NR 341 COMPLEX ADULT HEALTH Exam 1 Study Guide Chapters 1, 2, 3, 4, 5, 9, 10, 14
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Chapter 1 Overview of Critical Care Nursing
• Definition of critical care nursing
• Evolution of critical care
• Professional organizations o American association of critical-care nurses o Society of critical care medicine o Other professional organizations
• Certification
• Standards
• Critical care nurse characteristics
• Quality and safety emphasis
• Evidence-based practice
• Healthy work environment o Communication o Collaboration
• Other trends and issues
Chapter 2 Patient and Family Response to the Critical Care Experience
• Introduction
• The critical care environment
• The critically ill patient o Discharge from critical care and quality of life after critical care o Geriatric concerns
• Family members of the critically ill patient o Family assessment o Family needs o Communication o Visitation
o Family presence during procedures and resuscitation o Practice alerts
Chapter 3 Ethical and Legal Issues in Critical Care Nursing
• Introduction
• Ethical obligations and nurse advocacy
• Ethical decision making
• Ethical principles
o Creating an ethical environment
• Increasing nurses’ involvement in ethical decision making
• Selected ethical topics in critical care o Informed consent
Elements of informed consent o Decisions regarding life-sustaining treatment
Cardiopulmonary resuscitation decisions
Withholding or withdrawing life support o End-of-life issues
Patient self-determination act
Advance directives o Organ and tissue transplantation
Chapter 4 End-of-Life Care in the Critical Care Unit
• Introduction o Effects on nurses and the healthcare team
• Dimensions of end-of-life care o Palliative care o Communication and conflict resolution o Withholding, limiting, or withdrawing therapy
Ventilator withdrawal
Other commonly withheld therapies
Hospice referral o Emotional and psychological care of the patient and family o Caregiver organizational support
• Culturally competent end-of-life care
Chapter 5 Comfort and Sedation
• Introduction
• Definitions of pain and anxiety
• Predisposing factors to pain and anxiety
• Physiology of pain and anxiety o Pain
o Anxiety
• Positive effects of pain and anxiety
• Negative effects of pain and anxiety o Physical effects
o Psychological effects
• Assessment o Pain measurement tools o Pain measurement tools for nonverbal patients o Anxiety and sedation measurement tools
Sedation scales
o Continuous monitoring of sedation
o Pain and anxiety assessment challenges
Delirium
Neuromuscular blockade
• Management of pain and anxiety o Nonpharmacological management
Environmental manipulation o Complementary and alternative therapy
Guided imagery
Music therapy
Animal-assisted therapy o Pharmacological management
Opioids
Patient-controlled analgesia
Epidural analgesia
Nonsteroidal anti-inflammatory drugs
Other pain relievers
Sedative agents
Tolerance and withdrawal
• Management challenges o Invasive procedures o Substance abuse o Restraining devices o Effects of aging
Chapter 9 Ventilatory Assistance
• Introduction
• Review of respiratory anatomy and physiology o Upper airway
o Lower airway
o Lungs
• Physiology of breathing o Gas exchange o Regulation of breathing o Respiratory mechanics
Work of breathing
Compliance
Resistance
• Lung volumes and capacities
• Respiratory assessment o Health history o Physical examination
Inspection
Palpation
Percussion
Auscultation
Breath sounds
o Arterial blood gas interpretation
Oxygenation
• Partial pressure of arterial oxygen
• Arterial oxygen saturation of hemoglobin Ventilation and acid-base status
• PH
• Partial pressure of arterial carbon dioxide
• Sodium bicarbonate
• Buffer systems
• Base excess or base deficit
• Compensation
• Step 1: look at each number individually and label it
• Step 2: evaluate oxygenation
• Step 3: determine acid-base status
• Step 4: determine whether primary acid-base disorder is respiratory or metabolic
• Step 5: determine whether any form of compensatory response has taken place
o Noninvasive assessment of gas exchange
Assessment of oxygenation
• Pulse oximetry
Assessment of ventilation
• End-tidal carbon dioxide monitoring
• Colorimetric carbon dioxide detector
• Oxygen administration o Humidification o Oxygen deliver devices
Nasal cannula
High flox nasal cannula
Simple face mask
Face masks with reservoirs
Venture or air-entrainment mask
Aerosol and humidity delivery systems
Manual resuscitation bag (variable performance)
• Airway management o Positioning o Oral airways o Nasopharyngeal airways o Endotracheal intubation
Procedure for oral endotracheal intubation
Procedure for nasotracheal intubation
Verification of endotracheal tube placement o Tracheostomy
Tracheostomy tube designs
• Cuffed versus uncuffed tracheostomy tubes
• Single-versus double-cannula tracheostomy tubes [Show Less]