Patient Management and Care Flashcards
7 cards from real ACCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Patient Management and Care flashcards as text
A patient with acute liver failure develops cerebral edema. Which intervention is the priority to reduce intracranial pressure?
Answer: Elevate head of bed to 30° and give hypertonic saline or mannitol
Head-of-bed elevation with osmotic therapy (mannitol or hypertonic saline) is the first-line approach to lower ICP in acute liver failure.
A patient with pulmonary embolism is hemodynamically unstable. Systolic BP is 80 mmHg despite fluids. What is the most appropriate intervention?
Answer: Perform systemic thrombolysis with alteplase
Massive PE with hemodynamic instability is an indication for systemic thrombolysis with alteplase unless contraindicated.
Which parameter best guides fluid resuscitation in a mechanically ventilated patient with septic shock?
Answer: Pulse pressure variation (PPV)
Pulse pressure variation >13% in a fully ventilated patient reliably predicts fluid responsiveness, unlike static measures like CVP.
A patient in the ICU develops Clostridioides difficile colitis not responding to oral vancomycin. What is the next best treatment?
Answer: Oral fidaxomicin
Fidaxomicin is preferred over vancomycin for non-severe CDI and has shown superiority in recurrence reduction; it is the appropriate escalation.
A trauma patient receives massive transfusion. Which electrolyte abnormality is most commonly associated with rapid packed RBC transfusion?
Answer: Hypocalcemia
Citrate in banked blood chelates ionized calcium, causing hypocalcemia during massive transfusion, which impairs cardiac contractility.
Which approach is recommended when weaning vasopressors in a patient recovering from septic shock?
Answer: Wean adjunctive vasopressors before reducing norepinephrine
Adjunctive vasopressors (vasopressin, phenylephrine) should be weaned first while maintaining norepinephrine, reducing the risk of hemodynamic instability.
A patient with severe TBI has an ICP of 28 mmHg and CPP of 55 mmHg despite head elevation and sedation. What is the next step?
Answer: Administer hyperosmolar therapy (mannitol or hypertonic saline)
Hyperosmolar therapy is the next step for ICP >20 mmHg unresponsive to first-tier measures before considering surgical decompression.