is not electrically active.

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Aerobic Respiration

The process of using oxygen and glucose to produce energy (ATP) in the presence of oxygen. This also releases carbon dioxide and water as byproducts.

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Respiratory Acidosis

Decreased pH of blood due to an accumulation of carbon dioxide in the blood, often related to impaired lung function.

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Metabolic Acidosis

Low pH in the blood due to an excess of acid, like lactic acid, often caused by insufficient oxygen.

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Pleural Space

The space between the outer surface of the lungs and the inner thoracic wall, filled with a lubricating fluid.

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Lung Expansion/Reduction

The expansion or contraction of the lungs directly corresponds to the expansion or contraction of the thoracic cavity.

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Positive End Expiratory Pressure (PEEP)

Pressure added to the lungs at the end of exhalation, making it easier for the lungs to stay inflated and facilitate gas exchange.

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Tension Pneumothorax

A condition where fluid or air accumulates in the pleural space, causing pressure and potentially collapsing the lung.

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Lung Compliance

The ability of the lungs to expand easily during inhalation. Lower compliance means the lungs are stiffer and harder to inflate.

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What is Laryngospasm?

A life-threatening situation where the larynx (voice box) narrows, making breathing difficult. This is common in patients with conditions like COPD (chronic obstructive pulmonary disease) and asthma, as the drugs used to treat these conditions can trigger a narrowing of the airways.

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What is Tachycardia?

A rapid heartbeat, often exceeding 100 beats per minute. It can be caused by a variety of factors, including stress, dehydration, and certain medical conditions.

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What is Bradycardia?

A slow heartbeat, often below 60 beats per minute. It can be dangerous if it slows down too much, as the heart may not be able to pump enough blood to meet the body's needs.

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What is Hypertension?

High blood pressure, which can be dangerous if it's too high, increasing the risk of stroke and heart attack.

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What is Hypotension?

Low blood pressure, which can lead to dizziness, fatigue, and even passing out. It happens when the heart isn't able to pump enough blood throughout the body.

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What is Anaphylaxis?

A severe allergic reaction that can cause a range of symptoms, from mild skin reactions to life-threatening respiratory distress. It's triggered by exposure to an allergen, like peanuts or bee stings.

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What is Malignant Hyperthermia?

A dangerous condition that can happen after being exposed to certain drugs used in surgery, causing muscle rigidity, fever, and a rapid heart rate. This is a medical emergency that requires immediate attention.

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What is Local Anaesthetic Toxicity?

A serious condition that happens when local anesthetic is accidentally absorbed into the bloodstream. It can cause changes in consciousness, heart rhythm problems, and even cardiac arrest.

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Study Notes

Levels of Critical Care

  • Level 0: Pt whose needs are met on normal would.
  • Level 1 Critical Care: Pt at risk of condition deteriorating + put on acute ward with advice support by CC team.
  • Level 2: Pt requiring more observation + intervention including from a single failing organ system or those coming down from (Level 3: Requires advanced resp. support. Includes complex pts with multi-organ failure. (ICU))

Equipment

  • Portable monitoring
  • Portable ventilator (PEEP, FiO2 + V/ratio)
  • Airway management
  • IV access
  • PPE
  • Standardized

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