Introduction To Critical-Care- Exam Elaboration (100% Accurate) Question and Answers: Expert Solutions! 2025/2026 Version

Introduction To Critical-Care- Exam Elaboration (100% Accurate) Question and Answers: Expert Solutions! 2025/2026 Version 1) In this type of pattern, any physician with hospital admitting privileges can serve as the physician of record and oversee ICU care. Other physicians are now regarded as consultants. The **admitting and other attending doctors** manage treatment, change management, or perform procedures without the need to consult with a Critical Care Specialist. Critical Care Practice Patterns in the ICU The **Closed Model** refers to a system where these attending physicians manage the ICU without input from other consultants. 2) In this model, care is coordinated by a qualified Critical Care Specialist, who is responsible for both clinical and administrative duties. A specialized, multi-disciplinary team works together in this setting. The **intensivist** is the lead, overseeing patient care and ensuring the highest level of specialized attention in the ICU. Closed Model Pattern The **Transitional / Hybrid Model** allows for collaboration between the intensivist and primary physicians, ensuring comprehensive care coordination. 3) The **ICU Staff** model blends aspects of both open and closed systems. An ICU team works in close association with primary physicians to manage patient care. In this system, the **one nurse to two rooms** ratio is employed to ensure proper monitoring and care. Transitional / Hybrid Model Pattern This model relies on a high nurse-patient ratio to maintain close observation and immediate response to any changes in a patient's condition. 4) The **Headwall** in ICU rooms is a key feature where electrical, gas, and equipment mounts are integrated. This setup allows for flexible bed configurations, particularly in pediatric ICUs. Equipment included in the ICU: 1 The **Physiologic monitor** aggregates and displays vital health metrics such as ECG, blood pressure, and pulse oximetry. 5) The **Telemetry** system involves the electronic transmission of patient data, sending information to a central monitoring station for analysis. Equipment included in the ICU: **Electrocardiography** equipment analyzes cardiac rhythms and conduction. 6) The **Pulse oximetry** device is used to noninvasively measure blood oxygen saturation through light transmission across capillary beds. Equipment included in the ICU: **Impedance pneumography** measures respiratory rate by detecting electrical changes in ECG leads during the patient’s breathing cycle. 7) The **Wall oxygen supply** is a central feature in hospitals, delivering oxygen directly to patient rooms via a piping system. Equipment included in the ICU: **Wall air supply** is used for compressed air delivery, which blends with oxygen to regulate patient oxygen levels. 8) In the ICU, **Wall suction** systems are available at each bedside for a variety of purposes, such as clearing pulmonary secretions or draining wounds. Equipment included in the ICU: The **Emergency power system** ensures that ICU equipment remains operational in case of external power failure, with emergency outlets clearly marked in red. 9) ICU rooms often feature **emergency call buttons** that allow patients to signal staff immediately when help is needed. Equipment included in the ICU: The **positive pressure** and **negative pressure** systems adjust the air flow to prevent contamination, depending on the patient’s condition. 2 10) The **Transducer** device in the ICU converts pressure waveforms into electronic signals for fluid measurement and display. Equipment included in the ICU: **Infusion pumps** are used to regulate the precise delivery of medications or fluids to patients. 11) Intensive care unit (ICU) patients, especially those who are **obese**, face increased risks of complications related to **prolonged immobilization** and **recumbent positioning**. Intensive Care Unit (ICU) Such conditions require advanced care strategies and monitoring systems. 12) Hospitals choose specialty beds based on the **resource person with specific expertise** to meet the varied needs of their patient population. Things to Remember about ICU Beds: The increasing number of **obese patients** has driven the development of **specialized equipment** such as bariatric chairs, bed scales, and ceiling lifts to assist with patient mobility and care. 13) Choosing the appropriate ICU bed is a collaborative decision between **the physician and nursing team**, ensuring optimal care for each individual patient. Things to Remember about ICU Beds: Hospitals often have a **specialist resource person** with expertise in selecting the most appropriate specialty bed. 14) The increasing prevalence of **obese patients** has led to the creation of advanced technologies like **bariatric chairs**, **ceiling lifts**, and **bed scales**, all aimed at improving the early mobilization and care of these patients. Things to Remember about ICU Beds: These specialized tools help address the unique challenges posed by obese patients, ensuring better mobility and safety within the ICU. 15) In an ICU, the **closed model** is designed for a **Critical Care Specialist** to be in charge, limiting the involvement of other physicians in direct patient care, with those physicians acting as consultants. Critical Care Practice Patterns in the ICU 3 This model ensures that the intensivist manages all major decisions related to patient care. 16) The **ICU Staff** in the **Transitional/Hybrid Model** assists with direct patient care alongside primary physicians, fostering an environment where intensivists co-manage patient care. The intensivists make final decisions regarding treatment and procedures. Transitional / Hybrid Model Pattern This approach ensures a balanced level of collaboration while maintaining clear lines of responsibility. 17) The **Physiologic monitor** in the ICU continuously tracks vital signs and physiological variables, providing real-time data on heart rate, blood pressure, oxygen saturation, and other important health indicators. Equipment included in the ICU This equipment is essential for monitoring patients with critical conditions who require constant supervision. 18) **Telemedicine** in an ICU setting allows for remote monitoring and transmission of patient data, making it easier for specialists to intervene without being physically present in the room. Equipment included in the ICU This technology is integral in managing critically ill patients who require constant, specialized care. 19) The **pulse oximeter** is a noninvasive device used to measure the amount of oxygen in the blood by shining light through the skin and measuring its absorption. Equipment included in the ICU It provides crucial data for patients requiring oxygen therapy or monitoring during sedation and anesthesia. 20) **Wall oxygen supply** systems provide continuous oxygen to patients in ICU rooms, ensuring that the required flow rate is maintained for each patient. Equipment included in the ICU These systems are essential for maintaining oxygenation in critically ill patients who cannot breathe adequately on their own. 4 21) **Wall air supply** systems deliver compressed air to ICU patients, which is blended with oxygen to ensure proper respiratory support. Equipment included in the ICU These systems are critical for managing ventilators and other respiratory equipment that require a steady supply of air. 22) **Suction systems** are vital in the ICU to assist in removing fluids, secretions, or other obstructions from a patient's airway or surgical site. Equipment included in the ICU These systems maintain a safe and clear airway for patients, especially those who are intubated or recovering from surgery. 23) **Emergency power systems** in ICUs automatically activate backup generators when there is a loss of external power. This ensures that critical equipment remains functional, preventing disruptions in patient care. Equipment included in the ICU Red outlets are used to distinguish emergency power sources, ensuring that vital equipment stays operational. 24) In ICU rooms, the **positive pressure** system is used to keep airborne pathogens from entering, while the **negative pressure** system prevents contaminants within the room from escaping. Equipment included in the ICU These pressure systems are crucial for infection control, particularly for patients with highly contagious diseases. 25) **Transducers** in the ICU are devices that convert energy from one form to another, commonly turning pressure waves into electronic signals, allowing for accurate monitoring of fluid dynamics in the body. Equipment included in the ICU They play a key role in managing invasive monitoring systems, such as arterial lines or central venous pressure measurements. 5 26) **Infusion pumps** are used to accurately deliver fluids, medications, or nutrients to ICU patients, ensuring that they receive the right amount at the correct intervals. Equipment included in the ICU These pumps are essential in managing critical care, especially in patients with complex medication regimens. 27) ICU patients, particularly those with obesity, are at risk for complications arising from **prolonged immobilization** and **recumbent positioning**. These complications often include pressure ulcers, deep vein thrombosis, and respiratory complications. Intensive Care Unit (ICU) Advanced care and monitoring are essential to prevent and treat these issues, improving patient outcomes. 28) The choice of specialty beds in the ICU is a joint decision made by **the physician and the nursing team**, with input from other healthcare professionals, ensuring that patient comfort and safety are prioritized. Things to Remember about ICU Beds: These beds are selected based on the specific needs of the patient, whether for mobility, pressure relief, or other medical requirements. 29) A **resource person with specific expertise** is often consulted in hospitals for guidance on the selection of ICU specialty beds. This ensures that the bed chosen matches the specific medical needs of the patient, including those with complex conditions. Things to Remember about ICU Beds: The expertise of this person is invaluable in ensuring that the equipment used enhances patient care and recovery. 30) Due to the increasing number of obese patients, new technologies like **bariatric chairs**, **ceiling lifts**, and **bed scales** are being developed to aid in the early mobilization and care of these individuals. Things to Remember about ICU Beds: These innovations help healthcare providers meet the unique needs of obese patients, improving their ability to mobilize and recover safely. 6 Critical care nurses ___________ provide specialized care to patients experiencing a life threatening or potentially life-threatening illness. Must have an adequate understanding of the practice of critical care nursing that is embodied in different standards of care competencies as well as an affiliate and continuously adheres to professional organizations in critical care nursing. complex, intensive and continuous education and certification. Critical care nursing A _____________ type of care is significantly required through ________________ is concerned with human responses to life-threatening problems, such as trauma, major surgery, or complications of illness close patient monitoring, application of sophisticated equipment, and surveillance-based interventions Common elements driving the origin of critical care units remain important even today, including __________, __________ and ______________ to prevent clinical deterioration or health complications. 1) The health care facility 2) The critical care unit 3) The critical care nurse Quality critical care nursing practice requires the engagement and interconnection of three elements, namely: health care facility 1) The ______________,creates the necessary safety culture and quality environment that provides the foundation for the nursing practice. critical care unit 2) The __________________, incorporates the quality care framework within its policies and processes such as the use of high performance checklists and closely monitors the program score cards; thereby providing oversight mechanisms to create conditions for daily quality care supported by evidence informed practices which supports the clinical nurse in achieving best practice. critical care nurse 3) The ________________, by utilizing specific knowledge and building on previous experience, progresses along the continuum from novice to expert critical care nurse. The 7 critical care nurse maintains professional competence through ongoing learning and reflective practice. Contributes positively to the image of nursing and is committed to the delivery of quality patient care. In order to foster delivery of evidence-based and/or best practices within critical care nursing, defining competency is crucial. 1950s The specialty of critical care has its roots in the _________, when patients with polio were cared for in specialized units. 1960s In the _________, recovery rooms were established for the care of patients who had undergone surgery, and coronary care units were instituted for the care of patients with cardiac problems. The patients who received care in these units had improved outcomes. 1970s cardiovascular, surgical, neurological, trauma, transplantation, burn, pediatric, and neonatal units. Critical care nursing evolved as a specialty in the __________ with the development of general intensive care units. Since that time, critical care nursing has become increasingly specialized. Examples of specialized critical care units are: (8) electronic intensive care unit (eICU) With advances in technology, the______________ has emerged as another setting for critical care nursing. In an here, patients are monitored remotely by critical care nurses and physician The Critical Care Nurses of the Philippines, Inc, (CCNAPI) Care Nursing reflects a holistic approach in caring of patients. For ______________________, Critical 8 preventive care, risk factor modification and education The focus of caring includes ________, ________ and _______ to decrease future patient admissions to acute care facilities. patient and his/her family To achieve this holistic care process, participation by the______________ is always emphasized. - broad base of knowledge and experience through continuous education -evidence-based research. At the forefront of critical care science and technology, critical care nurses maintain professional competence based on a __________ and ___________. The intensive care unit (ICU) room _______________ is a highly specialized environment, differing in many ways from a standard hospital room. It provides a safe environment for the critically-ill patient where optimal standards of critical care can be delivered First, age group or medical specialties Secondly, specialty programs., labelled are General ICUs categorized into two main units. Neonatal Intensive Care Unit (NICU), Pediatric Intensive Care Unit (PICU), or Adult Intensive Care Unit. The Critical Care Unit can be broadly First, it could be categorized into age group or medical specialties such as: (3) Medical ICU, Surgical ICU, Cardio-thoracic ICU, Respiratory, Neurosurgical and Trauma. as: (6) Secondly, it can be categorized into specialty programs., labelled are General ICUs such 9 Level I Levels of ICU 1) ___________: These ICUs are referred to as high dependency ICU. Resuscitation, short term mechanical ventilation and simple invasive cardiovascular monitoring for less than 24 hours. 1:3 t ime. Level III Nurse patient ration in Level I is _______ and medical staff are not present in the unit all the Levels of ICU 3) ___________: These are tertiary referral unit for intensive care patients that provides comprehensive critical care including complex multi-system life support for an indefinite period. 1:2 The Nurse Patient Ration in Level II is ______ and junior medical staff is available in the unit all the time and consultant medical staff is available if needed. Level II Levels of ICU 2) ___________: These ICUs are located in general hospital and undertake more prolonged ventilation. They usually provide a high standard of general intensive care including complex multi-system life support. 1:1 Nurse patient ratio in Level III is ______. These levels demonstrated commitment to academic education and research. Open Units Critical Care Practice Patterns in the ICU an intensivist physician, a clinical pharmacist, a dietician, several respiratory therapists bedside nurses, and other health care providers such as clinical psychologists. ICU teams are typically composed of: (6) 10 intensivist 1. The ____________, a physician with specialized training in critical care medicine, is the leader of the team and has ultimate responsibility for medical decision-making. TRUE An extensive body of literature demonstrates that the presence of an intensivist as team leader as opposed to a physician without specialty critical care training, is associated with lower mortality. TRUE OR FALSE Clinical pharmacists 2. _______________ provide unique expertise on drugs that are the cornerstone of ICU treatment. Dieticians provide 3. ________________ unique expertise for patients' nutritional needs, and must account for the problem that feeding protocols are often contingent upon other therapies. Respiratory therapists 4. ________________ typically oversee the provision of mechanical ventilation, which is the central supportive therapy for patients experiencing respiratory failure and among the most common ICU treatment. Critical care nurses 5. __________________ are responsible for closely monitoring and reporting changes in patients' health and wellbeing. assessing vital signs, delivering drugs, and monitoring for complications of therapy. Nurses only care for a subset of patients, typically no more than two at any one time. Yet nurses are central members of the ICU team because they are directly involved in nearly all ICU treatments, in that they are responsible for ___________, ___________ and ___________. Clinical psychologists and other behavioral healthcare specialists 6. _____________ and ______________ play a unique role in that they specifically address patients' psychological recovery and they provide care for patients, families, and critical care providers. family members NURSING ALERT! 11 In the modern ICU, _______________ are increasingly considered to be part of the ICU team, especially when they take on the role of surrogate decision makers for loved ones who are too ill to advocate for themselves Critical Nurse Nursing _________________ is highly technical and is generally considered beyond the level of a new graduate. often, experience in medical-surgical nursing is required prior to entering the critical care environment. Clinical Inquiry Clinical Judgment Caring Advocacy Systems Thinking Facilitator of learning Response to diversity Collaboration The AACN has clearly defined eight critical care competencies that encapsulate the functions of these nurses: Clinical Inquiry A Critical Care Competencies of AACN: ________________ Ability to question and evaluate practice in an ongoing manner, using evidence based practice instead of tradition. Clinical Judgment A Critical Care Competencies of AACN: ________________ Use of competent data collection with a more global grasp of signs/symptoms; implementation of nursing skills with a focus on decision making and critical thinking. Caring A Critical Care Competencies of AACN: ________________ Implementation of a compassionate, therapeutic, and supportive environment in providing care to patients when interacting with families and other health care providers. Advocacy A Critical Care Competencies of AACN: 12 ________________Ability to protect and support the basic rights and beliefs of patients and families. Systems Thinking A Critical Care Competencies of AACN: ________________ Negotiating and navigating within the system of health care to provide resources that benefit the patient and family. Facilitator of learning A Critical Care Competencies of AACN: ________________ Promote and provide opportunities for formal and informal learning for patients, families, and members of the health care team. Response to diversity A Critical Care Competencies of AACN: ________________ Analyzing and implementing care based on differences in sociocultural, economic, gender, and cultural-spiritual aspects of patients, families, and other members of the health care team. Collaboration A Critical Care Competencies of AACN: ________________Capitalizing on the unique contributions made by each person in achieving positive outcomes based on collaboration with patients, families, and members of the health care team. 1990s These competencies are part of the synergy model the AACN developed in the ___________. synergy model practice. The ___________________ is used as a guide to help with certified critical care (1) patient characteristics are a driving force to nurses, (2) nursing competencies are needed to attend to patient needs, (3) the patient characteristics are a driving force behind the critical care competencies, and (4) when the patient characteristics and nursing competencies are in harmony, optimal patient care and outcomes are achieved. The synergy model is based upon the assumptions that: (4) 13 Practitioner Role _____________: The critical care nurses execute their practice roles 24-hours a day to provide high quality care to the critically ill patient. Care Provider Detects and interprets indicators that signify the varying conditions of the critically ill with the assistance of advanced technology and knowledge; (Direct patient care) Care Provider Plans and initiates nursing process to its full capacity in a need driven and proactive manner; (Direct patient care) Care Provider Acts promptly and judiciously to prevent or halt deterioration of patients' condition when conditions warrant, and (Direct patient care) Care Provider Co-ordinates with other healthcare providers in the provision of optimal care to achieve the best possible outcomes. (Direct patient care) Care Provider Understands family needs and provide information to allay fears and anxieties (Indirect patient care - Care of the Family) Care Provider Assists family to cope with the life-threatening situation and/or patient's impending death (Indirect patient care - Care of the Family) Extended roles as critical care nurses Extended roles as critical care nurses Extended roles as critical care nurses Extended roles as critical care nurses Extended roles as critical care nurses nutrition support; Sampling and analyzing arterial blood gases; Weaning patients off ventilators; Adjusting intravenous analgesia / sedations; Performing and interpreting ECGs; Titrating intravenous and central line medicated infusion and 14 Extended roles as critical care nurses or lethal ventricular tachycardia; Extended roles as critical care nurses Educator Initiating defibrillation to patient with ventricular fibrillation Removal of pacer wire, femoral sheaths and chest tubes,and Provides health education to patient and family to promote understanding and acceptance of the disease process thus facilitate recovery. Educator Participates in the training and coaching of novice healthcare team members to achieve cohesiveness in the delivery of patient care. advocate The critical care nurses' role includes being an _____________ - someone who acts or intercedes on behalf or another. Typically, the critical care nurse may be in the best position to act as the liaison between patient and family and other team members and departments because they are the healthcare professionals with the most interpersonal contact with the patients. Patient Advocate Patient Advocate Acts in the best interests of the patient Monitors and safeguards the quality of care which the patient receives Management and Leadership Role safe and quality care; Management and Leadership Role Management and Leadership Role ill patients in the acute setting; Management and Leadership Role setting; Performance of management and leadership skills in providing Accountability for safe critical care nursing practice; Delivery of effective health programs and services to critically Management of the critical care nursing unit or acute care 15 Management and Leadership Role Management and Leadership Role Taking the lead and supervision of nursing support staff. Utilization of appropriate mechanism for collaboration, networking, linkage - building and referrals. Role in Research Engage self in nursing or other health - related research with or under the supervision of an experienced researcher; Role in Research Role in Research Utilization of guidelines in the evaluation of research study or report Application of the research process in improving patient care infusing concepts of quality improvement in partnership with other team-players. Nurse Specialist / Clinical Nurse Specialist Expanded Roles 1. __________________________: is responsible for building up nursing competencies in the ICU entity. He / She contributes to continuous improvement in critical care nursing through staff and clients education and uphold quality nursing guidelines on patient care through clinical research and refinement of ICU Standards. Acute Care Nurse Practitioner (ACNP) Expanded Roles 2. _____________________: in the critical care unit takes lead in developing evidence-based practices to meet changing clinical needs and facilitates patient care processes across professional and organizational boundaries Outcome Specialist Expanded Roles 3.____________________: Outcome management has been introduced into the healthcare system to ensure achievement of quality and cost-effectiveness in the delivery of patient care. Critical Pathways, Protocols, Algorithms and Orders Some critical care units have adopted clinical pathways (e.g., 3) in the management of specific diseases such as Acute Myocardial Infarction and 16 Cardio-thoracic Surgeries. Qualified nurse experts are involved in the development and implementation of patient outcomes management Advanced education and training certified critical care nurse. Formal education __________ and ___________ plays a pivotal role in becoming _____________ - in conjunction with experiential learning, continuing professional development and training, and reflective clinical practice. reflective clinical practice nursing. knowledge, skills and attitude _____________ - is required to develop competence in critical care The ___________, ____________ and _____________ necessary for quality critical care nursing practice have been articulated in competency statements in many countries standards of professional performance The _______________________ describe expectations of the acute and critical care nurse. Critical care nurses adhere to it because it provides a framework for the quality of care delivered by the nurse. AACN Standards for Acute and Critical Care Nursing Practice The __________________ describe practice for nurses who care for critically ill patients. The standards of practice delineate the nursing process. Critical illness _____________ is an illness where a patient is suffering from a severe failure of one or more of their organs such as the heart, lung or kidneys (Intensive Care Society 2011). detect the deteriorating patient as quickly as possible The aim of recognizing and managing the critically ill or 'at risk' ward patient is to __________________________ so that appropriate plans can be made about the ongoing care of the patient. Timely detection of patients' deterioration and appropriate clinical interventions and ______________ can minimize the likelihood of serious adverse events. ______________ 17 1) Resiliency 2) Vulnerability 3) Stability 4) Complexity 5) Resource Availability 6) Participation in Care 7) Participation in Decision Making 8) Predictability The Synergy Model developed by the AACN has served as the foundation for certified practice since the late 1990s. It has eight patient characteristics and eight nurse competencies that constitute nursing practice form the basis of the model. Resiliency 1) _______________—the capacity to return to a restorative level of functioning using compensatory/coping mechanisms; the ability to bounce back quickly after an insult. Vulnerability 2) _______________—susceptibility to actual or potential stressors that may adversely affect patient Stability Complexity 3) _______________—the ability to maintain a steady-state equilibrium 4) _______________—the intricate entanglement of two or more systems (eg, body, family, therapies) Resource Availability 5) _______________—extent of resources (eg, technical, fiscal, personal, psychological, and social) the patient/family/community bring to the situation Participation in Care care 6) _______________—extent to which patient/family engages in aspects of Participation in Decision Making decision making 7) _______________—extent to which patient/ family engages in 18 Predictability 8) _______________—a characteristic that allows one to expect a certain course of events or course of illness deteriorating patient individual physiological response that may vary widely age functional capacity gender culture past medical history A ___________________ is identified by worsening physiological signs and symptoms. However, recognizing physiological deterioration can be complex and is influenced by many factors, such as: (6) • those who have never before had a significant illness and who have suffered a sudden, acute life threatening event. • those who suffer from chronic illness, perhaps involving frequent previous hospital admissions and who present as critically ill as a combination of their chronic illness with a life-threatening event • those who have become critically ill as a result of surgery state can be considered in three main categories: extensive trauma, severe burns, near drowning, major childbirth complications or deliberate self-harm Patients who present in a critically ill • those who have never before had a significant illness and who have suffered a sudden, acute life-threatening event, e.g. (5) 19 • those who suffer from chronic pulmonary airways disease (COPD) or chronic pancreatitis, chronic illness, perhaps involving frequent previous hospital admissions, e.g. (2) not expected, while in others, postoperative critical care is a recognised necessity. have become critically ill as a result of surgery - in some cases, the life-threatening situation is __________________ • those who Cardiac system Pulmonary system Neurologic disorder Drug ingestion and overdose Gastrointestinal disorders Endocrine Surgical In order to have a better representation of what conditions usually admitted into the ICU, it is important to regroup them according to body systems, followed below: Cardiac system ______________ Acute MI with complications, Cardiogenic shock, Complex arrythmias requiring close monitoring and intervention, Acute congestive heart failure with respiratory failure and/or requiring hemodynamic support, Hypertensive emergencies, Unstable angina, cardiac tamponade, Dissecting aortic aneurysm, Complete heart block Pulmonary system ______________ Acute respiratory failure requiring ventilatory support, pulmonary emboli with hemodynamic instability, massive hemoptysis Neurologic disorder ______________ Intracranial hemorrhage, meningitis with altered mental status or respiratory compromise, CNS or neuromuscular disorders with deteriorating neurologic or pulmonary function, status epilepticus, severe head injured patients, Drug ingestion and overdose ______________ Hemodynamically unstable drug ingestion, drug ingestion with significantly altered mental status with inadequate airway protection, seizures following drug ingestion 20 Gastrointestinal disorders ______________ Life threatening GI bleeding including hypotension, angina, continued bleeding, or with comorbid conditions, hepatic faiure, severe pancreatitis Endocrine ______________ DKA complicated by hemodynamic instability, altered mental status, respiratory insufficiency, or severe acidosis, severe hypercalcemia with altered mental status, hypo/hypernatremia with seizures Surgical ______________ Post-operative patient requiring hemodynamic monitoring/ventilatory support or extensive nursing care Others Environmental injuries 2000 Department of Health ______________ such as lighting, near drowning The Levels of Care was first devised in _________ by the ____________________________ to help to replace traditional boundaries that labelled patients as critical care patients or ward patients. minimizes the risk and optimizes the outcome for the patient rapid assessment and resuscitation The assessment and management of the deteriorating patient needs to be undertaken within a framework of safe practice that _______________. The main aim in managing the deteriorating, acutely ill patient is ___________ and ___________ in order to make the patient safe, rather than making a definitive diagnosis. ABCDE assessment process The____________________ is a comprehensive approach that enables identification of the major signs and symptoms of the deteriorating patient, so that appropriate clinical interventions can be instigated that may prevent further deterioration. A - Airway _____________: The aim of the airway assessment is to establish the patency of the airway and assess the risk of deterioration in the patient's ability to protect their airway with an effective cough and gag reflex 21 B - Breathing _____________: Breathing function should only be assessed after the airway has been judged as adequate, although some information about respiration function can be gathered during the initial airway assessment C - Circulation _____________: The aim of assessing the circulatory system is to determine the effectiveness of the cardiac output, which is essential for the adequate oxygenation of the vital organs. D - Disability _____________: Disability involves the review of the patient's neurological status and its assessment should only be undertaken once A, B and C have been optimized, as these parameters can all affect the patient's neurological status. E - Exposure _____________: By the time the assessment reaches 'E' (Exposure) there should be a good understanding of the patient's problems, initial clinical interventions should be under way and the patient should be showing signs of improvement TRUE TRUE OR FALSE. The higher the score, the more ill the patient is. The early warning scores are linked to an escalation process. American Association of Critical-Care Nurses (AACN) The __________ is a professional organization that was established in 1969 to represent critical care nurses. over 80,000 members The (AACN) is the largest nursing specialty organization in the world, with ______________ members, dedicated to providing knowledge and resources to those caring for acutely and critically ill patients. assisting acute and critical care nurses to attain knowledge and influence to deliver excellent care. The mission of the organization focuses on___________________. supports creating a healthcare system driven by the needs of patients and families The vision of the organization _____________________ in which critical care nurses make their optimal contributions, which is described as synergy. Society of Critical Care Medicine (SCCM) 22 1970 The __________ is a multiprofessional scientific and educational organization. Twas founded in _______ by a group of physicians, and it has grown to more than 15,000 members in over 100 countries. Society of Critical Care Medicine (SCCM) The _______________ is the largest non-profit medical organization dedicated to promoting excellence and consistency in the practice of critical care. CCNAPI February 1977 ______________ is the national organization of nurses interested in the field of critical care nursing. It was founded in _________________ with approved SEC registration (CN ), a founding member of the World Federation of Critical Care Nurses (2001) and accredited as a Provider of Continuing Professional Education by the Professional Regulation Commission (Provider Number 2009-019) WORLD FEDERATION OF CRITICAL CARE NURSES (WFCCN) 30 October 2001 The _____________ is an international federation comprised of national critical care nursing associations from over 50 countries and regions. It was founded on______________ in Sydney Australia. represent critical care nursing at an international level and to help improve critical care nursing practice worldwide. The key aims of the WFCCN are to _______________________. TRUE TRUE OR FALSE. WFCCN supports effective international cooperation between health professionals, institutions, agencies, healthcare industry and charities that have an interest in the care of critically ill patients. • Collects data from the patient, family, other healthcare providers, and the community, as appropriate, to develop a holistic picture of patient needs •Prioritizes data collection based on patient characteristics related to the immediate condition and anticipated needs • Uses valid evidence-based assessment techniques, instruments, and tools 23 APPLICATION OF NURSING PROCESS • Documents relevant data in a clear and retrievable format IN INTENSIVE CARE UNIT (ICU) Assessment Its competencies include the following: (4) • Derives diagnoses or relevant conditions from the assessment data • Validates diagnoses with the patient, family, and other healthcare providers • Documents diagnoses and relevant issues in a clear and retrievable format NURSING PROCESS IN INTENSIVE CARE UNIT (ICU) APPLICATION OF Diagnosis: The nurse caring for the acutely and critically ill patient analyzes and synthesizes data from the assessment in determining nursing diagnoses or conditions relevant to care. Its competencies include the following: (3) • Identifies outcomes from assessments and diagnoses • Respects patient and family perspectives and values in formulating culturally appropriate outcomes in collaboration with the patient and family, and with the interprofessional team • Considers associated risks, benefits, current evidence, clinical expertise, and cost when formulating expected outcomes • Modifies expected outcomes based on changes in patient condition or situation • Documents outcomes as measurable goals in a clear and retrievable format NURSING PROCESS IN INTENSIVE CARE UNIT (ICU) APPLICATION OF Outcomes Identification: The nurse caring for the acutely and critically ill patient identifies expected outcomes for the patient. Its competencies include the following: (5) • Employs critical thinking and judgment in developing an individualized plan using best evidence • Collaborates with the patient, family, and interprofessional team to develop the plan • Establishes priorities and continuity of care within the plan Includes strategies for health promotion and prevention of further illness or injury within the plan • Considers associated risks, benefits, current evidence, clinical expertise, resources, and cost when developing the plan 24 APPLICATION OF NURSING PROCESS IN • Documents the plan in a clear and retrievable manner INTENSIVE CARE UNIT (ICU) Planning: The nurse caring for the acutely and critically ill patient develops a plan that prescribes strategies and alternatives to attain outcomes. Its competencies include the following: (5) • Employs strategies to promote and maintain safe environment • Coordinates implementation of the plan with the patient, family, and interprofessional team • Intervenes to prevent and minimize complications and alleviate suffering • Facilitates learning for patients, families, and the community • Documents implementation in a clear and retrievable format • Provides age- and developmentally appropriate care in a culturally and ethnically sensitive APPLICATION OF NURSING PROCESS IN INTENSIVE CARE UNIT (ICU) Implementation: The nurse caring for the acutely and critically ill patient implements the plan. Its competencies include the following: (6) • Conducts systematic and ongoing evaluations using evidence-based techniques, tools, and instruments • Collaborates with the patient, family, and interprofessional team in the evaluation process • Revises the assessment, diagnoses, outcomes, and interventions based on the information gained during the evaluation process • Documents the results of evaluation in a clear and retrievable format PROCESS IN INTENSIVE CARE UNIT (ICU) APPLICATION OF NURSING Evaluation: The nurse caring for the acutely and critically ill patient evaluates processes and outcomes. Its competencies include the following: (4) 25