Deck 34: Intensive Care Management of Individuals With Primary Cardiovascular and Pulmonary Dysfunction

Question 1

Which of these interventions would not achieve the goal of trying to minimize oxygen demand on the patient?

A) Body positioning
B) Relaxation techniques
C) Coordinating treatment with other interventions
D) Coordinating treatment before medications take effect

Answer 1

D
Interventions should be timed so that medications are at their maximum effect for the most benefit for the patient.

Question 2

What pathophysiological deficits are present with advanced chronic airflow limitation caused by acute respiratory failure?

A) Decreased compliance of alveolar tissue
B) Increased diffusing capacity
C) Hyperinflated chest wall
D) Rounded hemidiaphragms

Answer 2

C
The pathophysiological deficits that are present with advanced chronic airflow limitation from acute respiratory failure include significant loss of alveolar tissue,increased compliance of alveolar tissue,hyperinflated chest wall,impaired respiratory mechanics,flattened hemidiaphragms,impaired breathing efficiency,and reduced diffusing capacity.

Question 3

Which of the following would be the best option for a patient unable to bear weight who you wish to mobilize into an upright position to improve cardiovascular and pulmonary function and gas exchange?

A) A chair at the side of the bed
B) Wait to try this intervention until weight-bearing status changes
C) Stretcher chair
D) Standing with maximum assistance of multiple assistants

Answer 3

C
Stretcher chairs are designed to position patients who are unable to bear weight in an upright position.

Question 4

What body position has been shown to have the greatest benefit for the patient with acute respiratory failure?

A) Sitting upright in a chair at the bedside
B) Scheduled four point turning
C) Randomized positioning
D) High Fowler position

Question 5

Which of the following is true regarding positive end-expiratory pressure (PEEP)?

A) Promotes venous return
B) Maintains airway patency during spontaneous ventilation
C) Improves myocardial perfusion
D) Promotes greater opportunity for gas exchange

Question 6

What intervention should the therapist concentrate on during a session of physical therapy with the cardiac patient including a short period of restricted mobility?

A) Aggressive coughing exercises
B) Positioning with the foot of the bed elevated
C) Rhythmic breathing exercises
D) Bed exercises while moving bilateral lower extremities at the same time.

Question 7

Which of the following is not a reason for administering oxygen for the cardiac patient after myocardial infarction?

A) To reduce hypoxemia
B) To depress the respiratory drive
C) To reduce angina
D) To reduce myocardial work

Question 8

Which of the following is not a secondary condition that may lead to cardiovascular and pulmonary dysfunction?

A) Spinal cord injury
B) Myocardial infarction
C) Stroke
D) Muscular dystrophy

Question 9

Which of the following is not a common complication related to a patient's premorbid status before open heart surgery?

A) Lung collapse
B) Deep vein thrombosis
C) Stroke
D) Pulmonary emboli

Question 10

While treating a patient with obstructive lung disease,what complicating factor(s)might you expect to find?

A) Rigid barrel-shaped chest wall
B) Decreased oxygen consumption
C) Decreased work of the heart
D) Effective cough mechanism

Question 11

Which of the following would you expect to see for a patient with end-stage respiratory failure?

A) Decrease in airway resistance
B) Carbon monoxide production
C) Work of breathing
D) Alveolar hyperventilation

Question 12

Which of these is not a classical sign and symptom of a severe asthma attack that may progress to status asthmaticus?

A) Audible wheezing
B) Tachypnea
C) Cyanosis
D) Bradycardia

Question 13

What risk increases in performing suctioning in a mechanically ventilated patient?

A) Interference with the gag reflex
B) Desaturation
C) Aspiration
D) Hyperoxygenation

Question 14

Which of these interventions is most beneficial for a patient with acute respiratory failure associated with restrictive lung disease?

A) A turning regimen
B) Mobilization in an upright position
C) Passive ROM exercises, especially of the upper limbs
D) Active ROM exercise, especially of the upper limbs

Question 15

What condition is described with the pathophysiological features of marked airway resistance secondary to bronchospasm,edema,and mucous secretion and retention?

A) Acute respiratory failure
B) Obstructive lung disease
C) Status asthmaticus
D) COPD

Question 16

Which of the following may contribute to generally low incidences of complications and mortality after open heart surgery?

A) Emphasis on patient education
B) Early weight bearing
C) Extubating the patient quickly after surgery
D) Foot and ankle exercises

Question 17

Which of the following is the primary goal of physical therapy to optimize oxygen transport in a patient with COPD?

A) Improve oxygen tension.
B) Reduce oxygen saturation.
C) Increase carbon dioxide levels.
D) Reduce PaO₂.

Question 18

Which heart structure is dysfunctional in the presence of pulmonary vascular congestion and cardiogenic pulmonary edema?

A) Right atrium
B) Left atrium
C) Right ventricle
D) Left ventricle

Question 19

In anticipation of an increased workload for a patient in the ICU who is ventilated,you decide to adjust the ventilator parameters.Which of the following would be the best adjustment to make?

A) Only increase oxygen concentration for at least 3 minutes before activity.
B) Only increase oxygen concentration for 10 minutes after activity.
C) Increase oxygen concentration for at least 3 minutes before activity and continue for 10 minutes after activity.
D) None of the above.

Question 20

Which of the following interventions would have the greatest effect on oxygen transport for a patient in ICU?

A) Active movement of large muscle groups
B) Active assisted movements
C) Passive motion
D) Sitting in a chair at the bedside