New to ICU, Critical Thinking, Code Blue,
Hemodynamic Monitoring, OR, PACU,
Reading EKG, Cardiac Output
DEARNURSES.ORG
ICU - IMAGINE BEING IN THIS SITUATION   -
THE NEW NURSE
IMAGINE BEING A NEW NURSE IN ICU

Imagine this is Nurse Jenna's first day on the job in an
ICU.
The night before she was extremely
anxious about
what she might have to face the next day.

The shift begins and as she enters
ICU, she hears a
Code Blue being called overhead. What is a Code
Blue?  She has no idea.

Suddenly she sees people rushing frantically to one
room, a
Crash Cart is pulled towards the room.
She is standing trying to make sense of the whole
thing but there is no one there to ask a question.
What is she supposed to do?

What Nurse Jenna is actually witnessing is a patient
being resuscitated (
CPR) or Code Blue.

Typically when a patient stops breathing
AHA
guidelines are followed.
The designated staff usually respond to the Code
Blue call. There is a Code Blue button in each room in
the
ICU. If a patient becomes unresponsive, the nurse
presses the button to alert the staff.

The trained staff grab the Crash cart, when a Code
Blue is called and take it to the room. CPR is usually
begun and the doctor decides what
medications are
given and the
course of treatment.

Vital signs, oxygen saturation,
EKG tracings are  
continually monitored and recorded.
























A 12 lead EKG are is also done. The doctor mans the
Code. Lab values, like the
ABG, is done and the need
for intubation is assessed. On occasion the
resuscitative efforts are not successful and family
members or responsible party may have to be
consulted about
decision making.

If intubation is necessary, the respiratory therapist
assists with this procedure. Following intubation, a
chest X-Ray is done for placement of the ET tube,
breath sounds are also checked. Breathing would be
assisted with
mechanical ventilation. (Ventilator
settings are ordered by the MD).

A nurse records
all medications given, time of
intubation, size of ET tube. Assessment and
documentation of the patient's status is also done.

Although this could be a very difficult situation for
a beginner, here are some helpful hints:

- check with the staff to see if help is needed with
calling for a
chest X-ray, or EKG
- or if an
IV solution is needed
- or if any help is needed to record medications and
Vital signs taken during the Code Blue.

This is just an overview of what a code setting would
look like.

For your learning pleasure here are some helpful
topics:
-
Easy EKG Reading,
-  
Hemodynamic monitoring
-  CPR
Some patients, like the liver transplant patients, are
recovered in the ICU instead of
PACU.
When Chest Pain Strikes
No one knows when Chest
Pain will strike. The EKG is a
diagnostic tool used for the
patient having chest pain.
HEMODYNAMIC
MONITORING
is done in the
ICU. The PAC(
Pulmonary
artery catheter) is a useful
diagnostic tool which is
inserted into the heart.
It is used to
diagnose
conditions such as sepsis, MI
and
Valvular disease.
The Cardiac Output is also
measured through this
catheter. A special
syringe is
attached to one of the ports of
the PAC and the
cardiac
output is measured.  
THE SA NODE FIRES AND
THE ATRIA CONTRACT.
It is like a light bulb that is  
turned on.
ANESTHETICS (Overview)
General Anesthetics are
usually given prior to and
during surgery.

Drugs such as Fentanyl,
Versed, and Propofol are
used to bring about a state of
unconsciousness during
surgery.
Your critical thinking can be a
challenge.
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PHARMACOLOGY CORNER
Neosynepherine IV (Phenylephrine) is given
to elevate
blood pressure.
This improves the neurological status of the
patient who is lethargic following conditions
such as SAH, which causes
bleeding in the
brain.
Side effects include abdominal
discomfort which may become severe.

Dopamine Hydrochloride IV is ordered to
increase
blood pressure.
At low doses, Dopamine is known to
increase renal perfusion and thus increase
urinary output. At high doses, it is known to
decrease urinary output as it causes
vasoconstriction.
TOPICS A - B  C-D  TOPICS E - H  TOPICS I - P  TOPICS Q - Z     Bulletin Board   SITE INDEX
Electrical Conduction
System of the Heart
The heart has an electrical
conduction system which
originates in the right atrium.
The
SA node is the beginning
of this system.
NURSING COMMUNICATION SKILLS
Nursing Communication is an essential
part of a day's work. Skills are needed
to accomplish positive feedback.
Learn more, click below:              
Nursing Communication