Week 6 - ICU Flashcards
examples of aspects to consider in ICU
level of consciousness
Imaging
pain level
vital signs variability
Lines
Imaging - lab results
constant checking and updates
blood work multiple times a day
Lines
IV lines
catheter
chest tube
ventilator line and machine
feeding tube
oxygen line
holder monitor
Prescribed levels of activity
Activity as tolerated
positioning
Activity As Tolerated
AAT
bedrest
begin their early ICU mobility
decreased cognition and/or delirium
acute change in cognition
OTA PTA in ICU`
functional mobility
basic ADLs
endurance
splinting
positioning
pressure injuries
comfort care
cognitive stimulation
Positioning to prevent
contractures
joint deformity
pain:
bed
w/c
special equipment
Comfort care
keeping pt. comfortable with positioning when nearing the end of their life
Delirium
start is usually rapid - w/in hours or few days
disturbance in mental abilities
confused thinking
reduced awareness of environment
recovery can take months, may linger for years after
contributing factors in ICU
immobility
pain
metabolic imbalances
medications/drug toxicity
sleep deprivation/disturbances
infection/sepsis
Metabolic imbalance examples
DKA
Hyponatremia
Thyroid dysfunction
Medications/drug toxicity
benzodiazepines
narcotics
DKA
Diabetic ketoacidosis
most common in type 1 diabetes
Hyponatremia
sodium level in blood is below normal
Thyroid dysfunction
too much or too little important hormones
benzodiazepines
slows brain activity
produces drowsy or calming effect
Narcotics
severe pain relievers
CAM
outcome measure for identifying delirium at bedside
often done by nurses
results are documented in chart
screening of delirium
CAM positive
CAM negative
Consequences of immobility
Integumentary
Neuromuscular
cardiovascular/respiratory
musculoskeletal
Integumentary
skin
pressure injuries
Neuromuscular
Muscle atrophy
musculoskeletal
bones weaken
pressure injuries - most common spots
heels
ankles
hips
tailbone
warning signs of pressure ulcers
unusual changes in skin colour or texture
swelling
pus-like draining
area of skin feeling cooler or warmer to the touch than other areas
tender areas
Pressure injury - Stage 1
non-blanchable erythema of intact skin
Pressure injury - Stage 2
partial thickness skin loss with exposed dermis
first layer is off/open
Pressure injury - Stage 3
full thickness skin loss
Pressure injury - Stage 4
a bite out of skin without showing tendons or bones
unstageable pressure injury
tendons and bones exposed
Pressure injury - deep tissue
persistent non-blanchable deep red, maroon, or purple discoloration
OTA PTA role with pressure injuries
positioning schedule
education
follow ups on safe use of equipment
delivery and set up of specialized equipment preventing further skin breakdowns.
Education to…
client
staff
family
how often should a patient reposition in bed?
every 2 hours at least
how often should a patient reposition in a wheelchair/chair
every 15 mins
sitting push ups
leaning to side or forward
ICU beds
auto lateral shifts
easier transfers in/out of bed
chair position
