Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Pulse oximetry measures the percentage of arterial hemoglobin that is in the oxyhemoglobin state. It reflects the amount of oxygen that hemoglobin is carrying as a percent of the maximum it can carry.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The gold standard and the most accurate method of measuring blood pressure, remains the intraarterial catheter. However, this method is invasive and time intensive, and carries the infrequent but real risk of arterial injury or thrombosis.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Blood pressure monitoring remains a standard and important ongoing measure of changes in the physiologic adaptation to stress and serves as a dynamic measure and singular predictor of adverse outcomes in medical and surgical patients.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The pulse pressure is important because it closely resembles stroke volume when accounting for arterial compliance and resistance. At a given arterial compliance (C), stroke volume (SV) is associated with changes in pulse pressure: C = SV/PP.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Flumazenil should be used with extreme caution in patients with benzodiazepine dependence or a history of seizures because it may precipitate life-threatening status epilepticus refractory to common treatment.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Flumazenil has a rapid onset of action in 1 to 2 minutes, peak effect in 5 to 10 minutes, and clinical duration of 30 to 90 minutes. Continuous patient monitoring must be ensured with longer lasting benzodiazepines because resedation is likely.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Flumazenil is a competitive antagonist of benzodiazepines. Although it reverses sedation, it is not as effective for reversing respiratory depression. In general, when oversedation occurs, brief support of ventilation permits the patient to recover.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Naloxone is a competitive antagonist of opioids and has been effectively used for the reversal of opioid-induced respiratory depression. It has a rapid onset of action and half-life of 45 minutes, although its effects last only 15 to 30 minutes.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Propofol is another ultra short-acting sedative-hypnotic that has no analgesic properties. It has an extremely rapid onset, short duration of action and predictable efficacy for inducing deep sedation.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Etomidate has been used for deep sedation because of its rapid onset, short duration of action and, most importantly, minimal effects on respiratory and cardiovascular function.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Etomidate is a short-acting, sedative-hypnotic agent and has no analgesic properties. Its use leads to the very rapid onset of profound sedation and hypnosis by enhancing neurotransmission at γ-aminobutyric acid (GABA) receptors.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Because of the potential for hypertension and tachycardia, ketamine should also be avoided in those with significant coronary artery disease. Ketamine also increases intraocular pressure and should be avoided in those with open globe injuries.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The most common side effect seen with ketamine is the emergence phenomenon. The patient awakens with unpleasant vivid dreams or hallucinations or reports nighttime awakenings as a result of unpleasant dreams.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Ketamine may be given by multiple routes but is administered almost exclusively by the IV route in adults. After an IV dose of 1 to 2 mg/kg, a dissociative state results in approximately 1 minute, with duration of action of approximately 15 minutes.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Ketamine use leads to the blockade of catecholamine reuptake and blood pressure is generally well supported. It also induces bronchial smooth muscle relaxation and is well tolerated in patients with reactive airway disease.