ISSUES RELATED TO FAMILIES
Family members play a valuable role in the patient’s recovery and should be considered
members of the health care team. They contribute to the patient’s well-being by:
o Providing a link to the patient’s personal life
o Advising the patient in health care decisions or functioning as the decision maker
when the patient cannot
o Helping with activities of daily living
o Providing positive, loving, and caring support
To provide family-centered care effectively, the nurse must be skilled in crisis
intervention.
o Interventions can include active listening, reduction of anxiety, and support of
those who become upset or angry.
o Other health team members (e.g., chaplains, psychologists, patient
representatives) may be helpful in assisting the family to adjust and should be
consulted as necessary.
The major needs of families of critically ill patients have been categorized as
informational needs, reassurance needs, and convenience needs.
o Lack of information is a major source of anxiety for the family. The family needs
reassurance regarding the way in which the patient’s care is managed and decisions
are made and the family should be invited to meet the health care team members,
including physicians, dietitian, respiratory therapist, social worker, physical therapist,
and chaplain.
o Rigid visitation policies in ICUs should be reviewed, and a move toward less
restrictive, individualized visiting policies is strongly recommended by the AACN.
o Research has demonstrated that family members of patients undergoing invasive
procedures, including cardiopulmonary resuscitation, should be given the option of
being present at the bedside during these events.
HEMODYNAMIC MONITORING
Hemodynamic monitoring refers to the measurement of pressure, flow, and oxygenation
within the cardiovascular system. Both invasive and noninvasive hemodynamic
measurements are made in the ICU.
Values commonly measured include systemic and pulmonary arterial pressures, central
venous pressure (CVP), pulmonary artery wedge pressure (PAWP), cardiac output/index,
stroke volume/index, and oxygen saturation of the hemoglobin of arterial blood (SaO )2
and mixed venous blood (SvO ).
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