OUM Critical Care Nursing Intensive Care of Adult

OUM – Critical Care Nursing Intensive Care of Adult and Pediatric patients with critically ill conditions Topic 5 Dr. S. N. Silva (MBBS)

Cardiovascular Disorders

Assessment l Physical – Critical parameter inspection, palpation and oscultation Laboratory – Cardiac enzymes, SE, Hb l CXR, ECG l

Myocardial Infarction Spectrum of IHD l Complications l l Heart failure l Cardiogenic shock l Rupture l CVA

Other heart diseases l Endocarditis l Predisposing conditions l Complications – Embolisation phenomina, Heart faiure, Renal failure l Cardiomyopathy l Presentation l Complications

Pediatric Heart Disease l Congenital heart diseases l Cyanotic l Acquired heart diseases l Endocarditis l Kawasaki disease l Rheumatic heart disease

Respiratory Conditions l Respiratory key assessment – l Assessment of breath sounds l Added respiratory sounds l Acute respiratory failure l Type I – low Pa. O 2 l Type II – High PCO 2 l Hospital acquired pneumonia - Discuss

Neurological conditions l Neurological evaluation l Raised intracranial pressure l Progression of intra cranial pressure l GCS l Spinal injury evaluation l CSF analysis

CSF

Neurological conditions Strokes – Cortex, Brain stem l Coma – reasons l Delirium l Encephalopathy – Discuss – Hepatic, uremic, Wernike’s etc l Guillen barre syndrome l Other – Snake bite, toxins, drugs l

Renal diseases ARF and ATN l ARF causes – Pre / Post / Renal l Hyperkalaemia – features, Ix, Management l Nutrition and fluid management l Acidosis l Hemodialysis l

Gastrointestinal l Upper GI bleeding l Varicoeal l Ulcers l Reasons l Management l Tears l Lower GI bleeding l AVM

Hematological emergencies Anaemia – heart failure l Rare l l Sickle cell crisis l Exchange transfusions l Plasmaperesis

Trauma l The deadly conditions l High spinal injuries, Massive head trauma, Massive hemothorax, Tamponade, Flial chest l Head injuries l Skull fractures, Concussion, Sontusion, Bleeding l Abdominal l Liver, Spleen lacerations l Acceleration / deceleration injuries

Burns Types l Shock l Infections l Nutrition l Infection prevention l Management l

SIRS and MODS Spectrum of SIRM and Septic shock l Management l MODS discuss l