Critical care Exam 1 studyguide questions pt 2

What is the value of certification in critical care nursing?

Certification can increase your credibility, demonstrate advanced knowledge, and often results in higher pay.

Which organizations support critical care nursing?

The American Association of Critical Care Nurses (AACN) and the Society of Critical Care Medicine (SCCM).

What are common certifications for critical care nurses?

CCRN, CCRN-E, PCCN, CMC, and CSC.

What does the Glasgow Coma Scale (GCS) measure?

It measures a patient’s level of consciousness.

What GCS score indicates a need for intubation?

A score of 8 or less indicates the need to intubate.

Is a higher or lower GCS score better?

Higher is better.

What vital signs are associated with acute brain injury?

Cushing’s Triad: bradycardia, hypertension, irregular respirations Cheyne stokes (alternations of rapid and shallow breaths); possible hyperthermia if hypothalamus is affected.

What are the vital signs commonly seen in shock?

Hypotension, tachycardia, tachypnea, and cool, clammy skin.

What is the purpose of the primary survey in emergency assessment?

To identify life-threatening conditions and prioritize immediate interventions (ABCDEFG).

What is included in the secondary survey?

A detailed history, a structured head-to-toe exam, and a review of lab results and records.

What are clinical signs of poor circulation?

Cyanosis, cool mottled skin, and oliguria.

What is the purpose of TELE-ICU?

To provide remote care to ICU patients, reduce mortality in underserved areas, and support overnight care (used by Orlando Health).

Which patients require a 1:1 nurse-to-client ratio?

Patients with cardiac arrest (Artic Sun therapy), on CRRT, prone for ARDS, on vasopressors, hemorrhaging, in DKA, or undergoing emergent bedside surgery.

What tasks can Unlicensed Assistive Personnel (UAPs) NOT perform?

They cannot assess, diagnose, plan, intervene medically, or evaluate—essentially anything within ADPIE.

What is the purpose of Early Warning Scores?

To alert nurses of patients who may decompensate by analyzing vital signs and labs pulled from the EHR.

What equipment typically indicates a patient needs ICU admission?

Ventilators/BiPAP, hemodynamic monitors, GTTS meds (e.g., vasopressors, antihypertensives), sedation, analgesics, neuromuscular blockers, central/arterial lines, and bedside procedures like bronchoscopies.

What are key manifestations of Guillain-Barré Syndrome (GBS)?

Ascending paralysis, "rubbery legs," and difficulty clearing secretions.

What are GBS nursing interventions?

Monitor respiratory status and oxygenation, frequent turning, and monitor for IV IG reactions.

What is the treatment for GBS?

IV IG; steroids are not effective.

What causes Myasthenia Gravis?

A decrease in acetylcholine receptors.

What are the manifestations of MG?

Progressive muscle weakness, starting inward and spreading outward to extremities, respiratory failure

What are the treatments for MG?

Anticholinesterase meds (pyridostigmine), immunosuppressants (cyclosporine), plasmapheresis, and IV IG.

What are the nursing interventions for MG?

Monitor respiratory function, chest physiotherapy, and ensure adequate nutrition and supportive care.

Which diuretics are used to manage increased ICP? What are some considerations for these rx?

Mannitol (may cause hypokalemia) and furosemide/Lasix (can be ototoxic, administer slowly).

Which steroids are used for ICP management related to craniotomies?

Dexamethasone (Decadron) and methylprednisolone (Solumedrol).

What side effects should be monitored when giving steroids?

Signs of Cushing’s syndrome (moon face, hump back) and hyperglycemia.

What barbiturates are used to reduce ICP?

Phenobarbital and pentobarbital.

What side effects should be monitored with barbiturate use?

Respiratory depression and hypotension.

What defines status epilepticus?

Seizure activity lasting over 30 minutes or two or more seizures without full recovery between them.

What are priority nursing interventions for status epilepticus?

Monitor airway and hemodynamics, maintain IV access, initiate seizure precautions, and prepare for intubation if needed.

What medications are used to manage status epilepticus?

First-line: Benzodiazepines (diazepam, lorazepam, midazolam); followed by antiepileptics (phenytoin, fosphenytoin, levetiracetam).

What principles guide answering priority setting questions?

Use the ABCs (Airway, Breathing, Circulation) to prioritize which patient to see or treat firs