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INFECTION

NSG. INTERVENTION

a. Monitoring for signs and symptoms ofinfection.

b. Culture and sensitivity results.

c. Administering appropriate antibiotics.

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NUTRITION

NSG. MANAGEMENT:

Provide enteral or parenteral feedings.

Monitoring weight,albumin, and nitrogenbalance.

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IMMOBILITY

Documents complication like pressureulcers, deep vein thrombosis, pulmonarycomplication, muscle wasting.

Observe strict repositioning schedule.

Do chest physiotherapy.

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Assess regularly for discomfort by theuse of visual aid or pain scale.

Request for analgesics available for 24

hrs.

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ANXIETY

Symptoms:

a. Tachycardia

b. Tachypnea

c .Restlessness

d. Inability to sleep

e. Diaphoresis

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Administering anxiolytics drugs

Encouraging unrestricted visitation byfamily members.

Providing therapeutic communication.

Using guided imagery.

Communicating the treatment plan.

Offering music therapy.

Spending extra time with the patient.

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Keeping social conversation andlaughter to a minimum and decreasingtelephone ring volumes.

Help control environment noise bylowering alarm volumes.

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SLEEP

Nurse must minimize unecessary noiseand lights and recognize any importantnightime rituals.

Perform necessary assessments andprocedures while allowing a minimum oftwo hrs. of uninterrupted sleep.

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COMMUNICATION

Modalities of communication includes:

a. Picture board

b. Paper and pen

c. Agreed on gestures

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Reasons for communicating withventilated responsive patient:

Experiences of pain

Identifying patients emotion

Determining patients symptoms

Responding to patients needs for

physical care

The physical environment of the ICU

The patients home and family

Treatment decision making

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Purpose of communicating sedatedand unresponsive patient:

Provide orientation

State procedural and task intentions

Provide reassurance

Apologize and or recognize discomfort

Obtain response

Provide intention and unintentionaldistraction

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Family members needs

There are five needs by most families

a. Reassurance

b. Flexible visitation

c. Information

d. Comfort

e.support

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CONCERNS OFCRITICALLY ILLPATIENTS

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BEING THIRSTY

HAVING TUBES IN THEIR MOUTHAND NOSE

NOT BEING ABLE TO COMMUNICATE BEING RESTRICTED BY TUBES OR

LINES

BEING UNABLE TO SLEEP NOT BEING ABLE TO CONTROL

THEMSELVES

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RECOMMENDED FIVEEVIDENCED-BASEDINTERVENTION TOFACILITATE

COMMUNICATION WITHMECHANICALLYVENTILATED:

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Be educated about the frustration thatmechanically ventilated patientsexperienced when they are attempting tocommunicate their needs and desires.

When communicating with ventilatedpatients they should:

a. Routinely ask patients about their feelingsand their state of mind.

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b. Ask permission before beginningnursing care and procedures.

c. Evaluate patients understanding of the

information conveyed by asking simpleyes or no question.

Demonstrate attention to the needs oftheir patients by informing them of their

surroundings, plan of care, and whenthey will return after leaving the bedside.

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Approach each patient with a kind, patientmanner : take time to investigate andunderstand what the patient is

communicating : and respond to thepatients communicated needs.

Provide writing materials and read thepatients words as they are written,

allowing the patients to verify that thereader understands the patient correctly.