Chapter 2 Flashcards
Unexpected, life-threatening
events.
Critical Illness
Disrupts patient and family
equilibrium.
Critical Illness
ICU from Different Perspectives
- Safeguarding fragile lives
Nurses
Perception of Critical Illness
- Mixed feelings;
sometimes a hint of impending
death.
Patients/Families
Perception of Critical Illness
- Communication Challenges (3)
Physiological barriers, verbal
restrictions (e.g., tubes), cognitiveaffecting drugs.
Memories of ICU Stay
- Fear, pain, anxiety
Negative
Memories of ICU Stay
- Feelings of safety, trust in
nurses.
Positive
Memories of ICU Stay (2)
Negative
positive
ICU from Different Perspectives (2)
Nurses
Patients/Families
Disequilibrium caused by
stressors (Selye, 1956).
Stress
Physiologic &
Psychological triggers.
Stressors
Environment & Implications
- Rich with stressors affecting
patients & families
ICU
Environment & Implications
- Compromised wholeness,
security, and control. Increases
vulnerability and potential mortality
Effects
Stimulates hypothalamus-pituitaryadrenal axis.
Stress Physiology & Acute Response
Stress Physiology & Acute Response
- norepinephrine and epinephrine
release.
Fight-or-flight mechanism
Fight-or-flight mechanism stages
Alarm
Resistance
(potential) exhaustion
Stress for the Patient (2)
Environment & Implications
Stress Physiology & Acute Response
Stress for the Family
- Critical conditions affect a family’s
emotional well-being.
Immediate Impacts
Immediate Impacts Anxiety Signs (2)
Physiologic
Behavioral
Stress for the Family
- Unfamiliar settings and equipment
escalate fear.
ICU’s Stressful Ambiance
Stress for the Family
- Health care team’s focus might
neglect the family’s emotional state.
ICU’s Stressful Ambiance
Stress for the Family
- Potential strained dynamics with
health care staff.
ICU’s Stressful Ambiance
Stress for the Family
- Sudden events disrupt routines,
thrusting families into crisis.
Family’s Adaptation & Decision Making
Stress for the Family
- Family cohesion and problemsolving shape coping mechanisms.
Family’s Adaptation & Decision Making
Stress for the Family
- Acknowledges and empathizes
with family’s fear and anxiety
Role of the Nurse
Stress for the Family
- Understands the adaptive nature of
the stress response.
Role of the Nurse
Stress for the Family (4)
Immediate Impacts
ICUs stressful ambiance
Family’s Adaptation & Decision Making
Role of the Nurse
Environmental Stressors in the ICU (2)
Noise
Lighting
Environmental Stressors in the ICU
- Noise sources (3)
Equipment, staff, alarms
Environmental Stressors in the ICU
- Noise consequences (3)
Sleep disruptions,
heightened stress, impaired
healing
Environmental Stressors in the ICU
- Importance in maintaining circadian
rhythms
Lighting
Environmental Stressors in the ICU
- Lighting issues (3)
Bright artificial lights, lack of
natural views, disrupted sleep
patterns.
Creating a Healing Environment
- Florence
Nightingale emphasizes holistic
care nurturing the whole person
Foundational Insight
Creating a Healing Environment
- Marrying
advanced technology with
psychological needs. Solutions
include restful interventions, music,
and mindfulness
Contemporary Challenge
Creating a Healing Environment
- A
2014 initiative to reimagine a more
patient-centric ICU.
The Humanization Movement
Creating a Healing Environment
- Eight Pillars of Humanizing ICU
Care
o Open visitation.
o Effective communication.
o Prioritizing patient wellbeing.
o Engaging relatives.
o Support for healthcare staff.
o Addressing post-ICU
challenges.
o Patient-friendly design.
o Comprehensive EOL care.
Nursing Interventions for the Patient
-Creating a Healing Environment (3)
Foundational Insight
Contemporary Challenge
The Humanization Movement
Promoting Rest and Sleep in the ICU
- Types of Sleep (2)
REM and NonREM