Med/Surg III Quiz #1 Review

what is the main purpose of critical care certification?

to validate the RN’s knowledge

what are implemented to ensure that care is appropriate and based on research?

Clinical Practice Guidelines

AACN Standards of Professional Practice (ethics)

discussing advance directives with the family and MD (or interdisciplinary team)

National Patient Safety Goals (name 3)

identifying patients correctly, safe medication administration, preventing infection and surgical mistakes (time-out) alarm safety

which organization supports critical care nurses?

AACN - American Association of Critical Care Nurses

Name 3 frequent stressors for critically ill patients

Alarms
Sounds
Lights

Bonus: Lack of a sleep from sedation

What is are some examples of interventions that support the family in a critical care environment? (3)

communicating with the family at a set time
Using simple terminology (lack of medical jargon)
determine family’s level of understanding

Communication with the family practices (hitn: VALUE)

V - value family’s input
A - acknowledge their emotions
L - listen to their concerns
U - understand the patient as a person
E - elicit questions from the family

Power of attorney

Document that grants authority to a trusted person to oversee monetary and business related possessions for the patient

Advance Directive

Document that addresses the medical treatment the patient wants or does not want especially in the event of a critical status (ex. DNR, will)

Healthcare Proxy

Document that grants a trusted person of the patient access to their medical history and diagnosis as well as input in medical decisions within the limits of the advance directives

POLST

portable medical order

specific instructions that must be carried out by the emergency team when a critical crisis occurs (ex: intubation) + work alongside advance directives

Palliative care

comfort care that is utilized for patients who are/aren’t in critical condition + more aggressive in life-sustaining
(ex: treatment of nausea for cancer patients)

Hospice care

comfort care or end-of-life care for patients who are expected to live for less than 6 months (ex: pain medication)

Predisposition of pain/and or anxiety in the critical patient

being restrained/unable to move freely

Pain definition

subjective experience of discomfort

Agitation

the emotional discomfort that may cause aggression or disorganized thinking

Delirium

Acute change in mental status due to a physiological or neurological concern

ABCDEF

Strategies of how to work well in the critical care environment

Assess
Both awakening and breathing trials
Choice of sedation
Delirium Assessment
early mobility
family engagement

Ethical Principles

Autonomy
Beneficence
Nonmaleficence
Justice
Veracity
Fidelity
Confidentially

Autonomy

patients have the right to make their own decisions and they should be respected

Beneficence

healthcare workerss have a duty to do good and work in the best interest of the patient

Nonmaleficence

healthcare workers must do no harm to the patient and prevent injury during practice

Justice

medical resources and care must be distributed fairly and equitably

Veracity

the truth must always be told in patient, interdisciplinary, and documentation settings

Fidelity

any issued promises must be upheld and loyalty must be kept

Confidentiality

every patient is entitled to their own privacy of their medical records and are protected by HIPPA

Catheter ablation purpose

treats dysrhythmias when medication and cardioversion aren’t effective

Catheter ablation mechanism

permanently interrupt electrical activity within the heart tissue

Examples of indications for catheter ablation (4)

VT
Afib
A flutter
symptomatic paroxysmal a fib

What baseline data should be obtained before catheter ablation? (5)

12-lead ECG
coagulation profile and use of anticoagulation or antiarrhythmic meds
electrolytes
BUN/creatinine
cardiac imaging

Immediate post-procedure protocols for catheter ablation (3)

monitor femoral/groin access site for hematoma, active bleeding, bruit
evaluate peripheral perfusion
monitor for cardiac tamponade, stroke/embolism

Patient education for catheter ablation (3)

avoid strenuous exercise
reinforce medical adherence to antiplatelets, anticoagulants, antiarrhymic drugs
keep insertion site clean and dry, monitor for signs of infection