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Kettering ACCS Review - Patient Assessment Latest Update with Verified Solutions

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Kettering ACCS Review - Patient Assessment Latest Update with Verified Solutions What are the Four critical life functions? ✔✔Ventilation Oxygenation Circulation Perfusion Which of the life functions is the first priority? ✔✔Ventilation What assessments would determine how well a patient is ventilating? ✔✔Chest movement Respiratory rate Tidal volume Breath sounds EtCO2 PaCO2 How would the adult critical care specialist determine if a patient has a problem with oxygenation? ✔✔Heart rate Color Sensorium SaO2 PaO2 What information would help the adult critical care specialist determine if a patient's circulation is adequate? ✔✔Pulse/Heart rate and strength Cardiac output What changes would indicate that a patient may not have adequate perfusion? ✔✔Blood pressure Sensorium Temperature Urine output Hemodynamics The most common problems are associated with this critical life function... ✔✔Oxygenation Acute Respiratory Failure ✔✔The inability of the respiratory system to meet the oxygenation, ventilation, or metabolic requirements of the patient Three Types of Acute Respiratory Failure (ARF) ✔✔Hypoxemic Hypercapnic Mixed Hypoxemic Respiratory Failure may be identified by... ✔✔PaO2 <= 50 - 60 torr on room air SpO2 < 93% on room air PaO2/FiO2 or (P/F) Ratio < 300 A-aDO2 > 200 torr Most common cause - (V/Q) Mismatching Hypercapnic Respiratory Failure may be identified by... ✔✔PaCO2 >= 50 Torr Forced Vital Capacity (FVC) < 10 mL/kg Maximal Inspiratory Pressure (MIP) > -20 cmH2O Clinical Course for Acute Respiratory Failure (ARF) ✔✔Hypoxemic respiratory failure (low PaO2, low PaCO2) followed by hypercapnic respiratory failure (low PaO2, high PaCo2) as patient becomes fatigued. Clinical Manifestations of Acute Respiratory Failure ✔✔Altered mental status Increased WOB Bradypnea Cyanosis Diaphoresis Tachycardia Diagnostic test helpful in identifying the cause of ARF ✔✔Chest Radiograph Classification of ARDS Severity ATS/ERS Criteria(Old School) ✔✔Acute Lung Injury P/F Ratio < 300 ARDS P/F Ratio < 200 PCWP < 18 mmHg Diffuse bilateral infiltrates Classification of ARDS Severity Berlin Criteria (New School) ✔✔Mild ARDS P/F Ratio < 200-300 Moderate ARDS P/F Ratio < 100-200 Severe ARDS P/F Ratio < 100 Diffuse bilateral opacities

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