CORRECT ANSWERS GRADED A

CVP 1 Exam1 ACTUAL - 250 QUESTIONS AND

CORRECT ANSWERS GRADED A+

What brings a patient to the ICU? - CORRECT ANSWER-Acute conditions -Respiratory failure -CV instability -Neurological disorders -Multi injuries -Organ system failure

Complications of Bedrest: Circulation - CORRECT ANSWER--Orthostatic hypotension

-DVT/PE

-Venous pooling d/t lack of muscle pump

Complications of Bedrest: Pulmonary - CORRECT ANSWER--Increased risk of atelectasis d/t not ventilating a lot of alveoli -Aspiration pneumonia d/t mucocilliary escalator not working -Impaired gas exchange -Reduced lung volumes -Reduced max. O2 consumption

Complications of Bedrest: Organ Systems - CORRECT ANSWER--Altered skin integrity -Osteoporosis -Urinary stasis, UTI -Constipation

Complications of Bedrest: Other - CORRECT ANSWER--Muscle atrophy

-Joint contractures -Sensory/perceptual abnormalities (ICU psychosis) -ICU-acquired delirium

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What does the research say about PT/mobility in ICU patients? - CORRECT ANSWER-Early mobilization of patients has been linked to improved outcomes & reduced length of hospital stay

What are the ABCs of ICU Liberation? - CORRECT ANSWER-A: Assess, prevent, & manage pain B: Both SAT & SBT (spontaneous awakening trials, spontaneous breathing trials)

C: Choice of analgesia & sedation

D: Delirium: Assess, prevent, & manage

E: Early mobility & exercise

F: Family engagement & empowerment

Why is C: choice of analgesia & sedation so important in ICU liberation? - CORRECT ANSWER--Choose the right medication/level of sedation; ensure that you are just sedated enough so you're not agitated because of the tube -Sedation can also cause delirium ***Chose drugs that are both quickly reversible but quickly acting

Why is D: Delirium so important in ICU liberation? - CORRECT ANSWER--Delirium needs to be avoided at all costs & can greatly change patient's trajectory -PTs have a job to "exercise" pt's brain to prevent this

Adult oxygen therapy escalation algorithm: Step 1 - CORRECT ANSWER--Start O2 at 1-5 L/min -Nasal prongs

Adult oxygen therapy escalation algorithm: Step 2 - CORRECT ANSWER-If continued distress or SpO2

<90%:

-Face mask -Increased O2 to 5-10 L/min

Adult oxygen therapy escalation algorithm: Step 3 - CORRECT ANSWER-If continued distress or SpO2

<90%:

-Face mask with reservoir 2 / 4

-Start O2 at 10-15 L/min & titrate to ensure bag inflates

Adult oxygen therapy escalation algorithm: Step 4 - CORRECT ANSWER-If continued distress or SpO2

<90%:

Continue to try to find a higher level of care and consider on of the following if available & adequate

O2 supply:

-HFNO: 30-60 LPM (can also adjust FiO2)

-CPAP: 10-15 cm H20

-BIPAP:

Safety guidelines for PT in ICU - CORRECT ANSWER--Before starting, check line, tube, drain from origin to insertion -Always have slack on lines -Prevent line occlusion -Reconnect & put everything back where you found it before leaving the room

Hand hygiene in ICU - CORRECT ANSWER--Wash IN -Wash OUT

-GLOVES

Diaphragmatic breathing - CORRECT ANSWER--Requires both "belly breathing" & lateral costal expansion -May increase efficiency -May decrease work of breathing

Accessory muscle breathing - CORRECT ANSWER--Increases during exertional activity -Increases with respiratory distress

Purpose of palpating breathing pattern - CORRECT ANSWER-Assess chest wall expansion during breathing to compare symmetry of chest wall between R & L side as well to compare the contribution from upper, middle, and lower chest wall movement during breathing

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What does asymmetry in breathing pattern indicate? - CORRECT ANSWER-Ineffective or inefficient breathing pattern

Purpose of cough exam - CORRECT ANSWER-Assess the effectiveness of a person's cough as well as any sputum production that may indicate a medical issue

What are the phases of cough? - CORRECT ANSWER-Stage 1: Inspiration

Stage 2: glottal closure

Stage 3: build up of intrathoracic & intraabdominal pressure

(Stage 2 & 3 happen together in a compression phase)

Stage 4: Glottal opening & expulsion

At what result does a Peak Cough Flow assessment indicate that interventions are needed? - CORRECT ANSWER-<270 L/min Increased risk of ineffective cough

What PFTs/Spirometry result indicates that there might be a cough problem? - CORRECT ANSWER- Vital capacity <50%

Is lung auscultation diagnostic? - CORRECT ANSWER-Kinda. No diagnosis is made solely on lung auscultation

Limitations to Lung Ausculation - CORRECT ANSWER-Generally poor to fair inter-rater reliability

Pros to lung auscultation - CORRECT ANSWER-Easy, quick, low cost, non-invasive, no radiation

Bronchial lung sounds - CORRECT ANSWER-1:2

Inhalation:Exhalation

Vesicular lung sounds - CORRECT ANSWER-3:1

Inhalation:Exhalation

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