Telemetry Unit: Acute Stroke Treatment Goals – Stroke Nursing Care in Med-Surg

00:01 Now let's talk about what the goal is in this telemetry/medical surgical unit.

00:05 Our idea is we want to maintain medical stability of the patient's ABCs.

00:10 Remember, that's our top priority, no matter what the unit, no matter what the patient, those are always our top priorities.

00:18 But because he's had a stroke, we're going to be watching that neurological status really closely. Also, his cardiovascular status, his rhythm, and his vital signs.

00:28 Now, we can watch his rhythm because he's in a telemetry unit, and he'll be on a monitored bed is what we call it, but really, he'll have a monitor that will show us his cardiac rhythm.

00:38 Now, we want to make sure that you recognize the signs of any deteriorating condition in his level of consciousness and mentation.

00:45 That's why in a telemetry unit, we've got a little lower ratio of nurses to patients.

00:51 So rather than just a regular Med-Surg unit, you've got a little extra time, more availability, to view your patients. So these patients are generally a little bit more critical than a Med-Surg unit and they require some special monitoring.

01:06 Now, obviously, all are working together to minimize possible complications from the stroke.

01:11 We want him to have optimum functioning by the time he goes home, and then after he's at home, we'll determine what type of outpatient care he needs.

01:19 So you're going to work with an interdisciplinary team.

01:22 Now, our job is to get this interdisciplinary evaluation and discharge planning done.

01:28 So who's going to be involved in discharge planning? Well, listen, it should start right away.

01:33 So, we're going to work with the physical therapist, the speech therapist, the occupational therapist, the social worker, and the registered dietician will all work together with the patient and family to come up with a good plan.

01:45 Okay. So, look at all that we're going to accomplish in telemetry.

01:48 We're going to make sure he stays stable, watch him for early signs of any problems or complications.

01:54 We're going to help him get as strong and safe as we can before he goes back home and we're going to make sure he has a solid discharge plan.

02:02 So, all these people work together to assess where he is right now and where we're sending him. So we need to know what his house is like, how many steps there are to get into his house? What does it take for him to get from his bedroom to his bathroom? Is his bedroom on the first floor? Is it on the third floor? Does he have to take stairs? All of those questions are vitally important.

02:23 The team will work together to get that information.

02:26 It is our job as the nurse to work with the team to make sure that our discharge plan is safe and effective.

02:34 We're the main person to coordinate with all these people and the physician to make sure Mr. Johnson will be safe when he goes home.

02:43 Now, I want to look at what a telemetry unit is, in case you're not familiar with it.

02:47 So that's why we have this question. So, what is a telemetry unit? Well, you already know, it's a smaller, usually a lower patient ratio than a regular Med-Surg unit.

02:58 We've got the ability to do some monitoring.

03:00 So, it's like what you should see here.

03:03 The patients are on a small box and it has wires coming off it, right? What you can do is connect those electrodes to the patient's chest wall, and you take that box. And usually, telemetry gowns have a little pocket in them, so you can either put them in the pocket of the gown, or we can tie a holder around their neck.

03:21 The point is, they're very mobile with this.

03:24 So, this will be their heart monitor. We can read it on a screen at the desk.

03:27 And usually, most hospitals have another central monitoring unit, that anyone who is on a heart monitor, their rhythm will be present on that screen.

03:36 And that is a cardiac monitor's tech's job.

03:40 They sit in a large room with lots of screens, and they watch everyone's rhythm.

03:45 But you also can see that at the nurses' desk.

03:48 So the nice part about this is, in ICU, the patient has a heart monitor on, but they're directly wired to a monitor in the room.

03:56 With telemetry, they can be mobile.

03:58 They can walk all the way around. It just stays right with them.

04:02 So that's what a telemetry unit offers that a Med-Surg unit doesn't.

04:06 It has the ability to have him on a heart monitor and we can watch that closely.