By Janice Jones PhD RN CNS, Brenda Fix MS RN NP
A DAVIS'S NOTES BOOK!This pocket-sized speedy reference is your go-to consultant for the medical info you must take care of grownup sufferers appropriately and successfully.
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Extra info for Critical Care Notes: Clinical Pocket Guide
Monitor respiratory rate and respiratory effort, respiratory depression, BP, HR. Sedation Assessment Scales Sedation-Agitation Scale (SAS) Score Level of Sedation-Agitation 7 Dangerous agitation 6 Very agitated 5 Agitated 4 3 Calm and cooperative Sedated 2 Very sedated 1 Unarousable Response Pulling at endotracheal tube, thrashing, climbing over bed rails Does not calm, requires restraints, bites endotracheal tube Attempts to sit up but calms to verbal instructions Obeys commands Difficult to rouse, obeys simple commands Rouses to stimuli; does not obey commands Minimal or no response to noxious stimuli Reprinted with permission from Riker, R.
Patients with delirium have higher ICU and hospital stays along with a higher risk of death. It is characterized by an acute onset of mental status changes that develop over a short period of time, usually hours to days. It may fluctuate over the course of a day. It may be combined with inattention and disorganized thinking or altered level of consciousness. The DSM IV describes three clinical subtypes: hyperactive, hypoactive, and mixed. Hyperactive delirium may be confused with anxiety and agitation.
Place TPN on infusion pump. Monitor hourly rate. Never attempt to “catch up” if infusion not accurate. ■ Patients generally are taken off of TPN prior to surgery. Complications Complications from TPN may be catheter-related, mechanical, or metabolic. 6 mmol/L Infectious Diseases Critical Care Risk Factors ■ ■ ■ ■ ■ Invasive devices Immunocompromising conditions Serious underlying illness Prolonged stay in critical care unit Colonization and cross-infection 26 27 ■ Overuse of antibiotics ■ Elderly Methicillin-Resistant Staphylococcus aureus (MRSA) Etiology Health-care associated bloodstream and catheter-related infections.