NR 341 Week 1 Nursing Care: Complex Health Situations

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Chamberlain University

NR-341 Complex Adult Health

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NR 341 Week 1 Edapt Notes: Nursing Care in Complex Health Situations

Critical Care Environment and Stress Reduction

The critical care environment, with its overwhelming stimuli such as artificial lighting, noise, and medical equipment, often increases stress and anxiety levels in clients and their families. Nursing interventions should focus on reducing these stressors by maintaining a calm, organized environment and ensuring natural lighting. This helps clients preserve their circadian rhythms, reducing disorientation. Strategies include orienting clients and their families to equipment, maintaining a clutter-free room by organizing tubes and wires, and reducing artificial lighting during rest periods. These approaches foster a more natural day-night cycle, improving client comfort and reducing anxiety (Patel et al., 2019).

Family Dynamics and Communication in Critical Care

Family involvement in critical care can be enhanced using evidence-based models like the EPICS Family Bundle, which incorporates Evaluate, Plan, Involve, Communicate, and Support. This framework promotes effective family engagement in the care of critically ill patients. For instance, assessing family coping mechanisms and ensuring honest communication foster a supportive care environment. Encouraging family participation in caregiving tasks, such as providing personal items, reduces isolation and enhances emotional support. The ISBAR communication technique is critical for healthcare providers, improving the clarity and accuracy of information sharing while reducing adverse outcomes (Rodgers & Peterson, 2020).

Pain and Stress Management Protocols in ICU Settings

Stress in ICU patients, exacerbated by their health conditions, can trigger physiological responses, including stress ulcers. A holistic approach to pain management, such as the ABCDEF Bundle, addresses pain, promotes mobility, and encourages family engagement. Tools like the Critical-Care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS) aid in pain assessment for non-verbal clients. Non-pharmacologic strategies, including positioning and family interaction, are complemented by conservative pharmacologic interventions to prioritize pain relief and reduce the risk of delirium (Smith & Lin, 2022).

NR 341 Week 1 Nursing Care: Complex Health Situations

Category	Findings	Interventions
Risk Factors for SRMD	Mechanical ventilation, altered clotting, renal failure, sepsis, hypotension	Administer PPIs, manage blood pressure, maintain adequate fluid volume.
Clinical Indicators	Low BP, delayed capillary refill, facial grimacing, elevated BUN/creatinine	Monitor BP, manage pain, assess renal function, and monitor urine output.
Ethical Considerations	Need for advanced care planning (DPOA, living will)	Educate clients and families about DPOA, living will, and patient-centered care options.
Health Disparities	Income, race, gender, and geographic barriers to care	Advocate for health equity and tailor care to address disparities.
Rapid Response Team Role	Early detection of clinical decline in non-critical settings	Activate RRT promptly to prevent in-hospital cardiac arrests and improve patient outcomes.
Palliative Care Objectives	Address symptom management and end-of-life planning	Maintain comfort, support families, and ensure dignified care during the dying process.
Organ Donation Focus	Preserve organ function post-mortem	Follow evidence-based protocols to maintain organ viability while supporting family and client.

References

Centers for Disease Control and Prevention. (2017). Health disparities. Retrieved from https://www.cdc.gov/healthdisparities/

Dukes, T., Tyson, M., & Cannon, R. (2019). The role of rapid response teams in reducing in-hospital cardiac arrests. Journal of Critical Care Nursing, 34(2), 112-119.

Jackson, S. (2017). Early recognition of cardiac arrest symptoms. American Journal of Emergency Medicine, 35(6), 1023-1028.

Patel, M., Wong, S., & Lee, T. (2019). Effects of lighting on circadian rhythms in ICU patients. Journal of Clinical Nursing, 28(4), 445-454.