Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Because fentanyl readily creates a reservoir in adipose tissue, accumulated large doses may result in a progressively increasing duration of effect. This does not generally occur in doses less than 10 µg/kg.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Fentanyl has many advantages, given its rapid onset, short duration, lack of histamine release and favorable cardiovascular profile. Fentanyl rapidly crosses the blood-brain barrier and produces analgesia in as little as 90 seconds.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
General anesthesia is a drug-induced loss of consciousness during which patients are not arousable, even with painful stimulation. The ability to maintain ventilatory function independently is often impaired.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Deep sedation and analgesia describes a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully after repeated or painful stimulation. 

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Dissociative sedation is a trancelike cataleptic state induced by the dissociative agent ketamine. It is characterized by analgesia and amnesia while protective airway reflexes, respirations and cardiopulmonary stability are maintained.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Moderate sedation and analgesia (formerly called conscious sedation) refers to a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, alone or accompanied by light tactile stimulation.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Minimal sedation (anxiolysis) is a drug-induced state during which patients respond normally to verbal commands. Although cognitive functions and coordination may be impaired, ventilatory and cardiovascular functions are unaffected.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Strategies for managing intubated patients with COPD focus on improving gas exchange while minimizing iPEEP. Reduction of iPEEP is achieved by decreasing airway resistance with bronchodilators and corticosteroids.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The initial evaluation of a decompensating vented patient should begin by confirming the position and patency of the endotracheal tube before other diagnoses are investigated, including evaluation of the tracheal balloon.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Patients with hemodynamic compromise or acute hypoxia on the ventilator should be auscultated and chest examined to ensure breath sounds. Changes in breath sounds may indicate a pneumothorax or migration of the endotracheal tube.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Patients with acute hemodynamic compromise or acute hypoxia on the ventilator should be bagged manually on 100% oxygen. Tension pneumothorax, increased iPEEP and accidental extubation are the most life-threatening concerns.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
When a patient's condition suddenly deteriorates during mechanical ventilation, a systematic approach should be applied to assess for life-threatening conditions. The first step in evaluation includes assessing the patient and vital signs.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
A potential complication of positive pressure ventilation is the development of iPEEP. iPEEP is the accumulation of end-expiratory volume and end-expiratory pressure that occurs when exhalation cannot be fully completed.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Positive pressure ventilation has a direct impact on the lungs. Whether delivered as a set volume or set pressure, invasive positive pressure ventilation forcibly distends the lung. It can be injurious causing volutrauma and barotrauma.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Propofol's ability to penetrate the blood-brain barrier rapidly and distribute into peripheral tissues is responsible for the rapidity and short duration of its clinical effect. Propofol can precipitate hypotension by increasing venous capacitance.