common problems of the critically ill patient
TRANSCRIPT
-
8/4/2019 Common Problems of the Critically Ill Patient
1/19
-
8/4/2019 Common Problems of the Critically Ill Patient
2/19
INFECTION
NSG. INTERVENTION
a. Monitoring for signs and symptoms ofinfection.
b. Culture and sensitivity results.
c. Administering appropriate antibiotics.
-
8/4/2019 Common Problems of the Critically Ill Patient
3/19
NUTRITION
NSG. MANAGEMENT:
Provide enteral or parenteral feedings.
Monitoring weight,albumin, and nitrogenbalance.
-
8/4/2019 Common Problems of the Critically Ill Patient
4/19
IMMOBILITY
Documents complication like pressureulcers, deep vein thrombosis, pulmonarycomplication, muscle wasting.
Observe strict repositioning schedule.
Do chest physiotherapy.
-
8/4/2019 Common Problems of the Critically Ill Patient
5/19
Assess regularly for discomfort by theuse of visual aid or pain scale.
Request for analgesics available for 24
hrs.
-
8/4/2019 Common Problems of the Critically Ill Patient
6/19
ANXIETY
Symptoms:
a. Tachycardia
b. Tachypnea
c .Restlessness
d. Inability to sleep
e. Diaphoresis
-
8/4/2019 Common Problems of the Critically Ill Patient
7/19
Administering anxiolytics drugs
Encouraging unrestricted visitation byfamily members.
Providing therapeutic communication.
Using guided imagery.
Communicating the treatment plan.
Offering music therapy.
Spending extra time with the patient.
-
8/4/2019 Common Problems of the Critically Ill Patient
8/19
Keeping social conversation andlaughter to a minimum and decreasingtelephone ring volumes.
Help control environment noise bylowering alarm volumes.
-
8/4/2019 Common Problems of the Critically Ill Patient
9/19
SLEEP
Nurse must minimize unecessary noiseand lights and recognize any importantnightime rituals.
Perform necessary assessments andprocedures while allowing a minimum oftwo hrs. of uninterrupted sleep.
-
8/4/2019 Common Problems of the Critically Ill Patient
10/19
COMMUNICATION
Modalities of communication includes:
a. Picture board
b. Paper and pen
c. Agreed on gestures
-
8/4/2019 Common Problems of the Critically Ill Patient
11/19
Reasons for communicating withventilated responsive patient:
Experiences of pain
Identifying patients emotion
Determining patients symptoms
Responding to patients needs for
physical care
The physical environment of the ICU
The patients home and family
Treatment decision making
-
8/4/2019 Common Problems of the Critically Ill Patient
12/19
Purpose of communicating sedatedand unresponsive patient:
Provide orientation
State procedural and task intentions
Provide reassurance
Apologize and or recognize discomfort
Obtain response
Provide intention and unintentionaldistraction
-
8/4/2019 Common Problems of the Critically Ill Patient
13/19
Family members needs
There are five needs by most families
a. Reassurance
b. Flexible visitation
c. Information
d. Comfort
e.support
-
8/4/2019 Common Problems of the Critically Ill Patient
14/19
CONCERNS OFCRITICALLY ILLPATIENTS
-
8/4/2019 Common Problems of the Critically Ill Patient
15/19
BEING THIRSTY
HAVING TUBES IN THEIR MOUTHAND NOSE
NOT BEING ABLE TO COMMUNICATE BEING RESTRICTED BY TUBES OR
LINES
BEING UNABLE TO SLEEP NOT BEING ABLE TO CONTROL
THEMSELVES
-
8/4/2019 Common Problems of the Critically Ill Patient
16/19
RECOMMENDED FIVEEVIDENCED-BASEDINTERVENTION TOFACILITATE
COMMUNICATION WITHMECHANICALLYVENTILATED:
-
8/4/2019 Common Problems of the Critically Ill Patient
17/19
Be educated about the frustration thatmechanically ventilated patientsexperienced when they are attempting tocommunicate their needs and desires.
When communicating with ventilatedpatients they should:
a. Routinely ask patients about their feelingsand their state of mind.
-
8/4/2019 Common Problems of the Critically Ill Patient
18/19
b. Ask permission before beginningnursing care and procedures.
c. Evaluate patients understanding of the
information conveyed by asking simpleyes or no question.
Demonstrate attention to the needs oftheir patients by informing them of their
surroundings, plan of care, and whenthey will return after leaving the bedside.
-
8/4/2019 Common Problems of the Critically Ill Patient
19/19
Approach each patient with a kind, patientmanner : take time to investigate andunderstand what the patient is
communicating : and respond to thepatients communicated needs.
Provide writing materials and read thepatients words as they are written,
allowing the patients to verify that thereader understands the patient correctly.