Category: Critical Care Nursing Ketamine leads to analgesia, amnesia and catalepsis. It does not produce unconsciousness, but rather a trancelike state. Patients often experience nystagmus, roving eye movements and random movements of the extremities.
Category: Critical Care Nursing Ketamine is a derivative of the street drug phencyclidine and is classified as a dissociative agent. It causes disruption between the thalamoneocortical and limbic systems, preventing the centers from perceiving visual, auditory or painful stimuli.
Category: Critical Care Nursing Benzodiazepines are amnestic, hypnotic and anxiolytic medications. They also have anticonvulsant and muscle relaxant properties but do not have analgesic effects. Because of this, they are commonly given with an analgesic agent.
Category: Critical Care Nursing Morphine has a histamine release and therefore is more likely to produce hypotension, especially in preload-dependent patients. Morphine undergoes hepatic metabolism to an active metabolite, followed by renal excretion.
Category: Critical Care Nursing Because fentanyl readily creates a reservoir in adipose tissue, accumulated large doses may result in a progressively increasing duration of effect. This does not generally occur in doses less than 10 µg/kg.
Category: Critical Care Nursing Fentanyl has many advantages, given its rapid onset, short duration, lack of histamine release and favorable cardiovascular profile. Fentanyl rapidly crosses the blood-brain barrier and produces analgesia in as little as 90 seconds.
Category: Critical Care Nursing General anesthesia is a drug-induced loss of consciousness during which patients are not arousable, even with painful stimulation. The ability to maintain ventilatory function independently is often impaired.
Category: Critical Care Nursing Deep sedation and analgesia describes a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully after repeated or painful stimulation.
Category: Critical Care Nursing Dissociative sedation is a trancelike cataleptic state induced by the dissociative agent ketamine. It is characterized by analgesia and amnesia while protective airway reflexes, respirations and cardiopulmonary stability are maintained.
Category: Critical Care Nursing Moderate sedation and analgesia (formerly called conscious sedation) refers to a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, alone or accompanied by light tactile stimulation.
Category: Critical Care Nursing Minimal sedation (anxiolysis) is a drug-induced state during which patients respond normally to verbal commands. Although cognitive functions and coordination may be impaired, ventilatory and cardiovascular functions are unaffected.
Category: Critical Care Nursing Strategies for managing intubated patients with COPD focus on improving gas exchange while minimizing iPEEP. Reduction of iPEEP is achieved by decreasing airway resistance with bronchodilators and corticosteroids.
Category: Critical Care Nursing The initial evaluation of a decompensating vented patient should begin by confirming the position and patency of the endotracheal tube before other diagnoses are investigated, including evaluation of the tracheal balloon.
Category: Critical Care Nursing Patients with hemodynamic compromise or acute hypoxia on the ventilator should be auscultated and chest examined to ensure breath sounds. Changes in breath sounds may indicate a pneumothorax or migration of the endotracheal tube.
Category: Critical Care Nursing Patients with acute hemodynamic compromise or acute hypoxia on the ventilator should be bagged manually on 100% oxygen. Tension pneumothorax, increased iPEEP and accidental extubation are the most life-threatening concerns.
