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CRITICAL CARE NURSING PDF

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PDF Drive is your search engine for PDF files. As of today we have 78,, eBooks for you to download for free. No annoying ads, no download limits, enjoy . PDF | Purpose of the ICU Guide The purpose of this book is to provide a step-by- step practical guide that will help new graduates and nursing. Consultant, Critical Care Nursing and Clinical Research .. To our critical care nursing colleagues around the world whose wonderful work and efforts.


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By the end of this topic, you should be able to: 1. Explain the principles involved in intensive care nursing;. 2. Describe the roles and responsibilities of CCN. Providing an easy-to-use reference, Critical Care Nursing outlines best practice for the assessment, monitoring and treatment of critically ill. The Oxford Handbook of Critical Care Nursing provides nurses working in critical care with an easily accessible guide to the knowledge and nursing care skills.

Considers factors related to safe patient care d. Uses clinical inquiry and integrates research findings in practice ANS: B Discussing end-of-life issues is an example of a nurse acting ethically on behalf of the patient and family. The example does not relate to acquiring knowledge, promoting patient safety, or using research in practice. Which of the following assists the critical care nurse in ensuring that care is appropriate and based on research? Clinical practice guidelines b.

Computerized physician order entry c.

Consulting with advanced practice nurses d. Some physician order entry pathways, but not all, are based on research recommendations.

Some advanced practice nurses, but not all, are well versed in evidence-based practices. The National Patient Safety Goals are recommendations to reduce errors using evidence-based practices. Improving accuracy of patient identification is another National Patient Safety Goal. Preventing errors related to look-alike and sound- alike medications is done to improve medication safety, not medication reconciliation.

Reducing harms associated with administration of anticoagulants is another National Patient Safety Goal. As part of nursing management of a critically ill patient, orders are written to keep the head of the bed elevated at 30 degrees, awaken the patient from sedation each morning to assess readiness to wean from mechanical ventilation, and implement oral care protocols every 4 hours. These interventions are done as a group to reduce the risk of ventilator-associated pneumonia.

This group of evidence-based interventions is often called a: a. ANS: A A group of evidence-based interventions done as a whole to improve outcomes is termed a bundle of care. This is an example of the ventilator bundle. Oftentimes these bundles are derived from clinical practice guidelines and are monitored for compliance as part of quality improvement initiatives.

At some point, these may become part of patient safety goals. You work in an intermediate care unit that has experienced high nursing turnover. The nurse manager is often considered to be an autocratic leader by staff members and her leadership style is contributing to turnover.

Critical Care Nursing Books

You have asked to be involved in developing new guidelines to prevent pressure ulcers in your patient population. The nurse manager tells you that you do not yet have enough experience to be on the prevention task force. This situation and setting is an example of: a.

ANS: B These are examples of an unhealthy work environment. A healthy work environment values communication, collaboration, and effective decision making. It also has authentic leadership. It is not an example of handoff communication, which is communication that occurs to transition patient care from one staff member to another.

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Neither does it relate to ineffective decision making. As a nurse, you can still implement evidence-based practice, but your influence in the unit is limited by the unhealthy work environment. Which of the following statements describes the core concept of the synergy model of practice? All nurses must be certified in order to have the synergy model implemented.

Family members must be included in daily interdisciplinary rounds. Nurses and physicians must work collaboratively and synergistically to influence care. Unique needs of patients and their families influence nursing competencies. ANS: D The synergy model of practice is care based on the unique needs and characteristics of the patient and family members.

Although critical care certification is based on the synergy model, the model does not specifically address certification. Inclusion of family members into the daily rounds is an example of implementation of the synergy model. With the focus on patients and family members with nurse interaction, the synergy model does not address physician collaboration.

ANS: C Response to diversity considers all of these aspects when planning and implementing care. A moral agent helps resolve ethical and clinical concerns. Consideration of these factors does not necessarily facilitate learning. Clinical judgment uses other factors as well. Which of the following is a National Patient Safety Goal? Select all that apply. Accurately identify patients. Eliminate use of patient restraints. Reconcile medications across the continuum of care.

Reduce risks of healthcare-acquired infection. Hospitals have policies regarding use of restraints and are attempting to reduce the use of restraints; however, this is not a National Patient Safety Goal. Which of the following is are official journal s of the American Association of Critical- Care Nurses?

American Journal of Critical Care b. Critical Care Clinics of North America c. Critical Care Nurse d. The first critical care units were: Select all that apply. ANS: B, C Recovery rooms and coronary care units were the first units designated to care for critically ill patients. Burn and neonatal intensive care units were established as specialty units evolved.

Attending a meeting of the local chapter of the American Association of Critical-Care Nurses in which a continuing education program on sepsis is being taught b.

Collaborating with a pastoral services colleague to assist in meeting spiritual needs of the patient and family c. Posting an article from Critical Care Nurse on management of venous thromboembolism for your colleagues to read e.

Attending a program to learn about sepsis—Acquires and maintains current knowledge and competency in patient care. Collaborating with pastoral services—Collaborates with the healthcare team to provide care in a healing, humane, and caring environment. Posting information for others—Contributes to the professional development of peers and other healthcare providers. Nurse practice council—Provides leadership in the practice setting. Evidence-based practices—Uses clinical inquiry in practice.

Which scenarios contribute to effective handoff communication at change of shift? ANS: C, D A reporting tool and bedside report improve handoff communication by ensuring standardized communication and review of assessment findings. The nephrologist has created an interruption that can impede handoff with the next nurse.

Which strategy is important to addressing issues associated with the aging workforce? Allowing nurses to work flexible shift durations b. Encouraging older nurses to transfer to an outpatient setting that is less stressful c. Certification does not prepare one for graduate school; however, achieving certification demonstrates motivation for achievement and professionalism.

Magnet facilities are rated on the number of certified nurses; however, that is not the purpose of certification. The synergy model of practice focuses on a. ANS: C The synergy model of practice states that the needs of patients and families influence and drive competencies of nurses.

The family of your critically ill patient tells you that they have not spoken with the physician in over 24 hours and that they have some questions they want clarified. During morning rounds, you convey this concern to the attending intensivist and arrange a meeting with the family at PM. Which competency of critical care nursing does this represent?

Advocacy and moral agency in solving ethical issues b. Clinical judgment and clinical reasoning skills c. Collaboration with patients, families, and team members d.

Facilitation of learning for patients, families, and team members ANS: C Although one might consider that all of these competencies are being addressed, communication and collaboration with the family and physician best exemplify the competency of collaboration.

Evidence-based practice b. Healthy work environment c. National Patient Safety Goals d.

Nursing process ANS: D The AACN Standards for Acute and Critical Care Nursing Practice delineate the nursing process as applied to critically ill patients: collect data, determine diagnoses, identify expected outcomes, develop a plan of care, implement interventions, and evaluate care. AACN promotes a healthy work environment, but this is not included in its standards. The charge nurse is responsible for making the patient assignments on the critical care unit.

An experienced, certified nurse is assigned to care for the acutely ill patient with sepsis who also requires continuous renal replacement therapy and mechanical ventilation.

The nurse with less than 1 year of experience is assigned to two patients who are more stable. This assignment reflects implementation of the a. National Patient Safety Goals. ANS: D This assignment demonstrates nursing care to meet the needs of the patient. The synergy model notes that the nurse competencies are matched to the patient characteristics.

Crew resource management concepts are related to team training; National Patient Safety Goals are specified by The Joint Commission to promote safe care but do not incorporate the synergy model.

The Quality and Safety Education for Nurses initiative involves targeted education of undergraduate and graduate nursing students on quality and safety concepts.

ANS: C The AACN vision is a health care system driven by the needs of critically ill patients and families where critical care nurses make their optimum contributions. The most important outcome of effective communication is to a.

ANS: D Many errors are directly attributed to faulty communication. Effective communication has been identified as an essential strategy to reduce patient errors and resolve issues related to patient care delivery.

You are caring for a critically ill patient whose urine output has been low for 2 consecutive hours. After a thorough patient assessment, you call the intensivist with report. Which information do you convey regarding background?

Current vital signs and history of aortic aneurysm repair 4 hours ago c. A statement that the patient is possibly hypovolemic d. Information regarding the low urine output is the situation. Acquires and maintains current knowledge of practice b. Acts ethically on the behalf of the patient and family c.

Critical Care Nurse

Considers factors related to safe patient care d. Uses clinical inquiry and integrates research findings in practice ANS: B Discussing end-of-life issues is an example of a nurse acting ethically on behalf of the patient and family. The example does not relate to acquiring knowledge, promoting patient safety, or using research in practice. Which of the following assists the critical care nurse in ensuring that care is appropriate and based on research?

Clinical practice guidelines b. Computerized physician order entry c. Consulting with advanced practice nurses d. Some physician order entry pathways, but not all, are based on research recommendations. Some advanced practice nurses, but not all, are well versed in evidence-based practices. The National Patient Safety Goals are recommendations to reduce errors using evidence-based practices. Improving accuracy of patient identification is another National Patient Safety Goal. Preventing errors related to look-alike and sound-alike medications is done to improve medication safety, but is not related to transferring the patient between settings.

Reducing harms associated with the administration of anticoagulants is another National Patient Safety Goal. As part of nursing management of a critically ill patient, orders are written to keep the head of the bed elevated at 30 degrees, awaken the patient from sedation each morning to assess readiness to wean from mechanical ventilation, and implement oral care protocols every 4 hours.

These interventions are done as a group to reduce the risk of ventilator-associated pneumonia. This group of evidence-based interventions is often called a a. ANS: A A group of evidence-based interventions done as a whole to improve outcomes is termed a bundle of care. This is an example of the ventilator bundle.

Oftentimes these bundles are derived from clinical practice guidelines and are monitored for compliance as part of quality improvement initiatives.

At some point, these may become part of patient safety goals. You work in an intermediate care unit and have asked to be involved in developing new guidelines to prevent pressure ulcers in your patient population. The nurse manager tells you that you do not yet have enough experience to be on the prevention task force and that your ideas will be rejected by others.

This situation is an example of a. A healthy work environment values communication, collaboration, and effective decision making. It also has authentic leadership. It is not an example of handoff communication, which is communication that occurs to transition patient care from one staff member to another. Neither does it relate to ineffective decision making. As a nurse, you can still implement evidence-based practice, but your influence in the unit is limited by the unhealthy work environment.

Which of the following statements describes the core concept of the synergy model of practice? All nurses must be certified in order to have the synergy model implemented.

Family members must be included in daily interdisciplinary rounds.Forgot your username? OSHs in Paediatrics. ANS: C The AACN vision is a health care system driven by the needs of critically ill patients and families where critical care nurses make their optimum contributions. The first critical care units were: Select all that apply.

Remodeling patient care rooms to include devices to assist in patient lifting ANS: A, C, D Modifying the work environment to reduce physical demands is one strategy to assist the aging workforce. At some point, these may become part of patient safety goals. OSHs in Critical Care. Subsequent chapters, structured by organ system, focus on care relating to specific organ function and dysfunction, including the respiratory, cardiovascular, neurologic, renal and gastrointestinal systems.

Considers factors related to safe patient care d. Oxford Pain Management Library.

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