INFECTION

NSG. INTERVENTION a. Monitoring for signs and symptoms of infection. b. Culture and sensitivity results. c. Administering appropriate antibiotics.

NUTRITION
NSG. MANAGEMENT: Provide enteral or parenteral feedings. Monitoring weight,albumin, and nitrogen balance.

IMMOBILITY
Documents complication like pressure ulcers, deep vein thrombosis, pulmonary complication, muscle wasting. Observe strict repositioning schedule. Do chest physiotherapy.

Assess regularly for discomfort by the use of visual aid or pain scale. Request for analgesics available for 24 hrs.

ANXIETY
Symptoms: a. Tachycardia b. Tachypnea c .Restlessness d. Inability to sleep e. Diaphoresis

Administering anxiolytics drugs Encouraging unrestricted visitation by family members. Providing therapeutic communication. Using guided imagery. Communicating the treatment plan. Offering music therapy. Spending extra time with the patient.

Keeping social conversation and laughter to a minimum and decreasing telephone ring volumes. Help control environment noise by lowering alarm volumes.

SLEEP
Nurse must minimize unecessary noise and lights and recognize any important nightime rituals. Perform necessary assessments and procedures while allowing a minimum of two hrs. of uninterrupted sleep.

COMMUNICATION
Modalities of communication includes: a. Picture board b. Paper and pen c. Agreed on gestures

Reasons for communicating with ventilated responsive patient:

Experiences of pain Identifying patients emotion Determining patients symptoms Responding to patients needs for physical care The physical environment of the ICU The patients home and family Treatment decision making

Purpose of communicating sedated and unresponsive patient:

Provide orientation State procedural and task intentions Provide reassurance Apologize and or recognize discomfort Obtain response Provide intention and unintentional distraction

Family members needs

There are five needs by most families a. Reassurance b. Flexible visitation c. Information d. Comfort e. support

CONCERNS OF CRITICALLY ILL PATIENTS

BEING THIRSTY HAVING TUBES IN THEIR MOUTH AND NOSE NOT BEING ABLE TO COMMUNICATE BEING RESTRICTED BY TUBES OR LINES BEING UNABLE TO SLEEP NOT BEING ABLE TO CONTROL THEMSELVES

RECOMMENDED FIVE EVIDENCED-BASED INTERVENTION TO FACILITATE COMMUNICATION WITH MECHANICALLY VENTILATED:

Be educated about the frustration that mechanically ventilated patients experienced when they are attempting to communicate their needs and desires. When communicating with ventilated patients they should:

a.

Routinely ask patients about their feelings and their state of mind.

b. Ask permission before beginning nursing care and procedures. c. Evaluate patients understanding of the information conveyed by asking simple yes or no question. Demonstrate attention to the needs of their patients by informing them of their surroundings, plan of care, and when they will return after leaving the bedside.

Approach each patient with a kind, patient manner : take time to investigate and understand what the patient is communicating : and respond to the patients communicated needs. Provide writing materials and read the patients words as they are written, allowing the patients to verify that the reader understands the patient correctly.