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Critical Care.docx

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University of Calgary
NURS 201
Marywyatt Sindlinger

Critical Care  Critical care units or intensive care units (ICUs) are designed to meet the special needs of acutely and critically ill patients.  ICU care has expanded from delivering care in a standard unit to bringing ICU care to patients wherever they might be. o The electronic or virtual ICU is designed to augment the bedside ICU team by monitoring the patient from a remote location. o The rapid response team, composed of a critical care nurse, a respiratory therapist, and critical care physician or advanced practice nurse, goes outside the ICU to bring rapid and immediate care to unstable patients in non–critical care units.  Progressive care units, also called high-dependency units, intermediate care units, or stepdown units, serve as transition units between the ICU and the general care unit or discharge. o The American Association of Critical Care Nurses’ (AACN) offers certification for progressive care nurses (PCCN) working with acutely ill adult patient.  The critical care nurse is responsible for assessing life-threatening conditions, instituting appropriate interventions, and evaluating the outcomes of the interventions. o Critical care nursing requires in-depth knowledge of anatomy, physiology, pathophysiology, pharmacology, and advanced assessment skills, as well as the ability to use advanced biotechnology. o The AACN offers critical care certification (CCRN) in adult, pediatric, and neonatal critical care nursing.  Advanced practice critical care nurses have a graduate (master’s or doctorate) degree and are employed in a variety of roles: patient and staff educators, consultants, administrators, researchers, or expert practitioners. o A clinical nurse specialist (CNS) typically functions in one or more of these roles. Certification for the CNS in acute and critical care (CCNS) is available through the AACN. o An acute care nurse practitioner (ACNP) provides comprehensive care to select critically ill patients and their families that includes conducting comprehensive assessments, ordering and interpreting diagnostic tests, managing health problems and disease-related symptoms, and prescribing treatments. Certification as an ACNP is available through the AACN. COMMON PROBLEMS OF CRITICAL CARE PATIENTS  Nutrition: o The primary goal of nutritional support is to prevent or correct nutritional deficiencies. This is usually accomplished by the early provision of enteral nutrition (i.e., delivery of calories via the gastrointestinal [GI] tract) or parenteral nutrition (i.e., delivery of calories intravenously). o Parenteral nutrition should be considered only when the enteral route is unsuccessful in providing adequate nutrition or contraindicated (e.g., paralytic ileus, diffuse peritonitis, intestinal obstruction, pancreatitis, GI ischemia, intractable vomiting, and severe diarrhea).  Anxiety: o The primary sources of anxiety for patients include the perceived or anticipated threat to physical health, actual loss of control or body functions, and an environment that is foreign. o Assessing patients for anxiety is very important and clinical indicators can include agitation, increased blood pressure, increased heart rate, patient verbalization of anxiety, and restlessness. o To help reduce anxiety, the nurse should encourage patients and families to express concerns, ask questions, and state their needs; and include the patient and family in all conversations and explain the purpose of equipment and procedures. o Antianxiety drugs and complementary therapies may reduce t
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