Module A Introduction To Critical Care, Advanced Pain & Fluid N Electrolytes

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Module A

Introduction to Critical Care, Advanced Pain & Fluid ‘n Electrolytes

Roy Model- Oxygenation-Perfusion

Required Readings (see syllabus for details)


Lewis, Heitkemper & Dirksen, (Current Ed.). Medical- Surgical Nursing.
a. Critical Care – basic concepts of ICU
b. Stress – understanding of the GAS theory and effect of stress on illness
c. Pain – difference between acute/chronic pain, age appropriate care, treatment
d. Advanced Fluid ‘n Electrolyte concepts

Additional required articles will be found on Etudes

Recommended Reading
Pharmacology, Nutritional, and Physiology reference books

Theory Objectives
1. Discuss three aspects of intensive care settings and supportive rationales.
2. Discuss the relationship of the critically ill client in selected case situations and
their placement on the health-illness continuum.
3. Identify the physiological and psychological concepts that are pertinent in caring
for the critically ill client.
4. Describe ineffective and adaptive responses of the critically ill client and their
significant others.
5. Identify stimuli influencing behaviors in the critically ill client
6. Discuss ways in which the nurse can intervene to alleviate or decrease the effect
of stressors in the critical care environment
7. Discuss principles of therapeutic communication in the critical care setting.
8. Discuss advanced concepts of pain management for the critically ill client.
9. Identify goals of therapy in care of the critically ill client.
10. Evaluate coping mechanisms and support systems utilized by individuals and
families in crisis.

Clinical Objectives:
1. Examine the critical care experience and manage the needs of the critically ill
patient and family.
2. Manage the care of a patient/ family that is experiencing stressors by
appropriately incorporating interventions such as relaxation, exercise, meditation,
and effective communication to facilitate adaptation.
3. Manage the care of a client with fluid ‘n electrolyte disturbances.
Drugs
Pain medications- Demerol, Morphine, Dilaudid plus Versed, Vistaril, Robinol
Diet
Diet as tolerated, Concept of small frequent meals
Lab
Electrolytes, Coagulation studies, Liver function profiles, Complete Blood Panel

Critical Thinking Question


1. Your client is an 45 year old female who was admitted with a subarchnoid bleed. Her
prognosis looks dim, the husband keeps repeating how much he loves her and that
she has been his sweetheart since high school. He refuses to leave the room, has
gotten minimal sleep the last 3 days, and hardly eaten. He refuses pastoral care
and says, “I am not giving up on my wife.” You are the intensive care nurse, what
would be your priority nursing diagnosis and interventions for this family?
2. You are working in a step down unit caring for a post-operative open heart client. It is
post-operative day 3 and the nurse during change of shift says to you, “he has a
drug history and is constantly asking for pain meds.” What assessment for this
client look like and what would be the nurse’s priority?

Key Terms
Stress and Adaptation
Review the General Adaptation Syndrome (GAS) theory by Hans Selye
Think about risk factors, patient presentation, nursing interventions

Advanced Pain Concepts


Facts and figures
Myths and Misconceptions associated with pain
Joint Commission/ Accreditation standards
Differentiate between chronic and acute pain and treatment options

Fluid ‘n Electrolytes
Volume imbalances- high or low
Electrolytes high/ low- Potassium, Sodium, Magnesium, Calcium, Phosphate

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