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DEPARTMENT OF NURSING EDUCATION & HEALTH STUDIES NURSING 3910 INTENSIVE CARE UNIT (ICU) WELCOME TO THE INTENSIVE CARE UNIT This handout is meant to help prepare you for your Observational Day in the ICU. There are many dimensions to the role of the nurse in the ICU environment and this handout will outline some of the major nursing responsibilities that are included in the ICU nursing scope. Please use this handout to become familiar with some of the essential concepts of Critical Care Nursing in Intensive Care and as a learning tool while you are enjoying your time in the ICU. DEVELOPED: 2012-02-23 [1] DEPARTMENT OF NURSING EDUCATION & HEALTH STUDIES NURSING 3910 INTENSIVE CARE UNIT (ICU) LEARNING OBJECTIVES & CRITICAL THINKING QUESTIONS 1. What are some physical, psychological, social and environmental issues that contribute to critical illness? How can multisystem disorders impact the physiological condition of the critically ill patient? 2. What are some of the common complications and needs of critically ill clients? What are some priority nursing interventions required to manage care for critically ill clients? 3. Discuss the principles of hemodynamic monitoring. What is involved in the nursing management of a client receiving hemodynamic monitoring? What are some diagnostic and circulatory monitoring devices used to maintain homeostasis in the critically ill client? 4. Describe the different types of artificial airways that are used in the ICU? What nursing interventions are necessary to manage care of an intubated client? What are some complications associated with artificial airway management? 5. Describe the principles of mechanical ventilation. What are the indications for and the modes of mechanical ventilation? What nursing interventions are necessary to manage a client receiving mechanical ventilation? What are some complications associated with mechanical ventilation? 6. What is the process of “weaning” a patient from mechanical ventilation? How does a nurse assess the readiness of a critical ill patient to resume spontaneous ventilation? What nursing assessments and management is involved in reducing ventilator support? 7. What are some strategies to manage issues related to the families of critically ill clients? What are some therapeutic communication techniques a nurse could use with an individual and family in crisis? How can a nurse apply the concept of holism to the critical care client? 8. Why is multidisciplinary and collaborative care integral to the ICU environment? What disciplines make up the multidisciplinary team and what are their primary roles in the ICU? 9. The role of a Critical Care Nurse can be very stressful and requires the ability to continually recognize signs of stress in self and others. What are some signs of burnout in the critical care area related to physical, cognitive, emotional, behavioral, and spiritual wellbeing? 10. In Canada, there are several colleges and universities that offer Critical Care Certification Programs, as well as a CNA Critical Care Nursing Certification. What is the process for completing these certifications? What are some of the benefits of this certification? Do you think all nurses working in a Critical Care Area should be certified? Why or why not? DEVELOPED: 2012-02-23 [2] DEPARTMENT OF NURSING EDUCATION & HEALTH STUDIES NURSING 3910 INTENSIVE CARE UNIT (ICU) 11. Complete the following chart: TYPE OF PROCEDURE/TREATMENTS DESCRIPTION INDICATION(S) COMMON MEDICATIONS COMMON COMPLICATIONS INTUBATION / EXTUBATION CARDIOVERSION TRANSESOPHAGEAL ECHOCARDIOGRAM (TEE) ARTERIAL LINES DEVELOPED: 2012-02-23 [3] DEPARTMENT OF NURSING EDUCATION & HEALTH STUDIES NURSING 3910 INTENSIVE CARE UNIT (ICU) ICU OBSERVATIONAL EXPERIENCE OVERVIEW Often times, a day in the ICU can be overwhelming, fast-paced, and can take you through a number of learning experiences; many of which you may not have the time to reflect upon or even be able to remember. Use this section of the handout to document some of the specifics of your day in the ICU. ICU TEAM BUDDY NURSE UNIT MANAGER CLINICAL COORDINATOR UNIT CLERK PHYSICIAN INTERNAL MED. RESIDENT FAMILY MED. RESIDENT RESPIRATORY THERAPIST PHARMACIST DIETICIAN PT/OT SPEECH THERAPIST OTHER PATIENT INFORMATION PATIENT # 1 PATIENT # 2 DEVELOPED: 2012-02-23 [4] DEPARTMENT OF NURSING EDUCATION & HEALTH STUDIES NURSING 3910 RECOVERY ROOM – CRITICAL THINKING QUESTIONS PERSONAL LEARNING PROCEDURES OBSERVED WHAT I LIKED MOST ABOUT THE ICU OVERALL THOUGHTS FOR THE DAY References: Lewis, S. M., Heitkemper, M., Dirksen, S. R., Barry, M., Goldworthy, S., & Goodridge, D. (2010). Medical-surgical nursing in Canada: Assessment and management of clinical problems (2nd ed.). St. Louis: Mosby. DEVELOPED: 2012-02-23 [5]