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Medical-Surgical Nursing, 11th Ed., Harding, Kwong, Roberts, Hagler & Reinisch
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65 - Critical Care

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Medical-Surgical Nursing, 11th Ed., Harding, Kwong, Roberts, Hagler & Reinisch | Registered Nurse (RN) School Study Aid

65 - Critical Care
28 Picmonics to Learn | 47 mins
Neurovascular Assessment 6 P's
Pain
Paresthesia
Pulse
Pallor
Pressure
Paralysis
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1 min
Chest Tubes: Management and Care
Confirm suction order
Assessment
Crepitus
Kinking
Shortness of Breath (SOB)
Infection
Excessive bubbling
Quick Interventions
If tube dislodges from patient, use petroleum gauze taped 3 ways
If drainage system is damaged, place disconnected drainage tube in sterile water
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1 min
Glasgow Coma Scale
LOC Assessment
Score of 3 to 15
8 or Less = Coma
Eye Opening
Verbal Response
Motor Response
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1 min
Oxygen Delivery Methods
Nasal Cannula
Simple Face Mask
Non-Rebreather Mask
Venturi-Mask
Safety Precautions
Oxygen In Use Sign
No Electrical Sparks
Six Feet Away from Open Flames
Nursing Considerations
Dry Nasal and Upper Airway Mucosa
Skin Irritation
Home Education
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1 min
Tracheostomy Care
Inner Cannula Removed and Cleaned
Clean Q8 Hours Around Stoma
One Finger Under Ties
Considerations
Speak with Deflated Cuff
Can Eat with Tube in Place
Keep Replacement Tube Nearby
Immediately Replace if Dislodged
Physician Does First Tube Change
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2 mins
Burns Assessment
Stage and Extent of Burn
Dyspnea
Singed Nasal Hairs
Pain
Initial Decrease Urinary Output
Paralytic Ileus
Signs of Inadequate Hydration
Shock
Hypothermia
Hyperkalemia
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2 mins
Burns Interventions
Ensure Airway Patency
O2
IV Fluid Replacement
Dry Sterile Dressing
Debridement
Elevate Burned Limbs
Analgesics
Silver Sulfadiazine
Escharotomy
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2 mins
Rule of 9's for Burns
Total Body Surface Area (TBSA)
Head
Anterior Torso (18%)
Chest
Abdomen
Posterior Torso (18%)
Upper Back
Lower Back
Extremities
Posterior Leg (each)
Anterior Leg (each)
Each Arm
Genitalia 1%
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2 mins
Parkland Formula
Burn victims
24 hours
TBSA% x Weight x 4 = Fluids
TBSA %
x Weight (kg)
x 4
= Fluid Requirement (in first 24 hrs)
Fluids in first 8 hours
1/2 of fluid given in first 8 hours
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1 min
Burns Considerations
Maintain Body Temperature
Increased Risk of Infection
Venous Thromboembolism (VTE) Prophylaxis
Curling's Ulcer
Excision and Grafting
Adequate Nutrition
Contractures
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2 mins
Wound Drainage Types and Devices
Drainage Types
Serous
Serosanguineous
Sanguineous
Purulent
Drainage Devices
T-tube
Penrose
Jackson-Pratt (JP)
Hemovac
Considerations
Record Drainage Amounts
Check Device Function
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2 mins
Parts of an ECG
PQRST
P Wave
Atrial Depolarization
QRS Complex
Ventricular Depolarization
T Wave
Ventricular Repolarization
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2 mins
ECG Interpretation
Rate
Rhythm
P Waves
Upright, Rounded, Before Every QRS
PR Interval (< 0.20 seconds)
Normal QRS (< 0.12 seconds)
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2 mins
ECG: Sinus Bradycardia
Rate
< 60 bpm
Rhythm
Regular
P Wave
Present, Upright, Every QRS
PR Interval
< 0.20 seconds
QRS Interval
< 0.12 seconds
Treatment
Atropine
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1 min
ECG: Sinus Tachycardia
Rate
> 100 bpm
Rhythm
Regular
P Wave
Present, Upright, Every QRS
PR Interval
< 0.20 seconds
QRS Interval
< 0.12 seconds
Treatment
Treat Underlying Cause
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2 mins
ECG: Atrial Fibrillation
Rate
Variable Rate
Rhythm
Irregular Rhythm
P Wave
No P Wave
PR Interval
No PR Interval
QRS Interval
QRS < 0.12 Seconds
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1 min
ECG: Atrial Flutter
Rate
Variable
Rhythm
Regular or Irregular
P Wave
Saw Tooth, Multiple Before Every QRS
PR Interval
Non-measurable
QRS Interval
< 0.12 seconds
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2 mins
12 Lead Contiguous Leads - Anterior Wall MI
Leads Elevated
Lead V3
Lead V4
Artery Affected
Left Anterior Descending (LAD)
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56 secs
12 Lead Contiguous Leads - Septal Wall MI
Elevated Leads
Lead V1
Lead V2
Artery Affected
Left Anterior Descending (LAD)
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48 secs
12 Lead Contiguous Leads - Inferior Wall MI
Leads Elevated
Lead II
Lead III
Lead aVF
Artery Affected
Right Coronary Artery (RCA)
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56 secs
12 Lead Contiguous Leads - Lateral Wall MI
Leads Elevated
Lead I
Lead aVL
Lead V5
Lead V6
Artery Affected
Circumflex
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1 min
Obstructive Sleep Apnea (OSA)
Cause/Mechanism
Narrowed or Obstructed Air Passage
Assessment
Apnea
Loud Snoring
Startle Response
Daytime Drowsiness
Interventions
Positional Therapy
Oral Appliance
Continuous Positive Airway Pressure (CPAP)
Surgery
Considerations
Weight Loss
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3 mins
Interventions for Impaired Skin Integrity
Assessment
Signs of Skin Breakdown
Pain
Redness
Decreased Skin Turgor
Bleeding
Bony Prominences
Intervention
Reposition Q2H
Pressure Relief
Maintain Clean and Dry Skin
Adequate Nutrition and Hydration
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2 mins
Types of Wound Healing
Types of Wounds
Acute
Chronic
Healing Process
Primary Intention
Approximated Edges
Secondary Intention
Edges Not Approximated
Tertiary Intention
Delayed Closure due to Infection and Necrosis
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2 mins
Patient Position Overview
Position Techniques
Trochanter Roll
Trapeze Bar
Ankle-Foot Orthotic (AFO) Devices
Positions
Fowlers Position
Supine Position
Trendelenburg
Side-Lying Position
Prone Position
Sims' Position
Nursing Considerations
Reposition q2 Hours/Prevent Skin Breakdown
Confirm Body Alignment
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2 mins
Stages of Hypothermia
Mild
32 to 35°C (90 to 95°F)
Shivering
Moderate
28 to 32°C (82 to 90°F)
Obvious Motor Impairment
Slowed Thinking
Severe
< 28°C (< 82°F)
Shivering Stops
Paradoxical Undressing
Arrhythmias
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3 mins
Severe Sepsis and Septic Shock Assessment
Microthrombi
DIC
Decreased Oxygen Saturation
Decreased WBC
Oliguria
High Output Heart Failure
Multiple Organ Failure
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2 mins
Hypothermia Interventions
Remove From Environment
Remove Wet Clothing
Passive Rewarming
Warm Clothing
Active Rewarming
Heated Blankets
Warm IV Solutions
Heated Oxygen
Warm Gastric Lavage
Considerations
Warm Trunk BEFORE Extremities
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2 mins

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