NR 340 CRITICAL CARE FINAL STUDY GUIDE

NR 340 CRITICAL CARE FINAL STUDY GUIDE • Ethics o Informed consent  Competence  Voluntariness  Disclosure of information o Proxy- makes decisions for patient, designated by state • Comfort and Sedation o Rapid sequence intubation  Succinocholine and etomidate o Conscious sedations  Versed and fentanyl o Reversal for fentanyl narcan o Reversal for versed flumazenil o Medications  Benzos • Versed • Ativan • Valium • Precedex- similar to versed, not as addicting  Opioids • Morphine sulfate • Dilaudid • Fentanyl • Druamorph- spinal  Local anesthetics “-caines” o Pain scale for sedated patients behavioral pain scale o Medication for alcohol withdrawl Haldol  CIWA score relates to treatment given • The Heart o Hemodynamics (BP)  Purpose of hemodynamic monitoring assessment of tissue perfusion  Swan ganz catheter • Measures pulmonary capillary wedge pressure (8-12) determines functioning of the left side of the heart (arterial)  CVP measures pressure on right side of heart (venous) • Normal: 2-6 • Indicates patients fluid volume status • If CVP is low give fluids to correct  Cardiac Index (CI): 2.5-4.2 • Less than 2 is BAD cardiogenic shock o Cardiogenic shock is usually caused by and MI (anterior) • Low CI caused by trauma, hypovolemic shock • Interventions: fluids