Critical Care / ICU Questions and Answers
ICU Syndrome Symptoms
fatigue; confusion; anxiety; and visual, auditory, and tactile hallucinations. Sometimes the patient's
experience can result in posttraumatic stress disorder.
What to do before entering the pt's room in ICU
inform the nursing staff of the activities you'll be per- forming and get an update on the patient's
condition.
To do once entered the ICU room
Observe the environment & every line, following it visually or tactilely from the monitoring equipment
to its point of insertion or attachment to the patient.
Modifcation/disconnecting for lines/leads & machines in ICU
modifications are almost always the responsibility of the nursing staff and should not be performed by
the therapist.
Before leaving ICU when done with pt.
Upon completion of the patient care activity, po- sition the patient appropriately with safety devices
such as bed rails or body alarms replaced. Reinspect the insertions or attachments of all lines, and
ensure that no lines are being compressed or pulled taut. Notify nursing staff that the activities have
been com- pleted before leaving the ICU.
NG tube.
What is it? Other names?
Nasogastric Tube.
Aka: Dubhoff tube; nasoduodenal (ND); nasojejunal (NJ) tube.
Flexible tube attached to an electric pump containing liquid nutrition inserted via nasal passages
through esophagus and into stomach. Held in place near insertion with tape. Can also be used to
administer oral medications. NG, ND, and NJ tubes differ in the location of the internal tip of the tube.
NG tube precautions
Feeding pumps for NG tubes must be stopped and patient positioned in upright or semi-upright position
for at least 30 minutes (1 hour for pediatric patients) prior to supine activities. Alert nursing staff when
activities are completed so that feeding can be resumed. Caution must be used with patient in supine
position during active ND and NJ tube feedings. Tubing can become dislodged if excess tension is placed
on it. Tubing can irritate patient's throat.
PEG tube.
Other names? What is it?
, Enterostomy feeding tube, percutaneous endoscopic gastrostomy/jejunostomy tube.
Both the PEG and PEJ tubes are inserted directly into the gastrointestinal tract, but the PEG tube entry
point is somewhat higher than the PEJ tube entry point.
PEG tube precautions
Patient should not lie flat during feeding through PEG or PEJ tube
Foley Catheter precautions
Keep the collection bag below the bladder level.
Drain urine from catheter tubing prior to mobility activities.
Be careful not to pull on the tubing as the patient moves away from the bed, and not to compress the
tub- ing, particularly by the patient's legs or the bed rails.
Colostomy, ileostomy bag - precautions
Inspect to ensure secure attachment before and after mobility activities. Have full bags emptied prior to
activities.
Avoid motions that might place tension on the bag and disrupt the seal. Avoid disturbance of bag during
placement and use of gait belt. Keep attachment sites dry.
Rectal tube precautions
Tubing can easily become dislodged. Keep bag below level of tube.
Use slippery sheet (or similar) for bed mobility.
Temporary Pacemaker precautions
Patient can participate in exercise and other physical activities as long as the they are medically cleared
for activity.
If the pacemaker becomes dislodged or disconnected, it can present a life-threatening situation for the
patient. Nursing staff should be called immediately!
PICC.
What is it?
Peripherally inserted central venous line.
Catheter inserted into the veins of the upper arm, terminating in the superior vena cava of the heart.
Provides a long-term means of administering medication or fluids.
PICC precautions
Avoid using a blood pressure cuff on an arm with a PICC.
Range of motion (ROM) of the involved extremity is not contraindicated.
Axillary crutches are often contraindicated, as pressure on the axilla of the involved arm can cause
thrombus formation.
Tunneled central venous catheter.
Other names? What is it?
ICU Syndrome Symptoms
fatigue; confusion; anxiety; and visual, auditory, and tactile hallucinations. Sometimes the patient's
experience can result in posttraumatic stress disorder.
What to do before entering the pt's room in ICU
inform the nursing staff of the activities you'll be per- forming and get an update on the patient's
condition.
To do once entered the ICU room
Observe the environment & every line, following it visually or tactilely from the monitoring equipment
to its point of insertion or attachment to the patient.
Modifcation/disconnecting for lines/leads & machines in ICU
modifications are almost always the responsibility of the nursing staff and should not be performed by
the therapist.
Before leaving ICU when done with pt.
Upon completion of the patient care activity, po- sition the patient appropriately with safety devices
such as bed rails or body alarms replaced. Reinspect the insertions or attachments of all lines, and
ensure that no lines are being compressed or pulled taut. Notify nursing staff that the activities have
been com- pleted before leaving the ICU.
NG tube.
What is it? Other names?
Nasogastric Tube.
Aka: Dubhoff tube; nasoduodenal (ND); nasojejunal (NJ) tube.
Flexible tube attached to an electric pump containing liquid nutrition inserted via nasal passages
through esophagus and into stomach. Held in place near insertion with tape. Can also be used to
administer oral medications. NG, ND, and NJ tubes differ in the location of the internal tip of the tube.
NG tube precautions
Feeding pumps for NG tubes must be stopped and patient positioned in upright or semi-upright position
for at least 30 minutes (1 hour for pediatric patients) prior to supine activities. Alert nursing staff when
activities are completed so that feeding can be resumed. Caution must be used with patient in supine
position during active ND and NJ tube feedings. Tubing can become dislodged if excess tension is placed
on it. Tubing can irritate patient's throat.
PEG tube.
Other names? What is it?
, Enterostomy feeding tube, percutaneous endoscopic gastrostomy/jejunostomy tube.
Both the PEG and PEJ tubes are inserted directly into the gastrointestinal tract, but the PEG tube entry
point is somewhat higher than the PEJ tube entry point.
PEG tube precautions
Patient should not lie flat during feeding through PEG or PEJ tube
Foley Catheter precautions
Keep the collection bag below the bladder level.
Drain urine from catheter tubing prior to mobility activities.
Be careful not to pull on the tubing as the patient moves away from the bed, and not to compress the
tub- ing, particularly by the patient's legs or the bed rails.
Colostomy, ileostomy bag - precautions
Inspect to ensure secure attachment before and after mobility activities. Have full bags emptied prior to
activities.
Avoid motions that might place tension on the bag and disrupt the seal. Avoid disturbance of bag during
placement and use of gait belt. Keep attachment sites dry.
Rectal tube precautions
Tubing can easily become dislodged. Keep bag below level of tube.
Use slippery sheet (or similar) for bed mobility.
Temporary Pacemaker precautions
Patient can participate in exercise and other physical activities as long as the they are medically cleared
for activity.
If the pacemaker becomes dislodged or disconnected, it can present a life-threatening situation for the
patient. Nursing staff should be called immediately!
PICC.
What is it?
Peripherally inserted central venous line.
Catheter inserted into the veins of the upper arm, terminating in the superior vena cava of the heart.
Provides a long-term means of administering medication or fluids.
PICC precautions
Avoid using a blood pressure cuff on an arm with a PICC.
Range of motion (ROM) of the involved extremity is not contraindicated.
Axillary crutches are often contraindicated, as pressure on the axilla of the involved arm can cause
thrombus formation.
Tunneled central venous catheter.
Other names? What is it?
