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Critical Care


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Awareness stage manifestations Demanding and angry or quiet and withdrawn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Signs and Symptoms of ICU psychosis Apathetic Withdrawn Less responsive Mistaken for depression Difficulties with concentration, memory, and sleep.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
Created by: UARN85