PT In ICU Flashcards
6 types of ICU
Trauma ICU Medical ICU Surgical ICU Neurosurgical ICU Cardiac Care Unit (CCU) Neonatal ICU
What should you be monitoring when a pt is in ICU?
Blood pressure
Cardiac function
Oxygen
Glucose (respiratory (rate CO2), temperature, ICP, CVP)
Two ways to monitor blood pressure?
Non invasive blood pressure cuff
Arterial line-invasive blood pressure monitoring
When you are measuring BP with an arterial line, what artery is the line inserted into?
Radial artery
Can be femoral, dorsalis pedis
When you are measuring BP with an arterial line, how is the wrist positioned?
Splinted in neutral
When you are measuring BP with an arterial line, what should you avoid in the wrist?
ROM and weight bearing
When you are measuring BP with an arterial line, where should the transducer be placed?
Level of R atria to be accurate
What does an ECG monitor?
heart rate and rhythm
Vary from 3-12 leads
Are they any mobility pxns when you have an ECG?
No specific mobility pxns
What does a swan ganz monitor?
Right heart, pulmonary artery/wedge pressure
What is a central line used for?
To administer meds, fluids, monitor CVP
Where is a swan ganz and central line inserted?
Into the neck
Where can pulse Ox be placed?
Fingers
Toes
Forehead
Ears
Reasons why pulse Ox may be innaccurate?
Cold hands
Moving
Poor contact btw sensor and skin
Nail polish
ICP can be monitored by what two ways?
Bolt
Ventriculostomy
Normal ICP should be what value?
Less than 15 mmHg
A ventriculostomy has the ability to…
Drain CSF from ventricle if ICP is high
Ventriculostomies are position dependent, true or false?
True
Drain must be clamped during mobilization
Must be recalibrated after session
Where is a lumbar drain inserted?
Between vertebrae into the spinal canal
What does a lumbar drain do?
Drains CSF
During mobilization, what must happen to the lumbar drain?
It must be clamped during mobilization
Femoral line- sheath may be used for procedures such as…
Cardiac cath
Angiogram
Femoral line, if sheath…. struck immobilization of ____
Hip
True or false: femoral line is not a contraindication to PT and we can exercise them.
False.
CONTRA
Femoral lines can be _____ or ______
Arterial or venous
Femoral lines are commonly used for….
Short term dialysis
Make sure that the line is intact prior to and after mobilization for femoral lines
True
What does CVVHD stand for?
Continuous veno-venous hemodialysis
What patients get CVVHD?
Critically ill patients with CRF
Where does the CVVHD usually access?
Jugular or femoral veins
Mobility with CVVHD is contraindicated, true or false?
False. It appears feasible and safe
What does ECMO stand for?
Extracoporeal membrane oxygenation
Is an ECMO, patients blood is ______
_____ is removed from the blood and the ______ are oxygenated
Removed
CO2
RBCs
When is a ECMO used?
When convention methods for cardiac and respiratory failure are unsuccessful
Where is access for ECMO?
Can be VA (venoatrial)
VV (venovenous)
and either
Femoral or jugular
Can be do mobility during ECMO?
Studies coming out showing feasibility during ECMO
Where are chest tubes inserted?
Inserts into pleural space
Chest tubes are used to drain….
To prevent…
Fluid/blood
To prevent lung from collapsing
Chest tubes can be placed to…
Suction or water seal