Perrin, Understanding the Essentials of Critical Care Nursing, 2/e Chapter 1 Question 1 Type: MCSA Which patient would the nurse identify as experiencing a critical illness? The patient: 1. With chronic airflow limitation whose VS are BP 110/72, P 110, R 16 2. With acute bronchospasm and whose VS are BP 100/60, P 124, R 32 3. Who was involved in a motor vehicle crash whose VS are BP 124/74, P 74, R 18 4. On hemodialysis for chronic renal failure with no urine output and whose VS are BP 98/50, P 108, R 12 Correct Answer: 2 Rationale 1: The blood pressure and respiratory rate are considered within normal limits. The heart rate is slightly elevated. Based upon these vital signs, this patient is not critically ill. Rationale 2: Acute bronchospasm can present a life-threatening situation, which can jeopardize a patient's survival. The patient’s pulse and respiratory rate are elevated, which could indicate a critical illness. Rationale 3: According to the vital signs, this patient is not critically ill despite being in a motor vehicle crash. Rationale 4: The patient on receiving hemodialysis for chronic renal failure is not considered critically ill unless another disease process or health issue develops. The patient’s vital signs are consistent with someone with chronic renal failure. Global Rationale: Cognitive Level: Analyzing Client Need: Physiological Integrity Client Need Sub: Physiological Adaptation Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 1-1: Define critical care. Question 2 Type: MCMA Of the following patients, which will the nurse expect to be transferred to a critical care unit? The patient: Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
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