critical care nursing :- introduction

What is critical care nursing?

Critical care nursing is the delivery of specialized care to critically
ill patients—that is, ones who have life-threatening illnesses or
injuries. Such patients may be unstable, have complex needs, and
require intensive and vigilant nursing care.
Illnesses and injuries commonly seen in patients on critical
care units (CCUs) include:
• gunshot wounds
• traumatic injuries from such events as automotive collisions
and falls
• cardiovascular disorders, such as heart failure and acute coronary
syndromes (unstable angina and myocardial infarction [MI])
• surgeries, such as abdominal aortic aneurysm repair and carotid
endarterectomy
• respiratory disorders, such as acute respiratory failure and pulmonary
embolism
• GI and hepatic disorders, such as acute pancreatitis, acute
upper GI bleeding, and acute liver failure
• renal disorders, such as acute and chronic renal failure
• cancers, such as lung, esophageal, and gastric cancer
• shock caused by hypovolemia, sepsis, and


nursing responsibilities
As a critical care nurse, you’re responsible for all parts of the
nursing process: assessing, planning, implementing, and evaluating
care of critically ill patients. Remember that each of these
steps gives you an opportunity to exercise your critical thinking
skills.
assessment
Critical care nursing requires that you constantly assess the
patient for subtle changes in condition and monitor all equipment
being used. Caring for critically ill patients may involve the use of
such highly specialized equipment as cardiac monitors, hemodynamic
monitoring devices, intra-aortic balloon pumps, and ICP
monitoring devices. As part of the patient assessment, you also
assess the patient’s physical and psychological statuses and interpret
laboratory data.

planning
Planning requires you to consider the patient’s psychological and
physiological needs and set realistic patient goals. The result is an
individualized care plan for your patient. To ensure safe passage
through the critical care environment, you must also anticipate
What’s the problem?
In planning, be sure to address present and potential problems,
such as:
• pain
• cardiac arrhythmias
• altered hemodynamic states
• impaired physical mobility
• impaired skin integrity
• deficient fluid volume.

implementation
As a nurse, you must implement specific interventions to address
existing and potential patient problems.
A call to intervene
Examples of interventions include:
• monitoring and treating cardiac arrhythmias
• assessing hemodynamic parameters, such as pulmonary artery
pressure, central venous pressure, and cardiac output
• managing pain
• monitoring responses to therapy.