NRNP 6566 Week 8 Knowledge Check (100% Correct) Verified Answers

NRNP 6566 Week 8 Knowledge Check • Question 1 What type of ICU sedation would be appropriate for a 32 year old male patient who is intubated with bilateral chest tube following a motor vehicle crash. ...

NRNP 6566 Week 8 Knowledge Check • Question 1 What type of ICU sedation would be appropriate for a 32 year old male patient who is intubated with bilateral chest tube following a motor vehicle crash. • Question 2 Describe the levels of sedation (minimal, moderate, deep, general anesthesia, and dissociation) and its affect on consciousness, airway, ventilation, and reflexes. • Question 3 The APRN has determined that a 21 year old motor vehicle crash victim needs a rapid sequence intubation. The patient weighs 77 kg. What medications are indicated to successfully achieve the rapid sequence intubation? • Question 4 A 66 year old women in the ICU is diagnosed with delirium. What would be the best approach to treating her delirium? Correct Answer: Delirium is common in critically ill adults. Delirium is a clinical diagnosis which can be detected with some screening tools such as the Confusion Assessment Method for the ICU (CAM-ICU) or the Intensive Care Delirium Screening Checklist. Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU (2018) by the Society of Critical Care Medicine recommends a muticomponent, nonpharmacologic intervention focused on reducing modifiable risk factors. These interventions include reorientation, cognitive stimulation, use of clocks, improved sleep, reduced sedation, early rehabilitation and mobilization, use of hearing aids and eye glasses. Haloperidol is not routinely recommended and studies have not shown that it shortens the duration of the delirium. However, short term use of haloperidol or an atypical antipsychotic may be warranted for those patients who experience significant distress, agitation, or physical risk to themselves or others. • Question 5 The NP is beginning to repair a laceration on a 22 year old female. The patient mentions that she is allergic to lidocaine. What medication would be an appropriate alternative for this patient? Correct Answer: Local anesthetics include two classes of medications that include esters and amides. Lidocaine and bupivacaine are amide anesthetics. In this patient, an ester anesthetics should be utilized. Procaine is an example of an ester local anesthetic. • Question 6 A 54 year old 112 kg women is admitted for incision and drainage of a left renal abscess. She needs TID wet to dry dressing changes that are very painful. She rates the pain during the dressing change as a 10 and describes in as sharp, pulling, and burning. Prior to the last dressing change she received 2 mg of morphine IV which was totally ineffective in relieving any pain of the dressing change. How would you manage the medication dosing prior to the next dressing change? • Question 7 A 36 year old man complains of sciatic type nerve pain in his left posterior leg. What medication would be best to manage his pain? • Question 8 A 44 year old man was given fentanyl to achieve moderate sedation for a colonoscopy. During the procedure, the patients oxygen saturation begins to decline and while assessing the patient the NP notices chest wall rigidity. What is the cause of the rigidity and how would you treat it? • Question 9 A 66 year old man is admired to the ICU with respiratory distress and bilateral pneumonia. He has a history of a CVA 2 years ago with right hemiplegia and aphasia. Current vitals signs are T 98.8 HR 115 BP 170/99. RR 32. Oxygen saturation is 90% on a nonrebreather mask. The patient weighs 70 kg. The NP decides to perform a rapid sequence intubation. What medications and doses would be appropriate for this patient? • Question 10 A 77 year old man fell and suffered a laceration across his upper right lip. The APRN decides to utilize a block for pain control which suturing the laceration. What type of block and what medication would be appropriate for this patient?