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Click to edit Master title style • Click to edit Master text styles –

Click to edit Master title style • Click to edit Master text styles – Second level • Third level – Fourth level » Fifth level PICU Nursing Lauren Turner RN, MS, CCRN, CCNS February 5, 2014

What is the PICU? Click to edit Master title style • Click to edit

What is the PICU? Click to edit Master title style • Click to edit Master text styles – Second level • Third level – Fourth level » Fifth level

Click to edit Master title style “Pediatric critical care nurses create an environment in

Click to edit Master title style “Pediatric critical care nurses create an environment in • which Clickcritically to edit Master texthighly stylesvulnerable infants and unstable, – children Second level benefit from the vigilant care and the • Third level coordinated efforts of a team of highly skilled pediatric – Fourth level healthcare -Curley » Fifth levelprofessionals”.

PICU Patient Population Click to edit Master title style • Click to edit Master

PICU Patient Population Click to edit Master title style • Click to edit Master text styles – Second level • • Neonates to Young Adults and their families Third level – (ages – Fourth level I » Fifth level day to up to 21 years of age) • Patients with a congenital or childhood disease • Most diverse unit in the hospital

Click to edit Master title style Baby sick at birth? They • will. Click

Click to edit Master title style Baby sick at birth? They • will. Click edit go to theto NICU with Dani Master text styles – Second level • Third level If Baby is healthy they go home! Family has a new baby! – Fourth level » Fifth level Once baby has gone home and then gets sick, they will come to the PICU Welcome to the PICU!

Sample PICU Diagnosis By System Click to edit Master title style • Neurologic: Click

Sample PICU Diagnosis By System Click to edit Master title style • Neurologic: Click to edit Master text styles – – – – Seizureslevel Second • Third level Traumatic Head Injury – Fourth level Drug Overdose/Depression/Suicide Attempt » Fifth level Hydrocephalus, VP Shunt Failure DI/SIADH Aneurism AVM

Sample PICU Diagnosis By System Click to edit Master title style • Respiratory: Click

Sample PICU Diagnosis By System Click to edit Master title style • Respiratory: Click to edit Master text styles – – – – – Pneumonia Second level • Third level Failure Respiratory – Fourth level Asthma » Fifth level RSV Croup Flu! Cystic Fibrosis Surgery: Tonsillectomy & Adenoidectomy Facial reconstruction

Sample PICU Diagnosis By System Click to edit Master title style • Cardiovascular: Click

Sample PICU Diagnosis By System Click to edit Master title style • Cardiovascular: Click to edit Master text styles – – Heart defect Second level • Third level Heart Transplant – Fourth level Cardiogenic Shock » Fifth level Abnormal heart rhythms (SVT, V Fib, flutter)

Sample PICU Diagnosis By System Click to edit Master title style • GI/GU: Click

Sample PICU Diagnosis By System Click to edit Master title style • GI/GU: Click to edit Master text styles – – – Transplant Second level(Liver, Small Bowel, Pancreas) Kidney • Third. Failure level Organ– Fourth Rejection » Fifth. UTI level Complicated Toxic Shock Syndrome Complications due to: Diabetes Cancer Lupus Trauma (Child abuse, accident)

Common Pieces of Equipment in the PICU Click to edit Master title style •

Common Pieces of Equipment in the PICU Click to edit Master title style • • Monitor Click to edit Master text styles – Second level Ventilator • Third level IV Pump – Fourth level Suction » Fifth level Crash Cart Central IV Line Surgical Drains

Click to edit Master title style • Click to edit Master text styles –

Click to edit Master title style • Click to edit Master text styles – Second level • Third level – Fourth level » Fifth level You can have patient’s that you can pick up, hold and interact with

Click to edit Master title style • Click to edit Master text styles –

Click to edit Master title style • Click to edit Master text styles – Second level • Third level – Fourth level » Fifth level You will also have very unstable patients who require diligent monitoring

Family Centered Care Click to edit Master title style • Click …“recognize to edit

Family Centered Care Click to edit Master title style • Click …“recognize to edit Master the vital text rolestyles that families play in ensuring – Second the levelhealth and well-being of patients. They • Third level that emotional, social, and developmental acknowledge Fourth level support– are integral components of health care. They » Fifth level promote the health and well-being of individuals and families and restore dignity and control to them. ” Institute for patient and family-centered care. (2012). Retrieved October 20, 2012, from http: //www. ipfcc. org/advance/topics/family-presence. html • What are some examples of family centered care?

Role of the PICU Nurse Click to edit Master title style • Click You

Role of the PICU Nurse Click to edit Master title style • Click You are to being edit Master hired by text Webster’s styles Dictionary as a new writer. – Second. They level ask you to write your definition of a • Third level PICU Nurse… – Fourth level » Fifth level • The Day of a PICU Nurse

Role of the PICU Nurse Click to edit Master title style • Many Click

Role of the PICU Nurse Click to edit Master title style • Many Click days to edit on the Master job I text see myself styles being a… – Second level • Nurse • Third level • Social Worker – Fourth level » Fifth level • Physical and Occupational Therapists • Mediator • Housekeeper • Respiratory Therapist • Chaplin • Friend

QUESTIONS? Click to edit Master title style • Click to edit Master text styles

QUESTIONS? Click to edit Master title style • Click to edit Master text styles – Second level • Third level – Fourth level » Fifth level

Review Question #1 Click to edit Master title style • Click A childtoadmitted edit

Review Question #1 Click to edit Master title style • Click A childtoadmitted edit Master to the text. PICU styles can be treated for all of the following: – Second level (Choose all that apply) • Third level A: – Fourth level Asthma » Fifth level B: Low blood pressure C: Cardiac Surgery D: Diabetes

Click to edit Master title style • Mary, a 5 edit year old female

Click to edit Master title style • Mary, a 5 edit year old female was just admitted to the Click to Master text styles PICU duelevel to an asthma attack. She used her home – Second nebulizer, but it did not relieve her breathing • Third level difficulties. – Fourth. Her level parents took her to the emergency » Fifth room where thelevel ER team treated her with 3 albuterol treatments. Mary continued to have respiratory distress and wheezing so she was placed on a continuous breathing treatment and admitted to the PICU. While in the PICU what does she need to be attached to?

Click to edit Master title style • • Oxygen! Click to edit Master text

Click to edit Master title style • • Oxygen! Click to edit Master text styles – Secondmonitor level Cardiac • Third level Continuous pulse ox – Fourth level Fifth IV levelfluids IV placed » with • What tests will be performed? • Blood work • Flu and RSV

Click to edit Master title style • Who Click will to edit help. Master

Click to edit Master title style • Who Click will to edit help. Master in her care? text styles – – – – Nurse level Second • Third level Doctor – Fourth level Respiratory therapist » Fifth level Nursing assistant Child life specialist Unit secretary Family!

Click to edit Master title style • Click John, to a 13 edit year

Click to edit Master title style • Click John, to a 13 edit year Master old boy textwas styles skateboarding after school with his friends when he fell and hit his head on – Second level Third level He was not wearing a helmet and at first the • cement. Fourth level said he–felt ok. A few minutes later his friend said » Fifth level that he started to mumble and wasn’t making much sense. His friend called John’s mom, who took him to the emergency room.

Click to edit Master title style • Click When to John editgot Master to

Click to edit Master title style • Click When to John editgot Master to thetext emergency styles room, his breathing was reallylevel slow and he was very lethargic. The ER – Second levelto sedate John and place a breathing tube. team • Third decide – Fourth level They then took John to get some CT images of his » Fifth level brain. The results were that John had multiple skull fractures and a brain bleed. He was them immediately transferred to the PICU for further care.

Click to edit Master title style • What Click to kinds editof. Master things

Click to edit Master title style • What Click to kinds editof. Master things text would styles John be attached to? – – – Cardiac level Second monitor • Third Pulse oxlevel – Fourth level Ventilator » Fifth level IV Fluids, sedation medication May still be under spinal precautions May have an ICP bolt to monitor brain swelling Who would be involved in his care?

Click to edit Master title style • • Nursesto edit Master text styles Click

Click to edit Master title style • • Nursesto edit Master text styles Click – Second(PICU level and Neurosurgery) Doctors • Third level Respiratory therapy – Fourth level » Fifth level Nursing assistant Unit secretary Chaplin Child life specialist PT/OT when awake and able to move.