By Janice Jones PhD RN CNS, Brenda Fix MS RN NP
A DAVIS'S NOTES BOOK!This pocket-sized speedy reference is your go-to advisor for the medical details you must take care of grownup sufferers appropriately and successfully.
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Additional info for Critical Care Notes: Clinical Pocket Guide
Muffled heart sounds. ■ May or may not present with pericardial friction. ■ Dullness of percussion of the left lung over the angle of scapula (Ewart’s sign). ■ ECG shows ↓ voltage of complexes. Diagnostic Tests ■ Echocardiogram Management ■ Pain management. ■ Pericardiocentesis performed by a physician. ■ Position changes decrease SOB. 48 49 ■ Wound care after pericardiocentesis, care of pericardial catheters. ■ Frequent assessments of VS, pulses, LOC, respiratory status, skin and temperature changes, intake and output.
Used as an emergency measure, a transcutaneous pacemaker should be used for 48–72 hours only. Electrodes should be changed every 24 hours minimally.
Transparent dressings may be changed every 7 days. ■ If TPN is temporarily unavailable, hang 10% D/W at the same rate as TPN. Monitor for hypoglycemia. ■ Place TPN on infusion pump. Monitor hourly rate. Never attempt to “catch up” if infusion not accurate. ■ Patients generally are taken off of TPN prior to surgery. Complications Complications from TPN may be catheter-related, mechanical, or metabolic. 6 mmol/L Infectious Diseases Critical Care Risk Factors ■ ■ ■ ■ ■ Invasive devices Immunocompromising conditions Serious underlying illness Prolonged stay in critical care unit Colonization and cross-infection 26 27 ■ Overuse of antibiotics ■ Elderly Methicillin-Resistant Staphylococcus aureus (MRSA) Etiology Health-care associated bloodstream and catheter-related infections.
Critical Care Notes: Clinical Pocket Guide by Janice Jones PhD RN CNS, Brenda Fix MS RN NP