INSTRUCTIONS Improving outcomes with therapeutic hypothermia
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Improving outcomes with therapeutic hypothermia
GENERAL PURPOSE: To provide nurses with information about management of patients undergoing therapeutic hypothermia. LEARNING OBJECTIVES: After reading the preceding article and taking this test, you should be able to: 1. Describe the physiology related to therapeutic hypothermia. 2. Identify indications for therapeutic hypothermia. 3. Discuss patient management issues related to therapeutic hypothermia.
- Which temperature is within the target range for therapeutic hypothermia?
- 90° F
- 94° F
- 30° C
- 35° C
- Which statement about therapeutic hypothermia is accurate?
- It decreases metabolism by 1% for every 1° C drop in body temperature.
- It protects long-term brain function.
- It's used in patients who regain consciousness after ROSC.
- It's most appropriate for hemodynamically unstable patients.
- Which parameter would generally make a patient a candidate for therapeutic hypothermia?
- age 15
- BP 78/60
- pulseless for less than 60 minutes
- Glasgow Coma Scale of 10
- Excluded from therapeutic hypothermia would be the patient who
- was pulseless for 45 minutes.
- is mechanically ventilated.
- arrives at the hospital 4 hours post cardiac arrest.
- is pregnant.
- Noninvasive cooling methods
- include closed-loop systems.
- require less nursing care than invasive methods.
- are extremely effective in reducing body temperature.
- don't require temperature monitoring.
- What percentage of the body should be covered with gel pads for cooling?
- One disadvantage of gel pads is that they
- frequently leak.
- are expensive to use.
- require manual temperature adjustments.
- frequently cause skin breakdown.
- The cold water immersion system described
- is used for all cooling phases.
- cools target organs as effectively as invasive methods.
- keeps patients cool for 48 hours.
- is portable.
- Advantages of the cold water immersion suit include
- rare overcooling.
- ease of maintaining target temperature.
- cooling in less than 1 hour.
- defibrillation safety.
- Invasive cooling methods
- rapidly induce hypothermia.
- use moderately cold solutions to prevent shivering.
- use D5W I.V. infusions.
- are preferred in patients with renal failure.
- Baseline data to collect before induction include
- erythrocyte sedimentation rate.
- Western blot.
- type and crossmatch.
- serum amylase.
- Recommendations for patient management during therapeutic hypothermia include all of the following except
- an oro- or nasogastric tube.
- two CVADs.
- electroencephalographic monitoring.
- I.V. sedation and analgesia.
- After ROSC, target temperature should be achieved within no more than
- 1 hour.
- 2 hours.
- 3 hours.
- 4 hours.
- What's the ideal heart rate for patients undergoing therapeutic hypothermia?
- 40 to 45 bpm
- 50 to 60 bpm
- 65 to 75 bpm
- 80 to 85 bpm
- To avoid dysrhythmias, body temperature should be no less than
- 82° F.
- 84° F.
- 86° F.
- 88° F.
- To combat shivering, warm compresses should be placed on the patient's
- Hypothermia is most likely to cause
- Which statement about rewarming is accurate?
- It's usually started 48 hours after induction.
- It should be done over 2 to 4 hours.
- It can cause hypotension.
- It usually includes a potassium infusion.