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PCM FINAL REVIEW > Special Considerations in the ICU > Flashcards

Special Considerations in the ICU Flashcards

1
Q

What are considerations for acute care?

A
  • medical history
  • current illness
  • medical stability (vitals)
  • sedation/level of alertness
  • cognition
  • prior level of function (PLOF)
  • Cognition
  • Activity tolerance to perform mobility and ADLs
  • strength to perform mobility and participate in ADLs
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2
Q

What are guideline for treating in the ICU concerning equipment?

A

Observe the type and location of the equipment or devices being used by the patient

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3
Q

What should we identify concerning the tubes in the ICU?

A
  • the location of all tubes, monitor lead connections, IV line connections, and insertion sites
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4
Q

What should all tubes and lead be free from?

A

Occlusion and tension

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5
Q

What should we observe during our treatment in the ICU?

A

The patient and be monitoring devices frequently; determine the response to the treatment; identify significant change in the patients condition or physiologic status

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6
Q

What should we notify nursing of when treating in the ICU?

A

Significant change in the patient’s condition or physiologic status

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7
Q

What are some examples of equipment we may see when treating in the ICU?

A
  • ventilator
    -IV line
  • oxygen
  • urinary catheter
  • arterial line
  • supplemental nutrition
  • suction
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8
Q

What does the physiological monitoring system tell us?

A

The cardiac and vital signs

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9
Q

What does an arterial pressure (A line) monitor?

A

blood pressure constantly

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10
Q

What are some monitoring systems that are looking at cardiac pressure?

A
  • central venous pressure (CVP)
  • Indwelling right atrial catheter (Hickman catheter)
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11
Q

What does an IV line provide?

A

Medication, fluids

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12
Q

What type of patient will need an arterial line?

A

patients with consistent blood draws

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13
Q

What is a PICC line?

A

Peripheral Inserted Central Catheter - prolonged IV antibiotics

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14
Q

What type of patient commonly has a central venous catheter?

A

Chemotherapy patients

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15
Q

What does mechanical ventilation do?

A

Sends a controlled flow of oxygen into a patient’s lungs

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16
Q

What can be adjusted with mechanical ventilation?

A
  • rate
  • pattern
  • duration of gas exchange
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17
Q

What are the 3 types of mechanical ventilation?

A
  • assist control
  • synchronized intermittent mandatory ventilation
  • pressure support ventilation
18
Q

What are some examples of a noninvasive mechanical ventilation?

A
  • NC
  • Face mask
  • CPAP (continuous positive airway pressure)
19
Q

What are some invasive mechanical ventilation methods?

A

Endotracheal tube (ETT)
nasotracheal
tracheostomy

20
Q

What is an oxygen therapy system?

A

Supplemental oxygen is indicated when concentrations of inspired oxygen are insufficient for respiration- patients are at risk for hypoxia and hypoxemia (<90%)

21
Q

What are modes of delivery for oxygen therapy?

A
  • nasal canula
  • face mask
  • nonrebreather
  • tracheostomy
  • CPAP
  • Bilevel positive airway pressure (BiPAP)
22
Q

What are some precautions and considerations when working with someone on mechanical ventilation?

A
  • positioning of tubes, lengths
  • energy level
  • maintaining open tubing, preventing occlusion
  • not stepping over lines
  • keeping lines above everything else
23
Q

What type of precautions would someone with a postsurgical drain have (usually)?

A

Abdominal precautions

24
Q

What is an ostomy device?

A

Opening in abdomen to allow elimination

25
Q

What are the 3 types of ostomies?

A
  • colostomy
  • ileostomy
  • Urostomy
26
Q

What are chest drainage systems used for?

A

To remove air, blood, or other undesirable matter from the patient’s chest or pleural cavity

27
Q

Where are tubes for an air chest drainage system positioned?

A

Anterior or lateral chest wall to remove air

28
Q

Where are tubes for fluid chest drainage positioned?

A

Posterior and inferior chest wall to remove fluids and blood

29
Q

What are urinary catheters used for?

A

To alleviate urinary retention, rebuild bladder muscle tone, collect urine output and cultures, and manage bladder conditions

30
Q

What are the two types of urinary catheters for males?

A
  • indwelling (foley) catheter through the urethra
  • condom catheter
31
Q

What are some of the different types of feeding devices?

A
  • nasogastric tube (NG tube)
  • Gastrostomy tube (G - tube)
  • total parenteral nutrition (TPN)
32
Q

How do we monitor intracranial pressure (ICP)?

A

Monitor screwed into skull between the arachnoid membrane and cerebral cortex to measure ICP

33
Q

What is normal ICP?

A

5 to 10-15 mmHG

34
Q

What medical interventions are there for ICP?

A
  • external ventricular drain (EVD)
  • Ventriculoperitoneal shunt (VP)
35
Q

Where is an EVD placed?

A

In the lateral ventricle to relieve ICP, hydrocephalus or CSF

36
Q

When is an EVD used?

A

After a hemorrhage

37
Q

What do we do with the EVD before patient mobility?

A

Clamp it!

38
Q

What is a swan-ganz catheter?

A

Placed in the pulmonary artery for cardiac function monitoring

39
Q

What does a swan Ganz catheter monitor?

A

pulmonary artery pressure, right atrium pressure, pulmonary wedge pressure, etc.

40
Q

What do we do if we have uncertianty about equipment?

A

Check with nursing or a more experienced therapist for guidance

41
Q

When do we check a patient’s status?

A

EACH TIME we see them - conditions can change hour by hour

42
Q

Research indicates that early mobilization leads to …

A

Better outcomes!!

PCM FINAL REVIEW (5 decks)

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