This document discusses critical care nursing and the care of critically ill patients. It defines critical illness as a life-threatening condition requiring intense and vigilant nursing care. Critical care nurses work in intensive care units (ICUs) and emergency departments, caring for patients with issues like respiratory failure, shock, neurological problems, infections, or post-surgery using advanced technology and equipment. The needs of critically ill patients and their families are also outlined, such as physical, emotional and psychological stress from the ICU environment.

1. Advanced Concept in
Nursing

2. CONCEPTUAL FOUNDATIONS IN
CRITICAL CARE NURSING
Critical care
• The care of patient
who are extremely ill
and whose clinical
condition is unstable
or potentially
unstable.

3. Definition of a Critically Ill
Patient
• Critically ill patients are defined as those patients
who are at high risk for actual or potential life-
threatening health problems.
• The more critically ill the patient is, the more
likely he or she is to be highly vulnerable,
unstable and complex, thereby requiring intense
(strong) and vigilant (alert) nursing care.

4. Critical care nursing
• Is the field of nursing with a focus on the
care of the critically ill or unstable patients.
Critical care nurses can be found working
in a wide variety of environments and
specialties, such as:
• Emergency departments.
• Intensive care units ( ICU)

5. Intensive Care Units
• ICU is a place where skilled nurses,
doctors, technologists, respiratory
therapists, and others competently care
for the sickest clients in the hospital.
• Intensive care nurses are also required to
be comfortable with a wide variety of
technology and its uses in the critical care
setting.

6. Technological Equipments of ICU
• This technology includes such equipment as:
– Hemodynamic and cardiac monitoring systems,
– Mechanical ventilator therapy,
– Intra-aortic balloon pumps (IABP),
– Ventricular assist devices (LVAD and RVAD),
– Continuous renal replacement equipment
(CRRT/CVVHDF),
– Extracorporeal membrane oxygenation circuits
(ECMO) and many other advanced life support
devices.

7. History of Critical Care Nursing
o The first intensive care units emerged in
the 1950s to provide care to very ill
patients who needed one-to-one care from
a nurse.

8. Reasons for admission to the
intensive care unit
1. Respiratory difficulties
2. Circulatory problems
(Hemodynamic unstable)
3. Neuralgic changes
4. Life – threatening infections or
risk of infection
5. Metabolic problems
6. Surgeries

9. Respiratory difficulties
• Pneumonia
• Pulmonary embolism
• Drug overdose
• Respiratory distress
Device used: ventilators/ respirators

10. 2. Circulatory problems
(Hemodynamic unstable)
• Hypotension (low blood pressure)
• Myocardial infarction (heart attack)
• Bleeding from internal or external wound
• Required sophisticated
monitoring of cardiac out put and
pressure within the heart.

11. 3. Neuralgic changes
• Loss of consciousness or changes in
mental status
• Head injury
• Brain surgery
• Stroke
• Spinal cord injury

12. 4. Life – threatening infections or
risk of infection
• Burn wound or sepsis
• Requires very intensive care for
medication administration and fluid
management

13. 5. Metabolic problems
• Abnormal electrolytes from diabetes
• Renal failure
• Acid base imbalance

14. 6. Surgeries
• Open heart surgery
• Thoracic surgery
• Brain surgery
• Extensive abdominal surgery or
orthopedic surgery

15. Needs of critically ill client and
family
Needs
• Physical,
• Emotional,
• Psychological,
• Social,
• Environmental

16. Problems
• Pain
• Immobility
• Disorientation
• Sleep deprivation
• Powerlessness
• Hopelessness
• Delirium (ICU psychosis)

17. Feelings
• Isolated
• Anxious
• Depressed
• Fear about their treatment
• The unknown

18. Stress producing things
• Unusual machines
• Loud noises
• Equipment alarms
• Constant light
• Constant attention
• Staff conversations
• Physical restraints
• Lack of privacy
• Inadequate control of pain and anxiety
• Separation from significant others

19. Alteration in sleep
• Impaired immunity and healing
• Increased in oxygen consumption
• Carbon dioxide production
• Negative nitrogen balance
• Stimulation of fight or flight response of
the sympathetic nervous system