NCM 118 - Critical Care Nursing

Critical Care

A specialized field of nursing focused on the care of patients with life-threatening conditions that require comprehensive monitoring and advanced medical interventions. Patients here often suffer from severe illnesses or injuries, such as respiratory failure, sepsis, multi-organ dysfunction, or major trauma.

Critical Care Units

Meaning of CCUs

Acuity

The level of severity of a patient's condition, often used to assess the need for critical care.

Intensive Care Unit (ICU)

Critical Care Unit (CCU) is also called?

Advanced Monitoring Systems

Technologies used to continuously track vital signs and detect early signs of patient deterioration.

Preload

VOLUME of blood in the ventricles at the end of diastole, influencing stroke volume and cardiac output.

Central Venous Pressure (CVP) or Right Atrium (RA) monitoring device

What advanced monitoring system measures preload?

Nitroglycerin
Diuretics (furosemide)
Morphine (decreasing venous return)

What lowers preload? (NDM)

Afterload

RESISTANCE the heart must overcome to eject blood during systole, which can be influenced by vascular tone and total blood volume.

Systemic Vascular Resistance (SVR) or invasive devices such as arterial catheters

What monitoring system measures afterload?

Hypertension

In afterload, increased resistance lead to?

Anaphylactic shock

In afterload, decreased resistance lead to?

Ace (-pril)
ARBs (-artan)
Beta blockers (-olol)

Antihypertensive medications (Vasodilators) that helps heart pump blood properly.

Epinephrine
Norepinephrine
Dopamine

These are vasopressors used in critical care to increase blood pressure and manage shock.

4.8 or 5-6L/min

Normal cardiac output

2.5-4L/min

Normal cardiac index

Cuff leak
Displacement

Mechanical ventilation low pressure alarm indicates only these and the rest are high pressure

Manual resuscitation bag and reintubation equipment

What should be kept at bedside in mechanical ventilation patients?

LOC, ABGs, Vital Signs

As a nurse caring for a patient under mechanical ventilation, what factors would you need to monitor?

24 hours

A nurse caring for a patient under mechanical ventilation must suction secretions, provide oral care, and reposition ET tube every ___ to prevent skin breakdown.

Compressions, airway, breathing

American Heart Association (AHA) guidelines changed ABC into CAB which stands for?

2RN, Head/supervisor, Doctor

In blood transfusion, verifications/signatures are needed from these people.

Life-Support Equipment

Devices such as ventilators, dialysis machines, and infusion pumps used to support failing organs and manage patient care.

Sterile Environment

Maintaining a _______ is essential to prevent infections in immunocompromised or vulnerable patients.

Accessibility

The unit is designed for easy access to patients by healthcare staff, with space for quick intervention and emergency procedures.

Patient Anxiety, Family Support, and Staff Well-being

Psychological Environment in CCUs that is just important as the physical ones.

Hemodynamics

The study of blood flow and the forces involved in circulating blood throughout the body.

Blood Pressure

The force of blood against the walls of arteries, which is a critical indicator of circulatory health.

Cardiac Output

The amount of blood the heart pumps per minute, essential for adequate tissue perfusion.

Central Venous Pressure (CVP)

The pressure in the thoracic vena cava near the right atrium, indicating venous return and right heart function.

Pulmonary Artery Pressure (PAP)

The pressure in the pulmonary artery used to assess left heart function and pulmonary circulation.

pulmonary artery catheters

In critical care, hemodynamic monitoring may involve non-invasive methods like blood pressure cuffs or more invasive techniques such as arterial lines and _______. The data collected from these methods help guide interventions such as fluid administration, vasopressor support, and mechanical ventilation adjustments.

Patient assessment and monitoring, administering medications, communication, and emergency response, documentation and reporting, and education and support

Role of Critical Care Nurse in a Critical Care Unit Setting

Patient Assessment and Monitoring

The continuous observation of a patient’s vital signs, neurological status, and overall condition in critical care.

Administering Medications and Treatments

The process of delivering complex medication regimens and managing life-support equipment in critical care.

Family Support

Providing emotional support and updates to the families of critically ill patients to help them cope.

Patient Anxiety

The feelings of fear and confusion that patients may experience due to their critical condition.

Documentation and Reporting

The accurate recording of patient status and interventions essential for continuity of care.

Critical Care Unit (CCU)

A specialized area in a hospital where critically ill patients receive intensive monitoring and care.

Intensive Care Unit (ICU)

An area of a hospital specifically equipped for the treatment of critically ill patients.

Septic Shock

What problem has the hallmark sign of hypotension that does not respond to fluid resuscitation?

Mechanical ventilation

In patient experiencing acute respiratory distress syndrome (ARDS), what is the most appropriate oxygen delivery method?

Semi-flower’s position

What is the correct positioning for client with increased ICP?

Ventricular Fibrillation (V-fib)

Which rhythm requires immediate defibrillation?

Vasopressors

Nursing intervention for neurogenic shock

Hypovolemic shock (dehydration)

In patients with burns covering more than 20%, what is the most important concern?

Restlessness

Which indicates early hypoxia in critically ill patients?

Calcium gluconate

What is the treatment for hyperkalemia with ECG changes?

Nitroglycerine
Diuretics (furosemide)
Morphine

These are medications used to manage heart failure and relieve symptoms related to preload or increased fluid volume.

Blood Urea Nitrogen and Creatinine

Acute kidney injury elevated lab value

Pulmonary embolism

The patient in ICU has dyspnea, tachypnea, and pleuritic chest pain. These are the hallmark symptom of?

Left lateral trendelenburg

Intervention for air embolism

Amylase and Lipase

Acute pancreatitis most indicative lab value

Air leak

continuous bubbling in chest tube indicate

Adenosine

Treatment of SVT

0.9% normal saline

First line fluid therapy for Sepsis

Naloxone (Narcan)

Treatment of opioid overdose in critical care

Radial Artery

Which artery is most commonly used for ABG in critical care?

Fluid overload

Elevated central venous pressure indicate

Aspirin

What first treatment an acute myocardial infarction patient can tolerate?

Pulmonary artery (PA) catheter

Provides detailed information on cardiac output, pulmonary pressures, and left ventricular function

nitroprusside (direct-acting)

Which intervention is most appropriate for a patient experiencing a hypertensive crisis?

Epinephrine

No. 1 treatment for anaphylactic shock

Hyponatremia

Low sodium levels in the blood

Blue

What color in code management indicates a cardiac arrest or respiratory arrest situation?

White

What color in code management indicates a seizure, fall, and patient desaturation?

Violet

What color in code management indicates a violent patient/relative/staff?

Pink

What color in code management indicates a baby switching?

Orange

What color in code management indicates a radioactive spill?

Situation
Background
Assessment
Recommendation

SBAR communication stands for?

IV line

The nurse who performed CPR becomes the medication nurse and stand near the ____ to administer drugs.

Correct depth of compression

Proper rate of compression

Full chest recoil

Minimal pause

Adequate ventilation

5 Qualities Of A Good CPR

Private Duty Nurse

If the relatives did not consent to transfer critical patient in the ICU, require a PDN (________) to allow patient in the ward only.