Hi. Welcome to our video series
on neurological disorders.
Now, it's okay if you're starting
with this point,
but I want to give you a little bit of
background of the patient that we're following.
Mr. Johnson came to the ER
showing us signs of stroke.
He was evaluated in the ER,
and it was determined that
he had an ischemic stroke.
Now, we're going to pick up
Mr. Johnson in intensive care
and talk about the hands-on nursing
care of a stroke patient in ICU.
In this graphic, you've got a representation
of the ER nurse in the black scrubs,
and the ICU nurse in the kind
of pink-colored scrubs.
Now, they're going to exchange
report on Mr. Johnson.
This is a really important skill
that you need to practice,
but I first want to talk about why
Mr. Johnson is going to ICU.
I mean, we know that he had a stroke,
but we gave him medication that,
hopefully, is resolving that.
But after a drug like alteplase,
which is a thrombolytic,
it really rips apart any clots
in the patient's body.
So, he's going to need very close monitoring.
That's just not possible on a unit
like Med-Surg where there are multiple
patients, and you can't visualize the patient.
In a Critical Care Unit, it's
usually very open,
you have high visibility, the
patient's on a monitor,
so they can keep a much
closer eye on the patient.
On a Med-Surg unit, a nurse can
have 6, 7, 8 patients at a time.
In ICU, their patient to nurse
ratio is much smaller,
usually 1 nurse to 2 patients, maybe 3,
depending on how critical they are.
Mr. Johnson is a new admit. He'll
need close monitoring,
both his cardiac and his neurological
status, so you're going to get report
as the ICU nurse -- Now, I want you to
think of yourself from that perspective.
As the ICU nurse, you're going to get
report from your colleague from ER.
Okay, now, here's your goals. You
know as an ICU nurse,
these 5 things are the things that
are going to be your focus
for Mr. Johnson coming to
the Critical Care Unit.
First, number 1, doesn't matter what
unit you're on, and you'll see me
say it over and over again,
but your role is always to maintain
the stability of the patient's airway,
breathing, and circulation.
Now, we talked about why he's coming to ICU
is because of frequent monitoring.
And that's a very common reason
why people are admitted
to a Critical Care bed.
Hey, those are really expensive beds,
and we don't have very many of them.
So you want to make sure the patients that
are admitted to those beds really need it.
Usually, it's because they need
very close monitoring of
any of the body systems. In this case,
it'll be very close of neuro
That will include their vital signs.
Now, we want to recognize
any signs of Mr. Johnson's
particularly, his level of consciousness
and his mentation.
ICU nurses, as all nurses are
trained in neuro assessment,
should recognize any changes.
And since there's a lower
nurse to patient ratio and a better
visualization of the patient,
they have the best chance of
catching these signs early.
We also want to look for
signs of complication
after the stroke or thrombolytic therapy.
So, if he's showing us any signs of bleeding
or any other issues with complications,
we'll be right on top of it because
he's in a Critical Care Unit,
or we can watch him very closely.
Because our goal here,
all throughout his stay, is
to preserve the function
that Mr. Johnson has
and minimize any further neurological
damage or disability he may experience.
Remember, right now, he's got the facial
drooping, he had the arm that was weak,
so we want to hopefully resolve that
and minimize any future risks.