NR 341
NR 341 Week 3 Exam One Study Guide (Chapters 1, 2, 3, 4, 5, 9, 10, 14)
NR 341 Week 3 Exam One Study Guide
NR 341 Week 3 Exam 1
NR 341 Week 3
... [Show More] Exam One Study Guide (Chapters 1, 2, 3, 4, 5, 9, 10, 14)
This blueprint is not inclusive of all content which may be on the exam.
Chapter 1 Overview of Critical Care Nursing
• Definition of critical care nursing
• Evolution of critical care
• Professional organizations
o American association of critical-care nurses
o Society of critical care medicine
o Other professional organizations
• Certification
• Standards
• Critical care nurse characteristics
• Quality and safety emphasis
• Evidence-based practice
• Healthy work environment
o Communication
o Collaboration
• Other trends and issues
Chapter 2 Patient and Family Response to the Critical Care Experience
• Introduction
• The critical care environment
• The critically ill patient
o Discharge from critical care and quality of life after critical care
o Geriatric concerns
• Family members of the critically ill patient
o Family assessment
o Family needs
o Communication
o Visitation
o Family presence during procedures and resuscitation
o Practice alerts
Chapter 3 Ethical and Legal Issues in Critical Care Nursing
• Introduction
• Ethical obligations and nurse advocacy
• Ethical decision making
• Ethical principles
o Creating an ethical environment
• Increasing nurses’ involvement in ethical decision making
• Selected ethical topics in critical care
o Informed consent
Elements of informed consent
o Decisions regarding life-sustaining treatment
Cardiopulmonary resuscitation decisions
Withholding or withdrawing life support
o End-of-life issues
Patient self-determination act
Advance directives
o Organ and tissue transplantation
Chapter 4 End-of-Life Care in the Critical Care Unit
• Introduction
o Effects on nurses and the healthcare team
• Dimensions of end-of-life care
o Palliative care
o Communication and conflict resolution
o Withholding, limiting, or withdrawing therapy
Ventilator withdrawal
Other commonly withheld therapies
Hospice referral
o Emotional and psychological care of the patient and family
o Caregiver organizational support
• Culturally competent end-of-life care
Chapter 5 Comfort and Sedation
• Introduction
• Definitions of pain and anxiety
• Predisposing factors to pain and anxiety
• Physiology of pain and anxiety
o Pain
o Anxiety
• Positive effects of pain and anxiety
• Negative effects of pain and anxiety
o Physical effects
o Psychological effects
• Assessment
o Pain measurement tools
o Pain measurement tools for nonverbal patients
o Anxiety and sedation measurement tools
Sedation scales
o Continuous monitoring of sedation
o Pain and anxiety assessment challenges
Delirium
Neuromuscular blockade
• Management of pain and anxiety
o Nonpharmacological management
Environmental manipulation
o Complementary and alternative therapy
Guided imagery
Music therapy
Animal-assisted therapy
o Pharmacological management
Opioids
Patient-controlled analgesia
Epidural analgesia
Nonsteroidal anti-inflammatory drugs
Other pain relievers
Sedative agents
Tolerance and withdrawal
• Management challenges
o Invasive procedures
o Substance abuse
o Restraining devices
o Effects of aging
Chapter 9 Ventilatory Assistance
• Introduction
• Review of respiratory anatomy and physiology
o Upper airway
o Lower airway
o Lungs
• Physiology of breathing
o Gas exchange
o Regulation of breathing
o Respiratory mechanics
Work of breathing
Compliance
Resistance
• Lung volumes and capacities
• Respiratory assessment
o Health history
o Physical examination
Inspection
Palpation
Percussion
Auscultation
Breath sounds
o Arterial blood gas interpretation
Oxygenation
• Partial pressure of arterial oxygen
• Arterial oxygen saturation of hemoglobin
Ventilation and acid-base status
• PH
• Partial pressure of arterial carbon dioxide
• Sodium bicarbonate
• Buffer systems
• Base excess or base deficit
• Compensation
• Step 1: look at each number individually and label it
• Step 2: evaluate oxygenation
• Step 3: determine acid-base status
• Step 4: determine whether primary acid-base disorder is respiratory or metabolic
• Step 5: determine whether any form of compensatory response has taken place
o Noninvasive assessment of gas exchange
Assessment of oxygenation
• Pulse oximetry
Assessment of ventilation
• End-tidal carbon dioxide monitoring
• Colorimetric carbon dioxide detector
• Oxygen administration
o Humidification
o Oxygen deliver devices
Nasal cannula
High flox nasal cannula
Simple face mask
Face masks with reservoirs
Venture or air-entrainment mask
Aerosol and humidity delivery systems
Manual resuscitation bag (variable performance)
• Airway management
o Positioning
o Oral airways
o Nasopharyngeal airways
o Endotracheal intubation
Procedure for oral endotracheal intubation
Procedure for nasotracheal intubation
Verification of endotracheal tube placement
o Tracheostomy
Tracheostomy tube designs
• Cuffed versus uncuffed tracheostomy tubes
• Single-versus double-cannula tracheostomy tubes
• Fenestrated tracheostomy tube
• Speaking tracheostomy valves
o Endotracheal suctioning
• Mechanical ventilation
o Indications
o Positive-pressure ventilation
o Ventilator settings
Fraction of inspired oxygen
Tidal volume
Respiratory rate
Inspiratory-to-expiratory ratio
Inverse inspiratory-to-expiratory ratio
Positive end-expiratory pressure
Sensitivity
o Patient data
Exhaled tidal volume
Peak inspiratory pressure
Total respiratory rate
o Modes of mechanical ventilation
Volume ventilation
• Assist/control ventilation
• Synchronized intermittent mandatory ventilation
Pressure ventilation
• Continuous positive airway pressure
• Pressure support
• Pressure assist/control
• Pressure-controlled inverse-ratio ventilation
• Airway pressure-release ventilation
o Noninvasive positive-pressure ventilation
o High frequency oscillatory ventilation
o Advanced methods and modes of mechanical ventilation
o Respiratory monitoring during mechanical ventilation
Alarm systems
o Complications of mechanical ventilation
Airway problems
• Endotracheal tube out of position
• Unplanned extubation
• Laryngeal and tracheal injury
• Damage to the oral or nasal mucosa
Pulmonary system
• Trauma
• Oxygen toxicity
• Respiratory acidosis or alkalosis
• Infection
• Dysphagia and aspiration
Cardiovascular system
Gastrointestinal system
Psychosocial complications
• Nursing care
o Communication
o Maintaining comfort and reducing distress
o Medications
o Nonpharmacological interventions
• Weaning patients from mechanical ventilation
o Approach to weaning using best evidence
o Assessment for readiness to wean (wean screen)
o Weaning process (weaning trial)
o Extubation
o
Chapter 10 Rapid Response Teams and Code Management
• Introduction
• Rapid response teams
• Roles of caregivers in code management
o Code team
Leader of the code
Code nurses
• Primary nurse
• Second nurse
• Nursing supervisor
Anesthesiologist or nurse anesthetist
Respiratory therapist
Pharmacist or pharmacy technician
Electrocardiogram technician
Chaplain
Other personnel
• Equipment used in codes
• Resuscitation efforts
o Basic life support
Responsiveness
Circulation and chest compressions
Airway
Breathing
o Advanced cardiac life support
Airway
Breathing
Circulation
Differential diagnosis
o Recognition and treatment of dysrhythmias
Ventricular fibrillation and pulseless ventricular tachycardia
• Critical actions
Pulseless electrical activity and asystole
• Critical actions
Symptomatic bradycardia
• Critical actions
Unstable tachycardia
• Critical actions
o Electrical therapy
Defibrillation
• Definition
• Procedure
Automated external defibrillation
• Definition
• Indications
• Procedure
Cardioversion
• Definition
• Procedure
Special situations
Transcutaneous cardiac pacing
• Definition
• Procedures
• Pharmacological intervention during a code
o Oxygen
o Epinephrine (adrenalin)
o Vasopressin
o Atropine
o Amiodarone (cordarone)
o Lidocaine (xylocaine)
o Adenosine (adenocard)
o Magnesium
o Sodium bicarbonate
o Dopamine (intropin)
• Documentation of code events
• Care of the patient after resuscitation
o Therapeutic hypothermia after cardiac arrest
Chapter 14: Acute Respiratory Failure
• Introduction
• Acute Respiratory Failure
o Definition
o Pathophysiology
Failure of Oxygenation
• Hypoventilation
• Intrapulmonary Shunting
• Ventilation-Perfusion Mismatch
• Diffusion Defects
• Low Cardiac Output
• Low Hemoglobin Level
• Tissue Hypoxia
Failure of Ventilation
• Hypoventilation
• Ventilation-Perfusion Mismatch
o Assessment
o Effects of Aging
o Interventions
Maintaining a Patent Airway
Optimizing O2 Delivery
Minimizing O2 Demand
Treating the Cause of ARF
Preventing Complications
o Nursing Diagnoses
• Respiratory Failure in Acute Respiratory Distress Syndrome
o Definition
o Etiology
o Pathophysiology
o Assessment
o Interventions
Oxygenation
Sedation and Comfort
Prone Positioning
Fluids and Electrolytes
Nutrition
Pharmacological Treatment
Psychosocial Support
• Acute Respiratory Failure in Chronic Obstructive Pulmonary Disease
o Pathophysiology
o Assessment
o Interventions
o Oxygen
o Bronchodilator Therapy
o Corticosteroids
o Antibiotics
o Ventilator assistances
• Acute Respiratory Failure in Asthma
o Pathophysiology
o Assessment
o Interventions
• Acute Respiratory Failure Resulting From Pneumonia
o Definition and Etiology
o Pathophysiology
o Assessment
• Ventilator-Associated Pneumonia
o Pathophysiology
o Assessment
o Interventions
Treatment
• Acute Respiratory Failure Resulting from Pulmonary Embolism
o Definition/Classification
o Etiology
o Pathophysiology
o Assessment
o Diagnosis
D-Dimer Assay
Ventilation-Perfusion Scan
Duplex Ultrasonography
High-Resolution Multidetector Computed Tomography Angiography
Magnetic Resonance Imaging
Pulmonary Angiogram
o Prevention
o Treatment
• Acute Respiratory Failure in Adult Patients with Cystic Fibrosis
o Etiology
o Interventions
Antibiotic Therapy
Airway Clearance
Nutritional Support
Ventilatory Support
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