Question

Why is pain assessment more challenging in critically ill patients?

-Which team members would the nurse consult to assist with the nutritional support of critically ill patients?

-What actions and treatments can reverse AKI at the initiation phase?

-When would hematochezia occur secondary to upper GI bleeding? -

Why are bowel sounds often hyperactive in GI bleeding?.

Answer 1

Ans) 1) Accurate assessment of pain in the critically ill is undoubtedly a challenge. In this setting, however, the nurse can rise to the challenge and have a significant impact on pain management. Some careful thought and planning may allow the nurse to adapt usual assessment tools for use by patients who have difficulty in communicating. When patients cannot communicate, having accurate knowledge about pain and about the patient's condition can help nurses to make appropriate use of behavioral and physiologic signs. More research is necessary to test specific pain assessment tools in ICU settings. In addition, more studies are needed to document the reliability and validity of scales based on behavioral and physiologic indicators of pain in critical care settings. In the meantime, nurses can take several steps to ensure adequate pain assessment: (1) use all means possible to document the patient's self-report of the pain experience, (2) supplement these ratings with behavioral and physiologic indicators of pain status, and (3) document findings to comunicate the patient's pain to others caring for the patient. A careful thorough attempt to assess pain can ensure better pain, outcomes as well as a quicker and more positive return to health.

2) Team members would the nurse consult to assist with the nutritional support of critically ill patients are dietitian and speech therapist

3) Acute kidney failure happens when your kidneys suddenly lose the ability to eliminate excess salts, fluids, and waste materials from the blood. This elimination is the core of your kidneys’ main function. Body fluids can rise to dangerous levels when kidneys lose their filtering ability. The condition will also cause electrolytes and waste material to accumulate in your body, which can also be life-threatening.
Acute kidney failure is also called acute kidney injury or acute renal failure. It’s common in people who are already in the hospital. It may develop rapidly over a few hours. It can also develop over a few days to weeks. People who are critically ill and need intensive care have the highest risk of developing acute kidney failure.
Acute kidney failure can be life-threatening and requires intensive treatment. However, it may be reversible. If you’re in good health otherwise, recovery is possible.

4) Develops after as little as 50-100 mL of blood loss in the upper gastrointestinal tract, whereas hematochezia requires a loss of more than 1000 mL. Although hematochezia generally suggests a lower bleeding source (eg, colonic), severe upper gastrointestinal bleeding may present with hematochezia in 10% of cases.