Lets Explore the ICU

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• Lets Explore the ICU

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What is the Purpose of the ICU?

• To provide ___________________ intensive
  ________________ and treatment of patients seven
  days a week.

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The ICU Health Care Team

• ____________________
• ____________________
• Nurses
• Physicians (IM, Pulmonary, etc.)
• _____________________
• Respiratory therapists
• Other medical consultants from a broad range of
  specialties including surgery, ____________,
  anesthesiology, and ________________

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Intensive Care Unit

• Where do the patients come from?
• The general hospital floors
• __________________
• _____________ from other hospitals nursing
  homes
• _______________________
• _________________ bypassing the ER

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Intensive Care Unit

• What types of patients would you see?
• Post heart surgery MIs
• Renal and Liver failure _________________
• Pulmonary embolism _________________
• ________ ___________________
• Arrhythmias Suicidal
• ______________ coma ARDS

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Equipment

• The monitors are your second major bedside
  assessment tool the first is your ___________.

• What is on the monitor screen?
• EKG
• Heart rate
• Blood pressure
• Arterial pressure
• O2 Saturation
• Respirations

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EQUIPMENT cont.

• _______________ a machine designed to
  mechanically move breathable air into and out of
  the _____________.

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• CHEST TUBES
• a flexible plastic tube that is inserted through
  the side of the ______________ into the _________
  space to drain _________, body ___________ or
  ____________

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LARYNGOSCOPE ETT

• _________________ An instrument that helps in
  intubation for mechanical ventilation.
• ________________ Tube inserted into a patient's
  __________ in order to ensure that the airway is
  not closed off and that air is able to reach the
  _________. Regarded as the most reliable
  available method for ____________ a patient's
  airway.

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CRASH CART

• A set of trays/drawers/shelves on wheels used in
  hospitals for transportation and
  __________________ of emergency
  __________/equipment at the site of the emergency
  for ________ _________________.
• Includes
• Defibrillator with pads
• AMBU bag
• Medications
• IV equipment
• Normal Saline
• Procedure kits
• Oxygen tank
• And much more

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Central IV Lines

• A catheter placed into a large vein in the
  __________ (internal jugular vein),__________
  (subclavian vein) or ________ (femoral vein).
• It is used to administer ____________ or fluids,
  obtain _________ tests and directly obtain
  cardiovascular _____________________ (central
  venous pressure).

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LABS

• _______________ mostly draw the labs
• Similar labs to those drawn in the ER
• Common Labs Include
• ABGs (drawn by the _____________ usually)
• Evaluates the respiratory effort
• _______________ levels
• Chemistry
• _________________--Fibrinogen, Prothrombin
• __________________proteins released into the
  bloodstream when heart muscle damage occurs

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Intensive Care Unit

• What are the routines of the ICU?
• Report, assessment, ____________________
• Record info flow sheets, ______ sheets,
  _______________ totals, lab results,
  ________________
• ________________
• KARDEX
• Carrying out orders
• Documentation ______________
• Administering ________________

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Intensive Care Unit

• How does the ICU affect the family members?
• Feelings of __________________
• Scared and afraid
• ________________
• Inquisitive
• _________________

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Intensive Care Unit

• How to care for the family members?
• Practice _________________ Care!!!
• Be ___________________
• EDUCATE, EDUCATE, ________________
• ___________________ needs
• Keep them _____________

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Whats next?

• Transfer to _____________
• Take to _________________
• Discharge (rare)

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• What are some important facts to consider before
  going into an ICU as a student?

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Intensive Care Unit

• There is more than one type of ICU? WHAT?

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Whats a NICU?

• Neonatal Intensive Care Unit/Special Care Nursery
• For _________________ and __________________ term
  infants
• Different levels of care for newbornsLevels
  I-III
• Level I Lowest level of care
  (_____________________)
• Level II ______________ careIV fluids,
  __________, feeder growers, CPAP, ________ wks
  gestation or greater
• Level III Highest level of care
• __________ weeks gestation or greater (generally)
• Ventilators
• Surgeries (sometimes in the unit!)_______________
  _______
• Nitrous oxide therapy, Extra Corporeal Membrane
  Oxygenation (ECMO) __________________________

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Who works there?

• Pediatricians
• ____________________
• NNPs, PNPs
• Nurses
• OT _______________
• ________ (positioning, massage)
• ____________________
• Respiratory Therapy

• Pharmacist
• Pharmacy Technicians
• ____________________
• Chaplains
• And more!

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Why do we need a special ICU for infants?

• In premature infants, every body system is
  ___________________
• What problems do you think that a baby would have
  with each body system?
• Nervous?
• Cardiovascular?
• GI?
• Immune?
• Endocrine?
• Respiratory?
• Musculoskeletal?
• Reproductive?
• Urinary?

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What problems would you see?

• Chronic lung disease of prematurity (BPD)
• Necrotizing enterocolitis
• __________________
• Meconium aspiration
• Congenital heart defects
• _____________
• Anemia
• Intraventricular Hemorrhage
• ___________________

• Retinopathy of prematurity
• ___________________
• _______________

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Developmental care

• Simulate a _____________ environment
• Warm, humid, dark, quiet
• Developmental positioning to aid with
  _____________ and ____________ development
• Make the environment less ______________
• Poor _________________and growth
• Abnormal ___________________

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Stress signals

• May be different than in term babies, children
  and adults
• Crying
• Less common in the very ill or very premature
  babies
• ____________________
• Wrinkled _____________
• Averted gaze

• __________ arms and legs
• stop hands
• shut down
• Changes in vital signs

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What stress cues are this baby displaying?
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What is RIGHT with this picture?
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The Goal