Medical CCRN : Critical Care Register Nurse Exam Dumps

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Exam Number : CCRN
Exam Name : Critical Care Register Nurse
Vendor Name : Medical
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CCRN Exam Format | CCRN Course Contents | CCRN Course Outline | CCRN Exam Syllabus | CCRN Exam Objectives


A criterion-referenced standard setting process, known as the modified Angoff, is used to establish the passing point/cut score for the exam. Each candidates performance on the exam is measured against a predetermined standard.

The passing point/cut score for the exam is established using a panel of subject matter experts, an exam development committee (EDC), who carefully reviews each exam question to determine the basic level of knowledge or skill that is expected. The passing point/cut score is based on the panels established difficulty ratings for each exam question.

Under the guidance of a psychometrician, the panel develops and recommends the passing point/cut score, which is reviewed and approved by AACN Certification Corporation. The passing point/cut score for the exam is established to identify individuals with an acceptable level of knowledge and skill. All individuals who pass the exam, regardless of their score, have demonstrated an acceptable level of knowledge.



I. CLINICAL JUDGMENT (80%)

A. Cardiovascular (17%)

1. Acute coronary syndrome:

a. NSTEMI

b. STEMI

c. Unstable angina

2. Acute peripheral vascular insufficiency:

a. Arterial/venous occlusion

b. Carotid artery stenosis

c. Endarterectomy

d. Fem-Pop bypass

3. Acute pulmonary edema

4. Aortic aneurysm

5. Aortic dissection

6. Aortic rupture

7. Cardiac surgery:

a. CABG

b. Valve replacement or repair

8. Cardiac tamponade

9. Cardiac trauma

10. Cardiac/vascular catheterization

11. Cardiogenic shock

12. Cardiomyopathies:

a. Dilated

b. Hypertrophic

c. Idiopathic

d. Restrictive

13. Dysrhythmias

14. Heart failure

15. Hypertensive crisis

16. Myocardial conduction system abnormalities

(e.g., prolonged QT interval, Wolff-ParkinsonWhite)

17. Papillary muscle rupture

18. Structural heart defects (acquired and congenital, including valvular disease)

19. TAVR



B. Respiratory (15%)

1. Acute pulmonary embolus

2. ARDS

3. Acute respiratory failure

4. Acute respiratory infection (e.g., pneumonia)

5. Aspiration

6. Chronic conditions (e.g., COPD, asthma, bronchitis, emphysema)

7. Failure to wean from mechanical ventilation

8. Pleural space abnormalities (e.g., pneumothorax, hemothorax, empyema, pleural effusions)

9. Pulmonary fibrosis

10. Pulmonary hypertension

11. Status asthmaticus

12. Thoracic surgery

13. Thoracic trauma (e.g., fractured rib, lung contusion, tracheal perforation)

14. Transfusion-related acute lung injury (TRALI)



C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)

1. Endocrine

a. Adrenal insufficiency

b. Diabetes insipidus (DI)

c. Diabetes mellitus, types 1 and 2

d. Diabetic ketoacidosis (DKA)

e. Hyperglycemia

f. Hyperosmolar hyperglycemic state (HHS)

g. Hyperthyroidism

h. Hypoglycemia (acute)

i. Hypothyroidism

j. SIADH

2. Hematology and Immunology

a. Anemia

b. Coagulopathies (e.g., ITP, DIC, HIT)

c. Immune deficiencies

d. Leukopenia

e. Oncologic complications (e.g., tumor lysis syndrome, pericardial effusion)

f. Thrombocytopenia

g. Transfusion reactions

3. Gastrointestinal

a. Abdominal compartment syndrome

b. Acute abdominal trauma

c. Acute GI hemorrhage

d. Bowel infarction, obstruction, perforation (e.g., mesenteric ischemia, adhesions)

e. GI surgeries (e.g., Whipple, esophagectomy, resections)

f. Hepatic failure/coma (e.g., portal hypertension, cirrhosis, esophageal varices, fulminant hepatitis, biliary atresia, drug-induced)

g. Malnutrition and malabsorption

h. Pancreatitis

4. Renal and Genitourinary

a. Acute genitourinary trauma

b. Acute kidney injury (AKI)

c. Chronic kidney disease (CKD)

d. Infections (e.g., kidney, urosepsis)

e. Life-threatening electrolyte imbalances

5. Integumentary

a. Cellulitis

b. IV infiltration

c. Necrotizing fasciitis

d. Pressure injury

e. Wounds:

i. infectious

ii. surgical

iii. trauma

D. Musculoskeletal/Neurological/



Psychosocial (14%)

1. Musculoskeletal

a. Compartment syndrome

b. Fractures (e.g., femur, pelvic)

c. Functional issues (e.g., immobility, falls, gait disorders)

d. Osteomyelitis

e. Rhabdomyolysis

2. Neurological

a. Acute spinal cord injury

b. Brain death

c. Delirium (e.g., hyperactive, hypoactive, mixed)

d. Dementia

e. Encephalopathy

f. Hemorrhage:

i. intracranial (ICH)

ii. intraventricular (IVH)

iii. subarachnoid (traumatic or aneurysmal)

g. Increased intracranial pressure (e.g., hydrocephalus)

h. Neurologic infectious disease (e.g., viral, bacterial, fungal)

i. Neuromuscular disorders (e.g., muscular dystrophy, CP, Guillain-Barré, myasthenia)

j. Neurosurgery (e.g., craniotomy, Burr holes)

k. Seizure disorders

l. Space-occupying lesions (e.g., brain tumors)

m. Stroke:

i. hemorrhagic

ii. ischemic (embolic)

iii. TIA

n. Traumatic brain injury (TBI): epidural, subdural, concussion

3. Behavioral and Psychosocial

a. Abuse/neglect

b. Aggression

c. Agitation

d. Anxiety

e. Suicidal ideation and/or behaviors

f. Depression

g. Medical non-adherence

h. PTSD

i. Risk-taking behavior

j. Substance use disorders (e.g., withdrawal, chronic alcohol or drug dependence)

E. Multisystem (14%)

1. Acid-base imbalance

2. Bariatric complications

3. Comorbidity in patients with transplant history

4. End-of-life care

5. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)

6. Hypotension

7. Infectious diseases:

a. Influenza (e.g., pandemic or epidemic)

b. Multi-drug resistant organisms (e.g., MRSA, VRE, CRE)

8. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, postpartum hemorrhage, amniotic embolism)

9. Multiple organ dysfunction syndrome (MODS)

10. Multisystem trauma

11. Pain: acute, chronic

12. Post-intensive care syndrome (PICS)

13. Sepsis

14. Septic shock

15. Shock states:

a. Distributive (e.g., anaphylactic, neurogenic)

b. Hypovolemic

16. Sleep disruption (including sensory overload)

17. Thermoregulation

18. Toxic ingestion/inhalations (e.g., drug/alcohol overdose)

19. Toxin/drug exposure (including allergies)



II. PROFESSIONAL CARING 7 ETHICAL PRACTICE (20%)

A. Advocacy/Moral Agency

B. Caring Practices

C. Response to Diversity

D. Facilitation of Learning

E. Collaboration

F. Systems Thinking

G. Clinical Inquiry



CLINICAL JUDGMENT

General

• Recognize normal and abnormal:

o developmental exam findings and provide developmentally appropriate care

o physical exam findings

o psychosocial exam findings

• Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed

• Recognize indications for, and manage patients requiring:

o capnography (EtCO2)

o central venous access

o medication reversal agents

o palliative care

o SvO2 monitoring

• Manage patients receiving:

o complementary/alternative medicine and/or nonpharmacologic interventions

o medications (e.g., safe administration, monitoring, polypharmacy)

• Monitor patients and follow protocols for pre- and postoperative care

• Assess pain

• Evaluate patients response to interventions

• Identify and monitor normal and abnormal diagnostic test results

• Manage fluid and electrolyte balance

• Manage monitor alarms based on protocols and changes in patient condition Cardiovascular

• Apply leads for cardiac monitoring

• Identify, interpret and monitor cardiac rhythms

• Recognize indications for, and manage patients requiring:

o 12-lead ECG

o arterial catheter

o cardiac catheterization

o cardioversion central venous pressure monitoring

o defibrillation

o IABP

o invasive hemodynamic monitoring

o pacing: epicardial, transcutaneous, transvenous

o pericardiocentesis

o QT interval monitoring

o ST segment monitoring

• Manage patients requiring:

o endovascular stenting

o PCI Respiratory

• Interpret blood gas results

• Recognize indications for, and manage patients requiring:

o modes of mechanical ventilation

o noninvasive positive pressure ventilation (e.g., BiPAP, CPAP, high-flow nasal cannula)

o oxygen therapy delivery devices

o prevention of complications related to mechanical ventilation (ventilator bundle)

o prone positioning

o pulmonary therapeutic interventions related to mechanical ventilation: airway clearance, extubation, intubation, weaning

o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2 )

o thoracentesis

o tracheostomy Hematology and Immunology

• Manage patients receiving transfusion of blood products

• Monitor patients and follow protocols:

o pre-, intra-, post-intervention (e.g., plasmapheresis, exchange transfusion, leukocyte depletion)

o related to blood conservation Neurological

• Recognize indications for, and manage patients requiring neurologic monitoring devices and drains (e.g., ICP, ventricular or lumbar drain)

• Use a swallow evaluation tool to assess dysphagia

• Manage patients requiring:

o neuroendovascular interventions (e.g., coiling, thrombectomy)

o neurosurgical procedures (e.g., pre-, intra-, post-procedure)

o spinal immobilization Integumentary

• Recognize indications for, and manage patients requiring, therapeutic interventions (e.g. wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment) Gastrointestinal

• Monitor patients and follow protocols for procedures pre-, intra-, post-procedure (e.g., EGD, PEG placement)

• Intervene to address barriers to nutritional/fluid adequacy (e.g., chewing/swallowing difficulties, alterations in hunger and thirst, inability to self-feed)

• Recognize indications for, and manage patients requiring:

o abdominal pressure monitoring

o GI drains

o enteral and parenteral nutrition Renal and Genitourinary

• Identify nephrotoxic agents

• Monitor patients and follow protocols pre-, intra-, and post-procedure (e.g., renal biopsy, ultrasound)

• Recognize indications for, and manage patients requiring, renal therapeutic intervention (e.g., hemodialysis, CRRT, peritoneal dialysis)

Musculoskeletal

• Manage patients requiring progressive mobility

• Recognize indications for, and manage patients requiring, compartment syndrome monitoring

Multisystem

• Manage continuous temperature monitoring

• Provide end-of-life and palliative care

• Recognize risk factors and manage malignant hyperthermia

• Recognize indications for, and manage patients undergoing:

o continuous sedation

o intermittent sedation

o neuromuscular blockade agents

o procedural sedation - minimal

o procedural sedation - moderate

o targeted temperature management (previously known as therapeutic hypothermia)

Behavioral and Psychosocial

• Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)

• Use behavioral exam tools (e.g., delirium, alcohol withdrawal, cognitive impairment)

• Recognize indications for, and manage patients requiring:

o behavioral therapeutic interventions

o medication management for agitation

o physical restraints



I. CLINICAL JUDGMENT (80%)

A. Cardiovascular (14%)

1. Cardiac infection and inflammatory diseases

2. Cardiac malformations

3. Cardiac surgery

4. Cardiogenic shock

5. Cardiomyopathies

6. Cardiovascular catheterization

7. Dysrhythmias

8. Heart failure

9. Hypertensive crisis

10. Myocardial conduction system defects

11. Obstructive shock

12. Vascular occlusion

B. Respiratory (18%)

1. Acute pulmonary edema

2. Acute pulmonary embolus

3. Acute respiratory distress syndrome (ARDS)

4. Acute respiratory failure

5. Acute respiratory infection

6. Air-leak syndromes

7. Apnea of prematurity

8. Aspiration

9. Chronic pulmonary conditions

10. Congenital airway malformations

11. Failure to wean from mechanical ventilation

12. Pulmonary hypertension

13. Status asthmaticus

14. Thoracic and airway trauma

15. Thoracic surgery



C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)

1. Endocrine

a. Adrenal insufficiency

b. Diabetes insipidus (DI)

c. Diabetic ketoacidosis (DKA)

d. Diabetes mellitus, types 1 and 2

e. Hyperglycemia

f. Hypoglycemia

g. Inborn errors of metabolism

h. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)

2. Hematology and Immunology

a. Anemia

b. Coagulopathies (e.g., ITP, DIC)

c. Immune deficiencies

d. Myelosuppression (e.g., thrombocytopenia, neutropenia)

e. Oncologic complications

f. Sickle cell crisis

g. Transfusion reactions

3. Gastrointestinal

a. Abdominal compartment syndrome

b. Abdominal trauma

c. Bowel infarction, obstruction and perforation

d. Gastroesophageal reflux

e. GI hemorrhage

f. GI surgery

g. Liver disease and failure

h. Malnutrition and malabsorption

i. Necrotizing enterocolitis (NEC)

j. Peritonitis

4. Renal and Genitourinary

a. AKI

b. Chronic kidney disease (CKD)

c. Hemolytic uremic syndrome (HUS)

d. Kidney transplant

e. Life-threatening electrolyte imbalances

f. Renal and genitourinary infections

g. Renal and genitourinary surgery

5. Integumentary

a. IV infiltration

b. Pressure injury

c. Skin failure (e.g., hypoperfusion)

d. Wounds



D. Musculoskeletal/Neurological/Psychosocial (15%)

1. Musculoskeletal

a. Compartment syndrome

b. Musculoskeletal surgery

c. Musculoskeletal trauma

d. Rhabdomyolysis

2. Neurological

a. Acute spinal cord injury

b. Agitation

c. Brain death

d. Congenital neurological abnormalities

e. Delirium

f. Encephalopathy

g. Head trauma

h. Hydrocephalus

i. Intracranial hemorrhage

j. Neurogenic shock

k. Neurologic infectious disease

l. Neuromuscular disorders

m. Neurosurgery

n. Pain: acute, chronic

o. Seizure disorders

p. Space-occupying lesions

q. Spinal fusion

r. Stroke

s. Traumatic brain injury (TBI)

3. Behavioral and Psychosocial

a. Abuse and neglect

b. Post-traumatic stress disorder (PTSD)

c. Post-intensive care syndrome (PICS)

d. Self-harm

e. Suicidal ideation and behavior



E. Multisystem (13%)

1. Acid-base imbalance

2. Anaphylactic shock

3. Death and dying

4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)

5. Hypovolemic shock

6. Post-transplant complications

7. Sepsis

8. Submersion injuries (i.e. near drowning)

9. Hyperthermia and hypothermia

10. Toxin and drug exposure



II. Professional Caring & Ethical Practice (20%)

A. Advocacy/Moral Agency

B. Caring Practices

C. Response to Diversity

D. Facilitation of Learning

E. Collaboration

F. Systems Thinking

G. Clinical Inquiry



CLINICAL JUDGMENT

General

• Manage patients receiving:

o continuous sedation

o extracorporeal membrane oxygenation (ECMO)

o nonpharmacologic interventions

o pharmacologic interventions

o intra-procedural and post-procedural care

o post-operative care

o vascular access

• Conduct physical exam of critically ill or injured patients

• Conduct psychosocial exam of critically ill or injured patients

• Evaluate diagnostic test results and laboratory values

• Manage patients during intrahospital transport

• Manage patients undergoing procedural sedation

• Manage patients with temperature monitoring and regulation devices

• Provide family-centered care Cardiovascular

• Manage patients requiring:

o arterial catheterization (e.g., arterial line)

o cardiac catheterization

o cardioversion

o CVP monitoring

o defibrillation

o epicardial pacing

o near-infrared spectroscopy (NIRS)

o umbilical catheterization (e.g., UVC, UAC)

• Manage patients with:

• cardiac dysrhythmias

• hemodynamic instability Respiratory

• Manage patients requiring:

o artificial airways (e.g., endotracheal tubes, tracheotomy)

o assistance with airway clearance chest tubes

o high-frequency oscillatory ventilation (HFOV)

o mechanical ventilation

o noninvasive positive-pressure ventilation (e.g., CPAP, nasal IMV, high-flow nasal cannula)

o prone positioning

o respiratory monitoring devices (e.g., SpO2, SVO2, EtCO2)

o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)

o thoracentesis

Hematology and Immunology

• Manage patients receiving:

o plasmapheresis, exchange transfusion or leukocyte depletion

o transfusion

Neurological

• Conduct pain exam of critically ill or injured patients

• Manage patients with seizure activity

• Provide end-of-life and palliative care

• Manage patients requiring:

o neurologic monitoring devices and drains (e.g., ICP, ventricular drains, grids)

o spinal immobilization Integumentary

• Manage patients requiring wound prevention and/or treatment (e.g., wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment)

Gastrointestinal

• Manage patients with inadequate nutrition and fluid intake (e.g., chewing and swallowing difficulties, alterations in hunger and thirst, inability to self-feed)

• Manage patients receiving:

o enteral and parenteral nutrition

o GI drains

o intra-abdominal pressure monitoring Renal and Genitourinary

• Manage patients requiring:

o electrolyte replacement

o renal replacement therapies (e.g., hemodialysis, CRRT, peritoneal dialysis)

Multisystem

• Manage patients requiring progressive mobility

Behavioral and Psychosocial

• Conduct behavioral exam of critically ill or injured patients (e.g., delirium, withdrawal)

• Manage patients requiring behavioral and mental health interventions

• Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)



I. CLINICAL JUDGMENT (80%)

A. Cardiovascular (5%)

1. Acute pulmonary edema

2. Cardiac surgery (e.g., congenital defects, patent ductus arteriosus)

3. Dysrhythmias

4. Heart failure

5. Hypovolemic shock

6. Structural heart defects (acquired and congenital, including valvular disease)



B. Respiratory (21%)

1. Acute respiratory distress syndrome (ARDS)

2. Acute respiratory failure

3. Acute respiratory infection (e.g., pneumonia)

4. Air-leak syndromes

5. Apnea of prematurity

6. Aspiration

7. Chronic conditions (e.g., chronic lung disease/bronchopulmonary dysplasia)

8. Congenital anomalies (e.g., diaphragmatic hernia, tracheoesophageal fistula, choanal atresia, tracheomalacia, tracheal stenosis)

9. Failure to wean from mechanical ventilation

10. Meconium aspiration syndrome

11. Persistent pulmonary hypertension of the newborn (PPHN)

12. Pulmonary hemorrhage

13. Pulmonary hypertension

14. Respiratory distress (RDS)

15. Thoracic surgery

16. Transient tachypnea of the newborn



C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (27%)

1. Endocrine

a. Adrenal insufficiency

b. Hyperbilirubinemia

c. Hyperglycemia

d. Hypoglycemia

e. Inborn errors of metabolism

2. Hematology and Immunology

a. Anemia

b. Coagulopathies (e.g., ITP, DIC)

c. Immune deficiencies

d. Leukopenia

e. Polycythemia

f. Rh incompatibilities, ABO incompatibilities, hydrops fetalis

g. Thrombocytopenia

3. Gastrointestinal

a. Bowel infarction/obstruction/perforation (e.g., mesenteric ischemia, adhesions)

b. Feeding intolerance

c. Gastroesophageal reflux

d. GI abnormalities (e.g., omphalocele, gastroschisis, volvulus, imperforate anus, Hirshsprung disease, malrotation, intussusception, hernias)

e. GI surgeries

f. Hepatic failure (e.g., biliary atresia, portal hypertension, esophageal varices)

g. Malnutrition and malabsorption

h. Necrotizing enterocolitis (NEC)

i. Pyloric stenosis

4. Renal and Genitourinary

a. Acute kidney injury (AKI)

b. Chronic kidney disease

c. Congenital genitourinary conditions (e.g., hypospadias, polycystic kidney disease, hydronephrosis, bladder exstrophy)

d. Genitourinary surgery

e. Infections

f. Life-threatening electrolyte imbalances

5. Integumentary

a. Congenital abnormalities (e.g., epidermolysis bullosa, skin tags)

b. IV infiltration

c. Pressure injury/ulcer (e.g., device, incontinence, immobility)

d. Wounds:

i. non-surgical

ii. surgical



D. Musculoskeletal/Neurological/Psychosocial (13%)

1. Musculoskeletal

a. Congenital or acquired musculoskeletal conditions

b. Osteopenia

2. Neurological

a. Agitation

b. Congenital neurological abnormalities (e.g., AV malformation, myelomeningocele, encephalocele)

c. Encephalopathy

d. Head trauma (e.g., forceps and/or vacuum injury)

e. Hemorrhage:

i. intracranial (ICH)

ii. intraventricular (IVH)

f. Hydrocephalus

g. Ischemic insult (e.g., stroke, periventricular leukomalacia)

h. Neurologic infectious disease (e.g., viral, bacterial, fungal)

i. Neuromuscular disorders (e.g., spinal muscular atrophy)

j. Neurosurgery

k. Pain (acute, chronic)

l. Seizure disorders

m. Sensory impairment (e.g., retinopathy of prematurity, hearing impairment, visual impairment)

n. Stress (e.g., noise, overstimulation, sleep disturbances)

o. Traumatic brain injury (e.g., epidural, subdural, concussion, physical abuse)

3. Behavioral and Psychosocial

a. Abuse and neglect

b. Families in crisis (e.g., stress, grief, lack of coping)



E. Multisystem (14%)

1. Birth injuries (e.g., hypoxic-ischemic encephalopathy, brachial plexus injury, lacerations)

2. Developmental delays

3. Failure to thrive

4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)

5. Hypotension

6. Infectious diseases (e.g., influenza, respiratory syncytial virus, multidrugresistant organisms)

7. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, maternal-fetal transfusion, placental
abruption, placenta previa)
8. Low birth weight/prematurity

9. Sepsis

10. Terminal conditions (e.g., end-of-life, palliative care)

11. Thermoregulation

12. Toxin/drug exposure (e.g., neonatal abstinence syndrome, fetal alcohol syndrome, maternal or iatrogenic).



II. Professional Caring & Ethical Practice (20%)

A. Advocacy/Moral Agency

B. Caring Practices

C. Response to Diversity

D. Facilitation of Learning

E. Collaboration

F. Systems Thinking

G. Clinical Inquiry



CLINICAL JUDGMENT

General

• Assess pain considering patients gestational age

• Follow protocol for newborn car seat testing, hearing and congenital heart disease screening

• Follow protocol for feeding and supplementation

• Identify and monitor normal and abnormal diagnostic test results

• Implement interventions to keep neonates safe (e.g., transponder use, safe sleep)

• Manage monitor alarms based on protocol and change in patient condition

• Manage patients receiving complementary alternative medicine and/or nonpharmacologic interventions

• Manage patients receiving medications (e.g., safe administration, monitoring, polypharmacy)

• Monitor patients and follow protocols for pre- and postoperative care

• Recognize indications for, and manage patients requiring, central venous access

• Recognize normal and abnormal:

o developmental exam findings and provide developmentally appropriate care

o family psychosocial exam findings

o physical exam findings

• Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed

Cardiovascular

• Apply leads for cardiac monitoring

• Identify, interpret and monitor cardiac rhythms

• Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability

• Recognize early signs of decreased cardiac output

• Recognize normal fetal circulation and transition to extra-uterine life

Recognize indications for, and manage patients requiring:

o 12-lead ECG

o arterial catheter

o cardioversion

o invasive hemodynamic monitoring Respiratory

• Interpret blood gas results

• Manage medications and monitor patients requiring rapid sequence intubation (RSI)

• Recognize indications for, and manage patients with, tracheostomy

• Recognize indications for, and manage patients requiring:

o assisted ventilation

o bronchoscopy

o chest tubes

o endotracheal tubes

o non-invasive positive pressure ventilation (e.g., bilevel positive airway pressure, CPAP, high-flow nasal cannula)

o oxygen therapy delivery device

o prone positioning (lateral rotation therapy)

o rescue airways (e.g., laryngeal mask airway [LMA])

o respiratory monitoring devices (e.g., SpO2, EtCO2) and report values

o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)

o thoracentesis

Hematology and Immunology

• Manage patients receiving transfusion of blood products

• Monitor and manage patients with bleeding disorders

• Monitor patients and follow protocols:

o pre-, intra-, post-intervention (e.g., exchange transfusion)

o related to blood conservation

Neurological

• Manage patients with congenital neurological abnormalities



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In the age of "Dr. Google," it can be tempting to click your way to self-diagnosis — but an overload of health information can cause its own set of symptoms.

"Cyberchondria," a subset of health anxiety, is described as a condition in which an individual excessively searches for health information online. 

While cyberchrondria may not start as a physical disease, it can cause intense levels of anxiety and fear that can negatively impact a person's health, according to Dr. Maggie Williams, a family physician in Scottsdale, Arizona, and medical director for MDLIVE Virtual Primary Care.

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Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said he and his colleagues used to call the condition "medical students' disease."

An overload of health information can cause its own set of symptoms called "cyberchondria," or heightened health anxiety.  (iStock)

"When you know a little, but not enough, you imagine you have everything and constantly worry," he told Fox News Digital.

Although cyberchondria is not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a formal diagnosis, it’s thought to be closely related to hypochrondria, a more general heightened anxiety about one’s health.

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In 2014, two U.K. researchers, Eoin McElroy and Mark Shevlin, created a "cyberchrondria severity scale" that measures a person's score across eight areas: compulsion, distress, excessiveness, reassurance seeking and mistrust of medical professionals.

Growing prevalence of cyberchrondria

As Siegel pointed out, the condition is becoming more common over time. 

"The invention of the internet and then the perfection of search engines created a global hypochondria, where patients searched to find possible explanations for their symptoms," he said.

"The invention of the internet and then the perfection of search engines created a global hypochondria, where patients searched to find possible explanations for their symptoms," a doctor told Fox News Digital. (iStock)

"It especially increased during the pandemic, when dogma abounded and everyone was suddenly an expert," Siegel added.

A study published in JIMR Formative Research last year found that COVID-19 caused a spike in the condition in spring 2020, as people experienced higher levels of "cyberchondria-related distress and compulsion during the pandemic."

"The invention of the internet and then the perfection of search engines created a global hypochondria, where patients searched to find possible explanations for their symptoms."

One user shared experiences with cyberchrondria on Reddit: "I thought that I might see something that will ease my mind, but … it makes it all worse and worse. Out of the 100 times I checked a symptom online, only 10 of them kinda made me feel safe."

Another user wrote, "I'm pretty sure I have this. The pandemic definitely made my health anxiety worse. Unfortunately, the pandemic also made it harder to get in to see a doctor in a timely manner and so the internet is the next logical place to look for answers."

In one study, more than half of respondents said they searched online instead of going to the doctor — and more than two in five turned to social media to ask about their symptoms. (iStock)

In a small study by MDLIVE Virtual Primary Care, more than half of respondents said they searched online instead of going to the doctor, and more than two in five (42%) turned to social media to ask about their symptoms.

Another 22% said they rely on artificial intelligence for medical answers.

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Nearly half of the 518 respondents, who provided data in August 2023, said they have misdiagnosed or mistreated an issue based on information they found online.

As Siegel warned, online medical information "isn't often accurate, and it isn't filtered, and it lacks clinical judgment."

Telltale signs of cyberchondria

Several signs may indicate that people are experiencing cyberchondria, Williams said.

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"Most people may not recognize the symptoms before it’s too late, after they’ve invested hours, delayed access to the doctor and worsened their overall anxiety," she told Fox News Digital.

One warning sign is spending one to three hours or more at a time searching for symptoms online.

A quarter of survey respondents said that when experiencing a health issue, they spend more than one hour searching for their symptoms online. (iStock)

A quarter of the survey respondents said that when experiencing a health issue, they spend more than one hour searching for their symptoms online.

Obsessive medical searches may also get in the way of day-to-day activities, Williams noted.

In the MDLIVE study, 41% of respondents said that compulsively searching for symptoms has gotten in the way of their daily tasks.

"Most people may not recognize the symptoms before it’s too late, after they’ve invested hours, delayed access to the doctor and worsened their overall anxiety."

"You may feel a compulsion to search online constantly, often rechecking symptoms multiple times, despite having completed an exhaustive search," Williams said.

Another symptom of cyberchrondria is high levels of distress and anxiety when searching for symptoms online — an rather than easing of concerns.

It’s best to consult with a health care professional at the onset of any symptoms, a doctor advised.  (iStock)

Fifty-eight percent of the participants in MDLIVE’s study said that searching online for their symptoms made them more anxious. 

"You may also have a heightened fixation on a particularly serious disease or condition, despite any evidence that you are suffering from it," Williams added.

Addressing or preventing cyberchondria

If you think you may be experiencing symptoms of cyberchondria, Williams said it’s important to set boundaries on the time spent searching for health information online. 

"Resist the urge to check and recheck symptoms," she advised.

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She also recommends avoiding "deep diving" into online forums or threads where people share "worst-case scenarios." 

"These tend to be exceptions rather than the rule, which can unnecessarily increase your anxiety," she said.

It’s best to consult with a health care professional at the onset of any symptoms, Williams advised. 

For those who might have trouble physically getting to a doctor’s office, a doctor suggested setting up a telehealth visit to address concerns in a timely manner, which will reduce the temptation to dive into online searching. (iStock)

"They can provide accurate information about your health concerns, potentially helping you to sidestep the slippery slope of cyberchondria," she said.

Siegel noted that as a physician, one of his jobs is to help patients sort through their fears and worries and put them in perspective of real risk and disease. 

"You may also have a heightened fixation on a particularly serious disease or condition, despite any evidence that you are suffering from it."

"This is even more the case with social media, where you end up searching through videos — especially TikTok — and become convinced you have a disease," he said. "This all increases anxiety and is bad for health."

For those who might have trouble physically getting to a doctor’s office, Williams suggested setting up a telehealth visit to address concerns in a timely manner, which will reduce the temptation to dive into online searching.

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It's important to address cyberchrondria seriously, just as you would with any other health issue, she said.

"If you're experiencing anxiety related to your health, you may find it helpful to speak with a mental health professional."

For people suffering from cyberchondria, experts recommend finding a trustworthy doctor who can guide them. (iStock)

While there are some reputable sources of health information on the internet, not all online information is factual or trustworthy.

"I still rely on the Centers for Disease Control and Prevention (CDC), National Institutes for Health, Mayo Clinic, NYU Langone and CIDRAP (Center for Infectious Disease Research and Policy)," said Siegel.

CLICK HERE TO GET THE FOX NEWS APP

That said, he warned that even vetted medical websites can still sometimes be wrong.

For those suffering from cyberchondria, Siegel advised them to find a doctor they can trust who can help guide them, while at the same time pulling back from online sources.

For more Health articles, visit www.foxnews.com/health.

Melissa Rudy is health editor and a member of the lifestyle team at Fox News Digital. 


Ozempic For Weight Loss: Cost, Side Effects And Efficacy

While Ozempic is not specifically labeled as a weight loss drug, studies sponsored by Novo Nordisk, the company that makes Ozempic, suggest people who take semaglutide—the active compound in Ozempic—may lose weight . In fact, the FDA approved semaglutide for weight loss in 2021 under the brand name Wegovy. However, Wegovy provides a higher dose of semaglutide than Ozempic—2.4 milligrams of semaglutide in Wegovy compared with 0.5 milligrams, 1 milligram or 2 milligrams of semaglutide in Ozempic.

As a GLP-1 receptor agonist, semaglutide enhances the effects of the naturally occurring hormone GLP-1. Dr. McGowan explains that in addition to its effects on blood glucose and diabetes, GLP-1 also impacts weight via two key mechanisms:

  • Affects the hunger centers in the brain (specifically, in the hypothalamus), reducing hunger, appetite and cravings
  • Slows the rate of stomach emptying, effectively prolonging fullness and satiety after meals
  • “The net result is decreased hunger, prolonged fullness and ultimately weight loss,” adds Dr. McGowan.

    In one large clinical trial sponsored by Novo Nordisk, 1,961 adults with excess weight or obesity who did not have diabetes were given 2.4 milligrams of semaglutide or a placebo once a week for 68 weeks, along with lifestyle intervention. Those who took semaglutide lost 14.9% of their body weight compared with 2.4% for those who took the placebo .

    It’s important to note that the dose of semaglutide used in this study was higher than the dose provided by Ozempic. However, 2.4 milligrams is the dose of semaglutide in the FDA-approved weight loss drug Wegovy.

    “Ozempic is FDA approved for the treatment of diabetes only. It is not a weight loss medication,” explains Dr. McGowan. “Its sister medication, Wegovy, is specifically approved for the treatment of weight,” he adds.

    Even though Ozempic and Wegovy are essentially the same medication (just available in different doses), it should be noted that while Ozempic is typically covered by insurance, often, Wegovy is not.

    High demand and subsequent inventory and supply chain strains have severely impacted the availability of Wegovy, notes Dr. McGowan. As a result, Wegovy has been repeatedly unavailable since its introduction and many people are turning to off-label use of Ozempic for weight loss. Dr. McGowan notes that this is interfering with the availability of Ozempic for those with diabetes.

    While taking semaglutide may help you lose weight while you are on the drug, most people will regain much of that weight if they discontinue using it. “Studies show that stopping Ozempic completely will likely lead to regaining most of the weight lost within several months,” notes Rekha Kumar, M.D., head of Medical Affairs at evidence-based weight care program Found, and practicing endocrinologist at an academic medical center in New York City.

    “GLP-1 medications [like Ozempic] are designed to be taken long-term,” explains Dr. McGowan. “They are chronic medications for the treatment of chronic conditions (both diabetes and obesity).”

    Is Ozempic Effective for Weight Loss?

    While Ozempic is not FDA-approved for weight loss, semaglutide, the active ingredient in both Ozempic and Wegovy (an FDA-approved weight loss medication), slows stomach emptying, which may decrease appetite.

    When combined with diet and exercise, semaglutide may promote weight loss and decrease the risk of cancer, diabetes and cardiovascular disease in individuals with obesity or overweight.

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