ICU Flashcards
Telemetry is
remote monitoring of vital signs. The monitor will show at least one view of the electrocardiogram (EKG) with the heart rate, respiratory rate, the oxygen saturation (SpO2), and blood pressure
the monitor may also display the output of any other measuring devices attached to the patient, like arterial line blood pressure, pulmonary artery pressure (Table 9.3), intracranial pressure, and electroencephalogram leads
Hemodynamic monitoring refers to
monitoring the functioning of the cardiovascular system. At its most basic, it is the monitoring of blood pressure and heart rate, but it may also include levels of fluid input and output, mental status, and the internal pressures and efficacy of the heart. In general, the more invasive and extensive measures taken for monitoring a patient, the more tenuous the cardiovascular status.
Normal blood pressure ranges from
90 to 160 mm Hg systolic and 60 to 80 mm Hg diastolic.
Systolic blood pressure is the
highest pressure of blood flow within arterial vessels that occurs during the contraction of the ventricles of the heart.
Diastolic blood pressure is the
lowest pressure within arterial vessels during a ventricular cycle.
The National Guideline Clearinghouse (n.d.-b) recommends involving rapid response team intervention for blood pressures
80 mm Hg or 180 mm Hg systolic and 100 mm Hg diastolic
Orthostatic measurements are taken
while supine, then sitting, and last while standing at 1- and 3-minute intervals.
A patient is considered to be orthostatic when there is
a drop in systolic blood pressure of 20 mm Hg, a drop in diastolic blood pressure of 10 mm Hg, or a heart rate increase of at least 20 bpm
mean arterial pressure (MAP),
a measurement of the average pressure in the major arteries. It is an in- dicator of the heart’s ability to perfuse the body’s tissues, particularly organs
Closely monitoring heart rate during therapy interventions is critical in the ICU. Normal resting heart rates are between
60 and 100 bpm
What numerically is considered bradycardia, or a slow heart rate.
<60 bpm
What numerically is tachycardia, or a rapid heart rate
A resting heart rate 100 bpm
The clinical indicators for initiating rapid response team intervention is a heart rate
40 or 160, or a heart rate 140 with symptoms
What are the symptoms that would require rapid response team intervention
Symptoms might include palpitations, dizziness, chest pain, shortness of breath, diaphoresis, or altered mental status.
Cerebral perfusion pressure (CPP) is an
indirect measure of cerebral tissue perfusion.
What numeric cerebral perfusion pressure (CPP) is associated with poor outcomes in patients with traumatic brain injury?
50 mm Hg or 70 mm Hg
Inter cranial pressure (ICP)
is the amount of pressure within the cranium.
A typical inter cranial pressure (ICP) goal is
20 mm Hg to 25 mm Hg (Kirkman & Smith, 2014 Zoerle et al., 2015), but the parameters may be notably different for TBI or acute hemorrhagic or ischemic stroke
Yankauer
used to suction excess oral secretions
Temporary external pacemakers are most commonly found in patients after heart surgery. Why?
help keep the heart rate stable
Sepsis is a
systemic inflammatory response to infection.
Secondary injury is
damage to the brain structures that occurs after the primary injury.
Examples of secondary injury causes are
brain tissue edema, increased ICP, seizure activity, impaired airway protection and hypotensive episodes, all of which may result in decreased oxygenation or decreased perfusion of brain tissue.
ICU-acquired weakness (ICU–AW) is defined by the American Thoracic Society (2014) as
generalized limb weakness developed during critical illness for which there is no explanation except the critical illness itself.
