By RN, MS, CCRN, Sheree Comer

ISBN-10: 0585439079

ISBN-13: 9780585439075

ISBN-10: 1569300356

ISBN-13: 9781569300350

This article presents particular, certain details to help you in picking wishes and plans of care and allow you to increase your personal particular nursing care plans for handling acutely unwell sufferers in severe care settings. geared up by means of physique structures, the care plans use NANDA-approved nursing diagnoses and record particular interventions and rationales.

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Instruct on leg exercises and position changes. Decreases venous pooling that can be potentiated by vasodilators and prolonged time in one position. Instruct to avoid hot baths, saunas, hot tubs, and alcohol intake. These promote vasodilation and when combined with diuretics, may increase chance of orthostatic hypotension and syncope. Instruct to avoid over-thecounter medications unless prescribed by MD. Some drugs contain sympathetic stimulants that can increase blood pressure or may cause drug interactions.

Specific antibiotics are determined by the culture information. Information, Instruction, Demonstration INTERVENTIONS RATIONALES Instruct patient to cover mouth and nose during coughing/sneezing. Instruct in handwashing and disposal of contaminated materials. Prevents spread of infection from airborne organisms. Good handwashing reduces spread of infection. Infection control procedures limit contamination and spread of infective materials. Instruct patient in good dental hygiene to use soft toothbrush; to avoid water pik and toothpicks; to obtain regular dental exams.

Decreased perfusion may result in dysrhythmias due to decrease in oxygen. Monitor hemodynamic parameters closely and titrate vasoactive drugs as warranted. Provides immediate information regarding efficacy of medication and status of hypertension. Observe for shift of point of maximal impulse (PMI) to left Shift occurs in cardiac enlargement. Auscultate over peripheral arteries for bruits. Atherosclerosis may cause bruits by obstructing blood flow. Observe extremities for swelling, erythema, tenderness, pain, positive Homans’ sign, positive Pratt’s sign.

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Critical Care Nursing Care Plan by RN, MS, CCRN, Sheree Comer

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