Critical Care Notes: Clinical Pocket Guide by Janice Jones PhD RN CNS, Brenda Fix MS RN NP

By Janice Jones PhD RN CNS, Brenda Fix MS RN NP

This pocket-sized, quickly reference is your go-to consultant for the scientific info you want to take care of grownup sufferers effectively and successfully.

thoroughly revised and up-to-date, the 2d version bargains much more of what you wish at a moment’s become aware of, together with insurance of rebreathing mask, cardiac surgical procedures, annoying mind and head accidents, MRSA prevention and therapy instructions, and lots more and plenty more!

Write-on, wipe-off, reusable pages make it effortless to take notes in any surroundings.

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Sample text

BP measurement via Doppler recommended if no A-line. ■ Monitor hemodynamics: cardiac index, cardiac output, CVP, PAP, PCWP. ■ Monitor fluid and electrolyte balance including urine output. Note signs of fluid overload and decreased urinary output. ■ Administer anticoagulants (unfractionated heparin, warfarin, aspirin). ■ Assess incisions and dressings for drainage, bleeding, erythema. ■ Obtain and monitor labs: CMP, CBC, PT/PTT, with close attention to K+ and Mg. ■ Medicate for pain as needed. ■ Antibiotics may be ordered prophylactically.

ECG 2-D echocardiogram MUGA scan Hemodynamic studies using a PAP catheter Stress test (noninvasive) if possible Management The following serves only as a guide to the treatment of heart failure. 0b013e31829e8776 ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ Primary goal in managing heart failure is to maintain cardiac output. Secondary goal is to decrease venous (capillary) pressure to limit edema. Monitor cardiac, respiratory, renal, and neurological status. Place patient in Fowler’s position Administer O2 via cannula or mask.

Keep intubated until anesthesia cleared from system. ■ Assess cardiac sounds, rate, rhythm. Continuous ECG monitoring. Pacing with epicardial wires may be warranted. ■ A VAD-generated pulse and patient’s intrinsic or native electrical activity will both appear on the monitoring system. The VAD-generated pulse is ordered in a fixed-rate mode or volume or automatic mode. ■ If VF or asystole occurs, patient will still have a palpable pulse resulting from ongoing pump ejection of the VAD. ■ Assess neurological status to ensure cerebral perfusion.

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