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NR 572 EXAM PREP LATEST ADVANCED ACUTE CARE MANAGEMENT ANSWERED
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NR 572 EXAM PREP LATEST ADVANCED ACUTE CARE MANAGEMENT ANSWERED
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NR 572 EXAM PREPLATEST
Advanced Acute
Care Management
ANSWERED
2023/2024
,1. What are the main components of the ABCDE bundle and how do they improve
patient outcomes in the ICU? (5 marks)
Answer: The ABCDE bundle consists of Awakening and Breathing Coordination,
Delirium monitoring and management, and Early mobility and exercise. These
interventions aim to reduce the duration of mechanical ventilation, prevent
complications such as ventilator-associated pneumonia and ICU-acquired weakness,
and improve cognitive and functional recovery.
2. What are the indications and contraindications for initiating non-invasive ventilation
(NIV) in acute respiratory failure? (5 marks)
Answer: NIV is indicated for patients with acute respiratory failure due to exacerbations
of chronic obstructive pulmonary disease (COPD), cardiogenic pulmonary edema, or
immunocompromised states. NIV is contraindicated for patients with hemodynamic
instability, impaired mental status, excessive secretions, facial trauma or surgery, or
high risk of aspiration.
3. What are the common causes and clinical features of acute kidney injury (AKI) in
critically ill patients? (5 marks)
Answer: AKI is a sudden decline in kidney function that can be classified into prerenal,
intrinsic, or postrenal causes. Prerenal AKI is due to decreased renal perfusion from
hypovolemia, sepsis, or heart failure. Intrinsic AKI is due to damage to the renal
parenchyma from ischemia, nephrotoxins, or inflammation. Postrenal AKI is due to
obstruction of the urinary tract from stones, tumors, or clots. Clinical features of AKI
include oliguria or anuria, fluid overload, electrolyte imbalances, acidosis, and uremia.
4. What are the principles and goals of palliative care in the ICU setting? (5 marks)
Answer: Palliative care is an interdisciplinary approach that aims to relieve suffering and
improve quality of life for patients with life-limiting illnesses and their families. The goals
of palliative care in the ICU setting are to provide symptom management, facilitate
,communication and decision making, align treatment with patient preferences and
values, and support bereavement and grief.
5. What are the risk factors and prevention strategies for catheter-associated urinary
tract infection (CAUTI) in critically ill patients? (5 marks)
Answer: CAUTI is a common nosocomial infection that can lead to increased morbidity
and mortality in critically ill patients. The risk factors for CAUTI include female sex,
advanced age, diabetes mellitus, prolonged catheterization, inappropriate catheter care,
and lack of aseptic technique. The prevention strategies for CAUTI include avoiding
unnecessary catheterization, using sterile insertion technique, maintaining a closed
drainage system, securing the catheter properly, performing routine catheter care, and
removing the catheter as soon as possible.
6. What are the indications and complications of extracorporeal membrane oxygenation
(ECMO) in acute respiratory distress syndrome (ARDS)? (5 marks)
Answer: ECMO is a form of mechanical circulatory support that provides oxygenation
and carbon dioxide removal for patients with severe ARDS who fail conventional
mechanical ventilation. The indications for ECMO in ARDS include refractory
hypoxemia, hypercapnia with acidosis, or hemodynamic instability despite optimal
ventilator settings. The complications of ECMO in ARDS include bleeding, infection,
thrombosis, hemolysis, air embolism, or mechanical failure.
7. What are the types and management of shock in critically ill patients? (5 marks)
Answer: Shock is a state of inadequate tissue perfusion that results in organ dysfunction
and death if not corrected. The types of shock are classified into hypovolemic,
cardiogenic, obstructive, or distributive based on the underlying mechanism. The
management of shock in critically ill patients involves identifying and treating the cause
of shock, restoring adequate tissue perfusion with fluids and vasopressors/inotropes,
monitoring hemodynamic parameters and organ function, and providing supportive
care.
, 8. What are the criteria and benefits of early enteral nutrition (EEN) in critically ill
patients? (5 marks)
Answer: EEN is the provision of nutrition via the gastrointestinal tract within 24 to 48
hours of admission to the ICU. The criteria for EEN include having a functional
gastrointestinal tract, being hemodynamically stable, and having no contraindications
such as bowel obstruction or ischemia. The benefits of EEN include preserving gut
integrity and immunity, reducing infectious complications and mortality, enhancing
wound healing and muscle strength, and improving glycemic control.
The nurse is caring for a patient with crush injuries to the lower extremities. For which
complication will the nurse monitor?
A. Bradycardia
B. Hypotension
C. Acute kidney injury
D. Spinal nerve injury - ANSWER C. Acute Kidney Injury
Crush injuries release myoglobin from the muscle places the patient at risk for
rhabdomyolysis and acute kidney injury.
Patient states that he was jogging close to the edge of a hillside, and that he tripped and
fell down the hill. There are no openings in the skin. A pulse cannot be obtained by
touch to the right foot, which is pale and cool to palpation. The patient rates his pain as
an "8" on a 0-to-10 scale.
What is the priority nursing action at this time?
A. Prepare for reduction.
B. Administer pain medication.
C. Obtain a Doppler of the right foot pulse.
D. Notify the physician of the lack of a pulse in the right foot. - ANSWER C. Obtain
Doppler of right foot pulse.
Doppler should be done to confirm lack of pulse, then notify the physician.
To control the patient's pain, which order does the nurse anticipate will be given by the
provider?
A. Morphine 1 to 2 mg IV
B. Meperidine 50 mg IM
C. Acetaminophen 650 mg by mouth
D. Apply ice packs to the right ankle - ANSWER A. Morphine
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