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Critical Care Nursing (Nursing): Course Outline

Course Description

The course builds on previous nursing courses (Health Assessment, Adult Health Nursing I & II). It focuses on concepts of Critical Care and analyzing client’s problems so appropriate care could be planned with more advanced

concepts Learners are expected to apply critical care concepts, nursing process and implement evidence based care while integrating pathophy siological, pharmacological, psychosocial, spiritual, and cultural concepts and theories within critical and emergency setting.

Course Objectives

On completion of this course the learner will:

  1. Analyze critically, the assessment data of the patient incorporating physical, psychological, social, emotional and spiritual aspects of care.
  2. Relate normal and altered physiological concepts to patient care in critical care and emergency setting.
  3. Apply a variety of concepts and theories to the care of individuals and families, using the nursing process and Gordon's functional Health pattern as the framework.
  4. Demonstrate an awareness of legal and ethical standards in caring for patients with various disorders in a variety of acute and intermediate care settings.
  5. Discuss the concept & principles of Disaster Management

Unit I

Conceptual Foundations In Critical Care Nursing

This unit will assist learners in understanding fundamentals concepts related to critical care nursing. Physiological concepts which affects overall nursing and medical management are highlighted in this unit. Special emphasis is on the psychosocial aspects of care which affect overall individuals, patient and their families’ responses towards the critical care experiences.

  1. Psychosocial implications in the care of critically ill patient and family
  2. Individual and family response to the critical care experience
  3. sleep and sensory balances (overload and deprivation) in critically ill patient
  4. Stress and coping
  5. contemporary issues in critical care area (ethical and legal issues in critical care)
  6. Bereavement and Death and Dying
  7. Spirituality
  8. Hope and quality of life
  9. Infection control in critical care
  10. Nutrition in critical care
  11. Complementary therapies

Unit II

Tools of Critical Care Nursing

In this unit learners will develop an understanding of different tool that are used in critical care setting for patients care monitoring

Methods of hemodynamic management

  1. Discuss various methods available to monitor different variables of hemodynamics
  2. Intraarterial pressure monitoring
  3. CVP care
  4. Left arterial pressure monitoring
  5. Pulmonary arterial pressure monitoring
  6. Cardiac output monitoring

Intraaortic balloon pump monitoring (IABP).

  1. Discuss Hemodynamics of IABP
  2. Describe the hemodynamic benefits of properly timed balloon pumping
  3. List indications, contraindications and complications of IABP
  4. Discuss Nursing responsibilities associated with IABP
  5. Ventilator Care

This unit will assist learners in planning and anticipating appropriate nursing care for the patients on invasive and noninvasive ventilation and its complications.

At the end of this unit, learners will be able to:

  1. Define Ventilator.
  2. Discuss indications of ventilator.
  3. Describe negative and positive pressured ventilation.
  4. Define different parameters of ventilators i.e.
    • Tidal volume (TV)
    • Minute volume (MV)
    • Fraction of Inspired Oxygen (FiO2)
    • I:E ratio
    • Positive End Expiratory Pressures (PEEP)
    • Sensitivity
    • Humidity and Temperature
  5. Discuss different types and modes of Ventilators.
  6. Discuss trouble shootings in the mechanical ventilation.
  7. Discuss in brief complications of mechanical ventilation on various systems of the body.
  8. Identify nursing care of patients on mechanical ventilation.
  9. Explain methods and care of patients who are weaned off from the ventilator.

Unit III

Emergency/Critical Care

Disasters and Triage Management:

This unit highlights the emergency care and anticipatory management in case of natural or man made disasters. Learners will also be able to appreciate the need for multidisciplinary interventions required in planning for and managing a disaster.

At the completion of this unit, learners will be able to:

  1. Discuss the concept of triage and priority setting in emergency setting and during disaster management.
  2. Describe and anticipate various types of disasters i.e. Natural and Manmade.
  3. Identify the chain of communication and need for multidisciplinary interventions during a disaster.
  4. Describe the role of an in-charge nurse, triage nurse and other Emergency Room nurses in ensuring a non-panic, well-coordinated management during a disaster (pre-hospital and hospital setting).
  5. Discuss the post disaster effect of patient in their quality of life
  6. Discuss the role of rehabilitation.

This unit will assist learners in planning and anticipating appropriate nursing care for the patients with hemorrhage and its complications with regard to the estimated blood loss.

At the end of this unit, learners will be able to:

  1. Classify the patients with hemorrhage according to the estimated blood loss.
  2. Appreciate    the   signs/symptoms   associated   with   each   class   of hemorrhage.
  3. Describe the nursing interventions appropriate for each class of hemorrhage.
  4. Demonstrate understanding of the patho-physiology of hemorrhagic shock.
  5. Appreciate the diversity in nursing care of patient in acute shock state.
Life threatening Emergencies:

This unit will assist learners in understanding various conditions that may lead to life threatening emergencies, including cardiopulmonary, emergencies and shock. The unit also highlights the differences in approaching a potentially fatal emergency victim in the Emergency Room

(ER) and in-patient care settings versus arrest situation out side the health care settings.

At the completion of this unit, learners will be able to:

  1. Describe various conditions classified as cardiac arrest.
  2. Predict the risk factors that may result in cardiac arrest.
  3. Identify the tools for Basic Cardiac Life Support (BCLS) in an ER & in- Patient care setting versus arrest situation outside health care facilities.
  4. Explain the etiological and patho-physiological alterations (Hypoxia, Hypo/Hyperkalemia, failure in Ca + transport system, Acidosis, MI etc.) that might lead to a cardiac arrest.
  5. Demonstrate a basic understanding of the management of cardiac arrest in an in-patient care setting.
  6. Demonstrate an understanding of the commonly used drugs in the management of cardiac arrest.
  7. Describe the complications of Cardio Pulmonary Resuscitation CPR.
  • Define shock
  • Discuss types of shock
  • Discuss the medical and nursing management of all types of shock
Overall Clinical Objectives Critical Care Nursing
    • Apply nursing process and critical thinking in delivering Holistic nursing care to clients in critical care and emergency setting.
    • Incorporate cognitive, interpersonal and technical skills from the humanities, natural and behavioral sciences while providing nursing care to clients.
    • Demonstrate awareness of legal and ethical standards when providing nursing care.
    • Demonstrate the knowledge of pharmacology used to treat all medical surgical disorders in critical care and emergency setting.
    • Demonstrate leadership abilities necessary to foster change in the delivery of care for the patients.
    • Provide culturally sensitive and realistic teaching to clients and families in collaboration with other health team members.
    • Collaborate with members of the health care team provide nursing care to critically ill patients.
    • Document all assessments, nursing care and discharge teaching provided to the clients in appropriate sheet