ICU Outcomes
1. Caring for a client with multi-system failure is certainly a specialty of ICU nurses. This
particular type of care requires a lot of focus and attention to details. Not only are ICU nurses
treating one particular diagnosis but monitoring all other malfunctions. This includes: treating
each failure, assuring no medications have negative interactions, maintaining quality of life,
aiding the patient to feel as normal and “human” as possible.
2. ICU nurses play a large role in assisting clients families through these difficult and often very
stressful times. This particular role is highly therapeutic and uses psycho-social interventions.
This includes the following:
1. Helping family member to adjust
2. Teaching the family about what is happening to the client and ways they can help
3. Aiding them in finding their role to assist with the client in post ICU care
4.Reiterating things said by MD to avoid any confusion
5. Field questions honestly and as therapeutically as possible
6. Encourage questions and discussion
3. Adenosine
Pharmacological Action: helps to correct faulty AV Node functioning enabling the heart
to have a normal sinus rhythm.
Side Effects: dizziness, blurred vision, SOB, chest pressure, facial flushing, transient
arrhythmias
Special Considerations: When given IV warm to room temperature. Assure that solution
is clear (can crystallize upon refrigeration)
Magnesium Sulfate
Pharmacological Action: treats hypomagnesia and Torsade De Pointes arrhythmias.
Side Effects: drowsiness, decreased respiratory rate, bradycardia, hypotension, diarrhea
Special Consideration: Must monitor HR, BP, RR, and ECG throughout administration.
Institute seizure precautions. Monitor for newborns for hypotension, respiratory
depression. Monitor I + O
Nitroglycerin
Pharmacological Action: Reduces chest pain by acting as a vasodilator
Side Effects: palpitations, syncope, hypotension, restlessness, weakness
Special Considerations: Monitor for interactions with other medications such as Aspirin,
Heparin, or Calcium Channel Blockers. Watch for hypotension and dizziness
Vasopressin
Pharmacological Action: alters the permeability of the renal tubes thus allowing for the
reabsorption of water. It will also act as a vasoconstrictor
Side Effects: dizziness, chest pain, abdominal cramps, diarrhea
Special Considerations: Monitor EG throughout therapy and cardiopulmonary
resuscitation. Assess for s/s of dehydration. Weigh patient daily and monitor I + O.
Assess for edema. Watch for signs of water intoxification
Sodium Bicarbonate
Pharmacological Actions: Sodium Bicarbonate is an alkaline so when administered it
will increase the pH of the blood and urine thus making them less acidic.
Side Effects: Metabolic alkalosis, hypernatremia, hypocalcemia, water retention and
edema, IV route may cause irritation at site.
Special Considerations: Assess fluid balance, monitor for s/s of alkalosis, observe IV site
closely to avoid extravasation, tissue irritation, or cellulitis
4. Ordered amount of drug ´ patient’s weight (kg) ´ 60
___________________________________
Drug concentration
= I.V. infusion rate (in ml/hour)
While you’re working your shift on the progressive care unit, the physician phones in an order to
start a patient’s I.V. dopamine infusion at 5 mcg/kg/minute. The patient weighs 73.5 kg.
5 X 73.5 X 60
————— = 6.89 ml/hour
3200
5. Care of a client on a ventilator
1. Check ventilator settings and modes: When making assessment of patient including
their vital signs, oxygen levels, lungs sounds, etc be sure to check the ventilator in order
to assure that it is set at the proper levels (respiratory rate, fraction of inspired, tidal
volume, peak inspiratory pressure)
2. Suction appropriately: suction only when needed. Don’t instill normal saline into the
tube. Limit suctioning pressure and suction for as little time as possible.
3. Assess Pain and sedation level
4. Prevent Infection: Keep head of bed elevated to semi-fowlers. Maintain oral care. Can
use prophylaxis for DVT and peptic ulcer disease.