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Critical Care
overview
Question | Answer |
---|---|
The first intensive care units emerged | in the 1950s as a means to provide care to very ill patients who needed one-to-one care from a nurse. |
Critically ill are defined as | those patients who are at high risk for actual or potential life-threatening health problem |
Critical care nurses should intervene | when the best interest of the patient is in question. |
Critical care nurses should act as | a liaison between the patient, the patient's family and other healthcare professionals ADVOCATE! |
What are Suchmans Stages of Illness? | Shock and Disbelief Denial Awareness Restitution Resolution |
Shock and Disbelief stage definition | Definition: Diagnosis does not have meaning |
Shock and Disbelief stage manifestations | Manifestations: Patient may be uncooperative or worry excessively |
Shock and Disbelief stage interventions | Provide accurate information when asked |
Denial stage definitions | Patient rejects diagnosis |
Denial stage manifestations | Patient may act like nothing is wrong |
Denial stage interventions | Nurse is non critical; clarify statements but do not stress reality |
Awareness stage definition | Attempt to regain control |
Awareness stage manifestations | Demanding and angry or quiet and withdrawn |
Awareness stage interventions | Provide consistent nursing care, do not argue with patient |
Restitution definition | Diagnosis is accepted |
Restitution stage manifestations | Sadness and crying; attempt to improve relationships with family and friends |
Restitution stage interventions | Assist patient with problem solving |
Resolution stage definition | patient's identity is changed |
Resolution stage manifestations | patient may openly participate in care |
Resolution stage interventions | promote self-care and independence |
Psychosocial concerns of patient | Concerned Lives turned upside down Changes in eating, sleeping, activity Missed work Fear Role changes Loss of control |
What is ICU delirium? | a disorder in which patients in an intensive care unit (ICU) or a similar setting experience a cluster of serious psychiatric symptoms. |
ICU Psychosis | Acute, transient disturbance of consciousness and cognition in critically ill patients Each additional day of delirium associated with 10 % increased risk of death |
Signs and Symptoms of ICU psychosis | Apathetic Withdrawn Less responsive Mistaken for depression Difficulties with concentration, memory, and sleep. |
ICU psychosis often vanishes magically with | with the coming of morning or the arrival of some sleep. |
Signs and symptoms of ICU delirium | Disorientated Agitated Moody Difficulty following simple directions Hallucinations Crawl over bed rails Wander halls Pull out tubes and lines Abusive |
Causes of delirium/psychosis | Increased age Immobility Undertreated pain Multiple medications Fluid and electrolyte imbalances Sleep deprivation Drug and alcohol use Sensory deprivation Cerebral hypoperfusion |
Treatment for delirium/psychosis | Encourage sleep Engage the patient Meet physical needs Involve family Continuity of care Educate |
Meds for delirium/psychosis | Haldol Risperidone Seroquel Zyprexa |