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D.O.P.E. acronym means? When do we use it?
Dislodgement, obstruction, pneumothorax, equipment
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Name the 3 stages of repair for a single ventricle patient
Norwood, Glenn, Fontan
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On an intubated patient with a BT shunt, what is one sign (besides hypoxemia) of shunt obstruction?
drop in end tidal CO2 - With an obstruction there is little to no blood going to the lungs. No oxygen/CO2 exchange. So O2 saturations and end tidal goes down.
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What is protamine?
Heparin reversal
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This medication is used for: chylothorax and GI bleeds
Octreotide
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What temperature is blood supposed to be kept at in the bedside cooler?
<6 degrees Celsius. Above 6 is quarantined for clots, and above 10 is thrown out. SO monitor the temperature of the cooler when you check it more so than that
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True/False - Breathing stimulates the closure of the PDA?
True
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Does intubation help the right or left side of the heart?
Left
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What am I?
Jackson Reese. Be careful because potential for unlimited PEEP. MD should use.
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If your patient is having a pulmonary hypertensive crisis & is intubated, what will your end tidal do & why?
Decrease. Lack of blood flow through pulmonary vasc. Low flow, little to no CO2 exchange happening
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Your patient has an EVD/bolt. Per our policy, (a) what should we do prior to moving the patient, and (b) how long can it be (the answer for A) for?
(A) Clamped (B) 30 minutes
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You have a s/p day 3 Glenn patient who started trophic feeds the shift prior. Pt is de-escalating and sedation is being weaned. Chest tube output increases & changes to cloudy serous/white from serosanguinous. What do you suspect?
Chylous effusion
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Your pt is post-Glenn, and starts breathing over the vent (tachypnea). Starts to desaturate first and then becomes hypotensive. Why?
CO2 levels drop d/t tachypnea. CO2 dilates vessels in brain. Glenns require permissive hypercapnia for blood flow into the lungs.
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You’re patient is post-op Norwood and PD cycling. After dwelling time is complete, you put your PD to drain, but nothing drains. While troubleshooting, your chest tube output increases & changes from bloody to serous.
Notify your provider, chest tube sample should be drawn and sent for glucose check (don’t test using glucometer). In this scenario, the patient needed an x-ray.
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