adult health 2 exam 1

what is light sedation

it is when the pt is alert and can respond to verbal commands

what is light sedation used for

mechanical ventilation

what is moderate sedation

it is when the pt can respond to verbal cues; movement

what is moderate sedation used for

Diagnostic procedures and minor surgical procedures

ex: endoscopy, cath lab

what is deep sedation

pt is not awake or alert and only responds to painful stimuli

what is the priority concern if a pt reaches deep sedation

AIRWAY

-make sure the airway is patent if this occurs

what is level of sedation is the goal in nursing

light to moderate

what is a daily wake up assessment

it is an assessment used for ventilator pts where ALL sedative medication is stopped

-this is usually done everyday in the morning

what is the purpose of a daily wake up assessment

-to prevent sedative dependence and withdrawal

-assess neurological status to see if there has been any changes to baseline

-determine if pt is ready to come off the vent

what is the protocol for restarting the sedation after the daily wake up assessment

start at a lower dose and titrate up gradually

-usually 50% lower than the dose given before

what is ventilator desynchrony

is when a pt is not tolerating the ventilator well

what medication is not given for pts who are agitated

Benzos

-they induce delirium

what are some prevention techniques for delirium

-light sedation for mechanical vent pts

-daily wake up assessment

-daily delirium assessment and monitoring

-early mobility

-sleep hygiene (ex: ear buds, limit light, shut curtains, etc.)

why is alcohol withdrawal syndrome and delirium tremens a concern for ventilated pts

because we may not realize a pts dependence on alcohol until they are taken off of the ventilator and they start to become and agitated and aggressive

what is delirium tremens

hyperactive agitated delirium that is caused by alcohol withdrawal

what is the first line medication given for pts going through alcohol withdrawal syndrome or delirium tremens

long acting benzos

when assessing a critical care pt who can't verbally express pain, what should the nurse always be assessing for a root cause of pain?

IV site

what are signs of opioid overdose

first sign: confusion/altered LOC

-lethargy/unable to arouse

-decreased SPO2

-increased etCO2

late sign: respiratory depression

what pts are more at risk for opioid overdose

-older pts

-obesity

-sleep apnea

-decreased kidney function

-opioid naive pts