Page 179 - Critical Care Nursing Demystified

164 CRITICAL CARE NURSING DeMYSTIFIED

KEY WORDS

ACLS – Advanced Cardiac Life Support ICD – implantable cardioverter
Asynchronous pacing (fixed) defibrillator
Atrial kick Isoelectric line
Baseline Lead wire
BLS – Basic Cardiac Life Support Nonconducted P wave
Cardiac monitor Pacemakers: transthoracic, epicardial,
Depolarization permanent, and transvenous
Dual-chamber pacing Premature beats
ECG calipers Repolarization
Ectopic beats Supraventricular
Electrode Synchronous pacing (demand)
Escaped beats 12-lead ECG

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1 Assessment of cardiovascular status is a vital skill set for critical care
nurses. Good, solid experience with basic medical-surgical patients is
required in many institutions prior to jumping into the critical care setting,
because many of the signs are subtle and experience is necessary so that
nothing is omitted. Not all of the rhythms you will learn in this chapter
cause a serious drop in a patient’s pulse and BP, but many of them do. The
addition of complex cardiac monitoring and equipment the nurse is chal-
lenged to learn and master is no replacement for sound, organized, thorough
nursing judgment. This is best acquired by exposure to a wide variety of
patients and situations.
Whenever cardiac output is in question, many body systems are involved.
We covered many of these in Chapter 3, but because these are essential skills,
a bit of repetition might be, a very good thing. In Table 4–1, refresh yourself
with what those signs and symptoms might be using the body systems approach.
These are not written in the order that the nurse would perform the skills,
because nurses are very good at multitasking and many of these might be done
simultaneously.