title: [Chemical restraint and nursing care in the intensive care unit].
abstract: The intensive care unit (ICU) presents patients with an environment that is unfamiliar and isolating. In addition to the relative severity of diseases treated, ICUs frequently employ tube therapy, complex medical treatments and diverse nursing routines. Such elevates the chances that patients will experience pain and anxiety, which, in turn, raise the likelihood of patient agitation and reduce ultimate treatment effectiveness. Research has shown that 71& of ICU patients experience agitation. Nurses have main caring responsibilities in such circumstances because they provide the greatest percentage of bedside care. The role of nurses is not only to assess patient needs in a timely fashion, but also to discuss with ICU physicians the level of chemical restraint needed in order to relieve patient pain and anxiety. As chemical restraints involve side effects, a study of patient airway status and breathing and circulation needs must be done prior to application. In terms of breathing, patient breathing sounds, patterns and saturation levels must be monitored regularly in order to identify airway distress preemptively. In terms of blood circulation, patients should have their blood pressure and body fluid status monitored concurrently at regular intervals. With such data, should a patient become hypovolemic, appropriate intravenous fluid support may be administered prior to chemical restraint use in order to help prevent advanced hypotension. Based on such, it is clear that ICU team members must work closely together in order to monitor and assess patients prior to administering chemical restraints and to put into place a patient-tailored safety care plan.
authors.affiliation: Respiratory Intensive Care Unit, Shin Kong Wu Ho-Su Memorial Hospital, School of Nursing, National Taipei College of Nursing, Taipei, Taiwan, ROC.
authors.forename: Chieh-Chen
authors.initials: CC
authors.lastname: Yu
authors.forename: Hui-Chi
authors.initials: HC
authors.lastname: Huang
mesh_terms: D001775:Blood Circulation; D005440:Fluid Therapy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007362:Intensive Care Units; D008991:Monitoring, Physiologic; D024802:Nurse's Role; D012119:Respiration; D017751:Safety Management
chemical_list: D006993:Hypnotics and Sedatives