Hemodynamics:
What are typical values for a CVP and PA (systolic and diastolic)?
What is: 2-8, 25/10
How often does the Impella cassette need to be changed?
What is: once per week
How do you page a code blue in the CVICU?
What is: you DON'T! One exception is a CT surgery code blue when a patient is in their CALS window
How often should oral care be preformed on an intubated patient?
What is: at least every 2 hours, more often if needed
How many airway carts are located on our unit? Where are they located?
What does CVP stand for? What value does it represent?
What is: Central venous pressure; right atrial pressure (*why is this important?)
How do you get a blood pressure on a patient with an LVAD (no a-line)?
What is: doppler map with manual cuff
What medications are located in the code cart?
What is: EPI, Amio, Lido, Levo (to mix gtt), Mag, dextrose, calicum, bicarb, NS flushes
When are lines and dressings changed?
What is: Tuesdays and Fridays (lines and dressings, chest tube dressing daily).
What information should be visible to patients/visitors on the whiteboard in the room?
What is: Your name, NA name, manager name, date, room #, UO, CT output, BG, IVF (as applicable).
How is CO calculated? What does CI account for?
What is: HR x SV; TBSA.
What actions should be taken when patient has a suction alarm on the Impella? What are potential causes of this alarm?
What is: Decrease P level, possibly change patient position, notify provider. Causes: patient is too dry, patient position, impella position, pain/bearing down
What are the shockable rhythms? (pulseless)
VT and VFIB
What is a contraindication for mobilizing your patient?
What is: Very few things! Devices/sheaths in the groin. If on pressor/inotrope, ASK providers. Usually, it is safe to at least move patients to the chair.
Explain the difference between defibrillation and cardioversion and when you would use them
What is: a defib is delivered at any point in the rhythm use for pulseless rhythms. Cardioversion delivers the shock on the R wave to avoid shocking on the t wave to prevent R on T, used for patient with pulse (vt, afib, SVT)
Name 8 hemodynamic values that can be derived from a PA catheter and CCO box.
What is: Preceptor choice!
How often should you complete neurovascular exams on patients with a new/femoral device?
What is: q15 min exam (for the first few hours, then q1), document at least q1 hour.
What should you do if your patient codes and no one is around?
What is: STAY WITH your patient; call for help!
Where can/should a Mepilex be placed?
What is: Almost anywhere! Bare minimum, sacral and heel. Over bony prominences, skin tears, device lines. etc.
How do you verify capture when transcutaneous pacing a patient?
Describe cardiac tamponade WITH numerical values.
What is: CVP and PA equalize, narrowed PP or pulsus paradoxus.
Name 2 complications from an Impella.
What is: Hemolysis, arrythmia.
What do you need to do when starting chest compressions on a patient with an Impella or IABP?
What is: Drop to P2 and change from ECG to pressure trigger.
How often should tubing be changed on Propofol or Cleviprex gtt? Why?
What is: q12 hrs; lipid content.
What do you need to have in the room if you get report on a heart receiving Flolan?
What is: An inhaled medication pump (LET RT KNOW!).