new to neurosurgical icu, need advice pleaseeeee

froggy8, BSN, RN · May 3, 2013

OR just any advice in general for this floor? thanks in advance!

Esme12, ASN, BSN, RN · May 4, 2013

Is this a critical care unit?

nrsang97, BSN, RN · May 6, 2013

Know your meds for seizures and vasospasam.

Know meds like vimpat, dilantin, keppra, zonegran, depakote, and their theraputic levels. Know nimotop. You will give it a lot for SAH patients. Know the BP meds that you will use lots IV/IVP Cardene, labetalol, hydralazine, and your PO bp meds. Know treatment for vasospasams like HHH therapy. Hypertensive, Hypervolemic, Hypernatremic therapy. You will be giving these patients a bolus of fluid quite often. Understand why.

ICP values normal 0-15. Sometimes we will let ICP go up to 25 before we call based on written paramaters. Be familiar with trouble shooting a EVD. You can't flush toward the pt only away. If the EVD wont drain check for kinks, make sure stop cocks are open, drop the drain down. IF not draining then flush the drain away from the pt. If still no drainage call the resident.

You will go to IR for angiograms, treat vasospasams with IA cardene, verapiamil, or even placing stents. Patients whose SAH was treated in IR with a coiling procedure have more risk of vasospasams. The window is 7-21 days out for vasospasam.

I can't think of anything else at this time. Keep asking questions on orientation. Pick your preceptor's brain, and the educator's brain as well. Even ask the docs questions. Most are happy to teach.

Good luck. I worked neuro ICU for 6 years. I really liked it.

NeuroRN123 · May 7, 2013

This is the best book I have ever ever come across for neuro ICU nursing. It has EVERYTHING you will need to know. I completely ate this book as a new nurse in NI.

The Clinical Practice of Neurological and Neurosurgical Nursing (Clinical Practice of Neurological & Neurosurgical Nursing): Joanne V. Hickey: 9780781795296: Amazon.com: Books

froggy8, BSN, RN · May 18, 2013

Thanks!!! I will do just these! Yes it is critical care, at least I think it is.... I thought all ICUs were critical care. But thanks all for their advice!!! Will keep u posted!