Cardiorespiratory physical assessment for the acutely ill: 2

The second of this two-part article aims to develop advanced cardiovascular and respiratory knowledge to enhance practice for the nurse caring for an acutely ill patient on a general ward. The first part dealt with the core aspects of care in respiratory and cardiovascular physical assessment, including respiratory function and failure, pulse oximetry, oxygen therapy, fluid therapy, pulse measurement, blood pressure and electrocardiogram monitoring (Vol 11(11): 750-8). As the use of critical care beds within trusts becomes more difficult to manage, with ever-increasing patient dependency and occupancy figures remaining high, critically ill patients are likely to remain in wards longer or be discharged from a critical care environment earlier. These patients will require more frequent, direct, non-invasive and invasive monitoring to ensure that they do not deteriorate, and that any deteriorations are detected early and managed effectively. The skills and information discussed here will help nurses advance their practice and improve the quality of their care.