Exam1 1- Foundations Flashcards
Autonomy
Self determination
Justice
Fair & equitable
Beneficence
doing good
Nonmaleficence
Prevent harm
Veracity
Truth
Fidelity
Faithfulness
Malpractice
Professional negligence
- duty
- breach/failed
- causation
- injury
Informed consent
*Competence, Voluntariness, disclosure
understanding
decision
authorization
Physiologic Alterations
- Increased catabolism
- insulin resistence ->hyperglycemia
- decreased immune & allergic response
- sodium & water retention, inc. blood volume
- increased metabolic rate
To correct Hypoxia
- Give oxygen
- monitor saturation
- may need intubation and mechanical ventilation
Improve CO
optimize preload, contractility, and afterload
antidysrhythmics, fluids/diuretics, inotropes, vaodilators, correct electrolyte imbalance
Improve oxygen carrying capacity
blood/blood products
Decrease metabolic demands
relieve pain, reduce anxiety, keep warm & dry, control fever, allow rest, suction if needed, use sedation or neuromuscular blockade
Psychosocial alterations are influenced by
culture developmental stage general health social support personality financial resources, and previous experiences
Alterations in consciousness
- Alteration in circadian rhythms
- Sensory deprivation and overload
- ICU syndrome
- Medications, intoxications
- Fluid & electrolyte disturbances
- hypoxia, decreased CO
- infection
- age >60
- sleep pattern disturbances
- nutritional deficiencies
- metabolic or endocrine disorders
- brain injury or neruological disorder
Depolarizing tranquilizer
Succinylcholine (Anectine, Etomidate)
Nondepolarizing tranquilizer
Pancuronium (pavulon), vercuronium (norcuron)
Malignant hyperthermia
106F caused by genetic defect in muscle cell membrane
- seizure
- muscle rigidity
- massetor
- triggered by gases and stress
Malignant hyperthermia Tx
Dantrolene 2-3mg/kg, up to 10mg/kg
Stop gas, give 100% O2, cool down, relax muscle reaction
-Life-threatening up to 72hr post op
Thorazine
Hiccups
Neostigmine
Urine retention
Demerol
shivers
Professional organization
AACN - association
CCRN - certification
competency
CCRN
Certification >1080hr competence
Standards of practice
Nursing process, ADPIE
Assessment, diagnosis, planning, implementation, evaluation
Commission
Act of negligence that is “done”
Omission
Act of negligence that is not done (when it should have been)
breach of duty
injury results
causation
nurse actually caused injury to pt
Damage
Death?
Abandonment
unilateral severance of relationship when client still needs care
Elements of informed consent
competence, voluntariness, disclosure
Stressors for staff
OT
Technology
Stressors for client
sleep deprivation sensory overload powerlessness altered circadian rhythm invasive lines
ICU Psychosis (ICU syndrome)
48hr post admission, resolves 48hr post discharge -perceptual distortions -decreased attention span -disorientation -Memory loss labile emotions
Nutrition
pre albumin check for changes
serum albumin check for malnutrition
Response to acute illness or injury
culture, developmental stage, resources
Pain management
FLACC Mankowski Wong baker TO4-check for twitches BIS- EEG
Unstable client
Fentanyl- short-acting
Milky (MOA), lasts 12hrs
propofol
Short term sedation DO NOT USE FOR HEAD TRAUMA
versed, Romasicom
Pre-op meds
Dry out
-atropine/robinul/scopalomine
Ulcers, acidity
-nexium, pepcid, zantac
