Advanced Management of Complex and Critically Ill Patients

Credit

Handouts/Brochure

Speaker

Cyndi Zarbano, MSN-Ed, CCRN, CMSRN, LNC Related seminars and products

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Cyndi Zarbano, MSN-Ed, CCRN, CMSRN, LNC, has been a nurse for nearly 30 years specializing in intensive care. She earned her legal nurse consultant training through the Vickie Milazzo Institute in 2008 and has worked on nearly 250 cases for various boards of nursing. She has worked with attorneys on pre-corrective action and with nurses to meet consultation requirements to fulfill corrective action guidelines.

Additionally, Cyndi has worked as a legal nurse consultant responsible to analyze medical records, determine merit, assist with client interviews, attend medical appointments, locate testing experts, complete chronologies, review billing for accuracy, provide deposition/jury question development, and assist in court strategy development. Cyndi is a renowned national seminar speaker having spoken for numerous companies since 2008, including her own, Clinical Review Consultants. She works for Mayo Clinic in Minnesota continuing her passion for bedside nursing in critical care.

 

Speaker Disclosures:
Financial: Cynthia Zarbano is the owner of Clinical Review Consultants and has an employment relationship with Mayo Mankato. She receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Cynthia Zarbano has no relevant non-financial relationships.

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Outline

Understand Hemodynamics Today

• Cardiac Output = Heart Rate x Stroke Volume
  • Use a simple analogy to learn the components and finally Get It
• Preload, Afterload and Contractility
• Manipulating the mathematical equation to stabilize

The ICU Trio in Crisis!

• IV Fluids - picking the right one for the situation
• 5 pressor agents - How they work when to use them
  • Blood products! FFP, Platelets, PRBC’s and Cryoprecipitate

Demystify hemodynamic waveforms and

Correctly Measuring Each

• Assessment clues to hemodynamic instability
• Central Venous Pressures
• Arterial Lines
• Swan Ganz Catheters

Mechanical Ventilation for Nurses

• How to manage patients on ventilators
• Avoiding Ventilator Acquired Pneumonia (VAP)
• Using CPAP or BiPAP

Manage Shock

• Assessment and management of:
  • Cardiogenic Shock
  • Septic Shock
  • Hypovolemic Shock

Manage the Neuro Patient

• Use a “5-point Neuro Check” to easily identify changes in condition
• Stroke and Stabilization
  • Ischemic
  • Hemorrhagic
  • Delirium
  • How to assess & intervene

Life-threatening EKG Changes: Clues from the 12-Lead

• Spectrum of coronary artery ischemia
• 5-step method for finding myocardial ischemia and injury
• STEMI and NSTEMI - What’s the difference?
• Location, location, location!

End-of-Life Care in the ICU

• The needs of the patient
• Practical tips to help your patients and families with the end-of-life journey

Objectives

• Summarize the difference between preload, contractility and afterload as components impacting cardiac output.
• Identify correct locations for measuring CVP, Arterial Line and Wedge waveforms.
• Differentiate between hypotonic, isotonic and hypertonic IV fluids and when each is considered most effective.
• Recognize the blood product of choice for Disseminated Intravascular Coagulopathy.
• Contrast the difference between hypovolemic shock, septic shock and cardiovascular shock in both assessment and treatment priorities.
• Identify two ways to increase the ventilator patient’s oxygenation status.
• Compare and contrast CPAP and BiPAP, as well as their target populations.
• State 5 common causes of delirium.
• Identify the difference between a STEMI and NSTEMI.
• Recognize the three biggest concerns patients recognize at end of life.

Target Audience

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