| 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| Awareness stage manifestations | Demanding and angry or quiet and withdrawn |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Withdrawn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 |
