Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In pulmonary embolism, the ECG is often normal, but may show sinus tachycardia (the most common finding), Brugada pattern, atrial fibrillation or the classically reported S1Q3T3 (McGinn-White) pattern.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Signs of pulmonary hypertension and right heart failure may be present in pulmonary embolism. Lung examination may reveal crackles, decreased breath sounds, wheezing, rhonchi or a pleural friction rub.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Unexplained tachypnea or tachycardia may be the only diagnostic clue in pulmonary embolism. Hypoxia, though typical, is not a universal finding, and its absence cannot exclude pulmonary embolism.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Chest pain resulting from pulmonary embolism is often pleuritic and associated with dyspnea, hemoptysis, cough or syncope. Physical examination findings are generally nonspecific in pulmonary embolism.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
All patients suspected of having acute coronary syndrome should be treated with aspirin, if not contraindicated (e.g., aortic dissection also suspected), or alternatively prasugrel or ticagrelor if there is aspirin allergy.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
There are no specific physical examination findings of acute coronary syndrome, but if it is severe enough to induce left ventricular dysfunction, signs such as hypotension and an S3 or S4 heart sound can be present.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In the absence of an obvious cause of chest pain (e.g., shingles), a chest x-ray and ECG should be obtained. A chest CT can help diagnose a number of causes including pulmonary embolism, aortic dissection, pneumothorax and pneumonia.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
A number of clinical strategies may be used in the ICU patient who shows evidence of ileus or significant GI dysmotility. Electrolytes should be corrected, minimizing subsequent alterations, particularly in potassium and magnesium.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In gastric emptying, solids empty by zero-order kinetics, which is related to the steady antral grinding of solids and a fixed rate of emptying through the pylorus unaffected by meal volume.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In gastric emptying, liquids empty by first-order kinetics, which relate to increased fundic pressure, causing a rapid parabolic emptying of liquids and the rate of emptying speeds up with increasing meal volume.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
A nasogastric tube placed for gastric decompression in postoperative ileus would be expected to benefit the surgical patients, but instead it worsens outcomes by increasing the incidences of pneumonia, leading to slower returns of GI function.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
When present, ileus in critical illness has been shown to be associated with nutritional deficits, greater risk of aspiration, sepsis, prolonged mechanical ventilation and increased allocation of healthcare resources.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Ileus is characterized objectively by measurements limited mostly to research tools such as measuring gastric emptying by acetaminophen absorption tests or passage of radiolabeled carbon compounds, or small intestinal manometry.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Usually, ileus is characterized clinically by hypoactive or absent bowel sounds, abdominal distention and delayed passage of stool and gas, but the process may involve nausea, vomiting and abdominal tenderness.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In the postoperative surgical intensive care unit, evidence of postoperative ileus ranges from 24% to 75%. Ileus can affect the entire gastrointestinal tract or just a segment, from the proximal gut, to the small bowel, to the colon.