ICU Patient Assessment and Concerns

Questions and Answers

What is the primary focus of the initial assessment in critically ill clients?

Performing invasive procedures

Assessing the client's ABCs (correct)

Evaluating the family’s concerns

Gathering detailed medical history

Which of the following interventions can help reduce anxiety in critically ill patients?

Creating a healing environment (correct)

Enhancing physical restraints

Restricting visitation to the family

Limiting communication with the patient

What is an essential aspect to assess during the initial evaluation of a critically ill patient?

Their financial status

Initial level of consciousness (correct)

Social support systems

Previous medical history

During the assessment phase, what might happen before the process is completed?

Implementation of interventions Signup and view all the answers

Which of the following is NOT a cause of death mentioned for 2020?

Car accidents Signup and view all the answers

In providing care to critically ill patients, what aspect is important in fostering trust?

Involving the patient in care decisions Signup and view all the answers

What is a significant reason for assessing family coping in critically ill situations?

To provide emotional support and care coordination Signup and view all the answers

Which of the following best describes the 'IPPA' method used in physical examination?

Inspection, Palpation, Percussion, Auscultation Signup and view all the answers

Which ABG finding is considered a hallmark of ARDS?

Hypoxemia with PaO2 < 36C Signup and view all the answers

What does the presence of air bronchograms indicate in the lungs?

Bronchi filled with air Signup and view all the answers

What would pulmonary function tests (PFT) show in a patient with ARDS?

Decreased vital capacity Signup and view all the answers

What heart rate (HR) indicates a significant cardiovascular response in ARDS according to the criteria provided?

HR > 90 BPM Signup and view all the answers

Which of the following is a key characteristic of lung volume in ARDS?

Decreased lung volume Signup and view all the answers

What is the role of pulmonary artery pressure monitoring in diagnosing ARDS?

It helps distinguish ARDS from cardiogenic pulmonary edema by showing normal pressures. Signup and view all the answers

What happens to the WBC count in ARDS according to the provided criteria?

WBC count typically exceeds 12,000 cells/mm3 Signup and view all the answers

When is invasive mechanical ventilation indicated for patients with ARDS?

When NIV management fails to support oxygenation and/or ventilation Signup and view all the answers

What is a potential early sign of cardiorespiratory compromise in patients?

Activity intolerance Signup and view all the answers

Which of the following is NOT one of the major components in the pathogenesis of chronic pulmonary hypertension?

Inflammatory response Signup and view all the answers

What causes the development of plexiform lesions in the pulmonary arteries?

Inflammation leading to increased immune cell activity Signup and view all the answers

Which recommendation should be made to a patient regarding their activity level?

Limit activities and increase rest Signup and view all the answers

Why is maintaining adequate fluid intake important for patients with pulmonary hypertension?

To keep mucus thin for easier expectoration Signup and view all the answers

Which type of dietary approach is advised for patients with pulmonary hypertension?

Small, frequent, well-balanced meals Signup and view all the answers

What is a key factor in the development of chronic pulmonary hypertension?

Obstruction of pulmonary arterioles Signup and view all the answers

Which immune cells are notably increased in the context of inflammation related to pulmonary hypertension?

T and B lymphocytes Signup and view all the answers

Which medication is administered as a loading dose for severe COVID-19 patients?

Remdesivir Signup and view all the answers

Which medication listed is classified as a sympathomimetic drug?

Salbutamol Signup and view all the answers

What is the primary use of corticosteroids in the treatment of COVID-19?

To reduce inflammation Signup and view all the answers

In patients with hemodynamic instability, what is the first-line vasopressor?

Norepinephrine Signup and view all the answers

What is the primary purpose of mucolytic agents such as Acetylcysteine?

To liquefy mucus Signup and view all the answers

Which symptom would indicate the need for an initial assessment of Breathing in COVID-19 patients?

Cough Signup and view all the answers

What volume of fluid should be encouraged daily to support respiratory function?

2500 to 3000 mL Signup and view all the answers

Which of the following interventions could be used to address ineffective airway clearance?

Endotracheal suctioning Signup and view all the answers

What is the recommended practice for patients experiencing hypoxemia?

Prone positioning Signup and view all the answers

Which drug class is used for prophylactic anticoagulation in severe COVID-19 cases?

Anticoagulants Signup and view all the answers

What is the effect of bronchodilators on respiration?

They improve ventilation. Signup and view all the answers

What is the primary goal of Conservative fluid management in patients with COVID-19?

To prevent fluid overload Signup and view all the answers

When assessing respiratory status, which vital signs should be monitored at least every 4 hours?

Respiratory rate and oxygen saturation Signup and view all the answers

Which position is recommended to assist patients with respiratory difficulties?

Fowler's or high-Fowler's position Signup and view all the answers

Which assessment is NOT part of the 'Circulation' evaluation in the ACDE approach?

Assessment of oxygen saturation Signup and view all the answers

What should be monitored in patients receiving intravenous fluids for respiratory support?

ABG results Signup and view all the answers

Study Notes

Diarrheal Disease and Critical Illness Assessment

COVID-19 was one of the leading causes of death in 2020.
Top causes of death included ischaemic heart diseases, neoplasms, cerebrovascular diseases, diabetes, pneumonia, and hypertensive diseases.

Assessment of Critically Ill Clients

Initial assessment focuses on the ABCs (Airway, Breathing, Circulation).
Monitor patient's level of consciousness and changes throughout the assessment.
Begin with the client's primary concern and subsequent pertinent questions.

Objective Data Collection

Gather through physical examination (IPPA: Inspection, Palpation, Percussion, Auscultation).
Interventions may be initiated before the completion of the assessment.

Interventions in Critical Care

Create a healing environment to reduce anxiety and stress in critically ill patients.
Foster trust and provide informative communication.
Encourage patient autonomy to restore a sense of control.

Diagnostic Studies in ARDS

ABG analysis is critical for diagnosing ARDS, showing hypoxemia (PaO2 < 38 C).
PFT indicates decreased lung compliance and reduced vital capacity and minute volume.
Pulmonary artery pressure monitoring helps differentiate ARDS from cardiogenic pulmonary edema.

COVID-19 Treatment and Management

Remdesivir indicated for hospitalized patients with severe COVID-19; initial dose 200 mg IV, followed by daily 100 mg.
Corticosteroids such as Dexamethasone are used in severe cases.
Prophylactic anticoagulation is essential for patients to prevent thromboembolic events.

Nursing Management

Maintain airway patency and assess for dyspnea and abnormal breathing sounds.
Monitor vital signs, oxygen saturation, and respiratory function at least every four hours.
Encourage fluid intake of 2500-3000 mL daily to facilitate mucus clearance.

Pharmacological Interventions

Sympathomimetics (e.g., Salbutamol) and anticholinergics (e.g., Ipratropium bromide) may be prescribed for bronchoconstriction.
Mucolytics, such as Acetylcysteine, help liquefy mucus for easier expectoration.

Pathophysiology of Pulmonary Hypertension

Chronic pulmonary hypertension often arises secondarily from other conditions.
Key components in its pathogenesis include endothelial dysfunction, vascular remodeling, and thrombosis.

Health Education for Home Care

Emphasize adherence to prescribed medication regimens.
Discuss the need for activity limitation and increased rest.
Advise on maintaining fluid and adequate nutritional intake for improved health outcomes.

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Description

This quiz focuses on the assessment of critically ill clients in the ICU environment. It covers key topics related to patient needs, coping mechanisms, and the impact of diseases like diabetes and kidney disorders. Additionally, it highlights the implications of major health crises such as COVID-19.