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Caring for patients with burn injuries

Culleiton, Alicia L.; Simko, Lynn M.

Nursing Critical Care . 8(1):14-22, January 2013.

Caring for a patient with severe burn injuries offers many challenges for critical care nurses. Find out about various types of burns and providing initial resuscitative care for a patient if treatment in a designated burn center facility or burn ICU isn't possible.

Extracorporeal membrane oxygenation: A review

Trinsey, Ashley

Nursing Critical Care . 12(4):16-23, July 2017.

Extracorporeal membrane oxygenation (ECMO) is a mechanical circulatory support device that is used when the heart and/or lung functions are affected by severe disease or organ dysfunction. ECMO therapy provides temporary, lifesaving support to the body until surgical intervention or more permanent treatments can be provided. This article reviews the two main types of ECMO therapy along with therapeutic indications, function, and management of critically ill adult patients using ECMO.

Inflammatory mechanisms associated with COPD: A principle-based concept analysis

Conley, Patricia B.; Kelechi, Teresa J.

Nursing Critical Care . 12(3):24-30, May 2017.

Identification of the attributes, antecedents, and outcomes of inflammation in chronic obstructive pulmonary disease (COPD) is essential. Studies examining the mediators of inflammation have investigated the physiologic, cellular, and molecular causes, but none of the findings are conclusive. This principle-based concept analysis of debilitating pulmonary inflammation focuses on identifying the mediators that initiate and exacerbate chronic COPD. Determining the exact mediators will help develop treatments to better target the detrimental pathogenesis of inflammation in COPD. Nurses, working together with other healthcare scientists, can improve healthcare delivery and quality of life for their patients through future research.

Acute ischemic stroke: The golden hour

Anderson, Jane A.

Nursing Critical Care . 11(3):28-36, May 2016.

Acute ischemic stroke is a medical emergency resulting from an embolic or thrombotic occlusion of an intracranial artery. This article provides acute care nurses with a summary of recent updates on the rapid evaluation and workup for patient selection and treatment with I.V. fibrinolysis.

Burn injuries in the ICU: A case scenario approach

Simko, Lynn Coletta; Culleiton, Alicia L.

Nursing Critical Care . 12(2):12-22, March 2017.

This article uses a case scenario to review various types of burn injuries, burn pathophysiology, and what nurses need to know to provide comprehensive assessment and resuscitative care to patients with this type of injury.

Pneumocephalus assessment and management

Vacca, Vincent M. Jr.

Nursing Critical Care . 12(4):24-29, July 2017.

Pneumocephalus is a pathologic collection of air contained within the intracranial space. Although traumatic head injury accounts for 75% of all cases, pneumocephalus is also common following neurosurgery. Simple, asymptomatic pneumocephalus can often be managed conservatively; however, tension pneumocephalus is a neurosurgical emergency.

Using the Montessori method to engage patients with dementia

Volland, Jennifer; Fisher, Anna

Nursing Critical Care . 10(2):9-14, March 2015.

Created for use on children with mental retardation, then used with children from lower-income areas, the Montessori method has been adapted to engage adults with dementia by stimulating their minds with activities that use fine motor skills and build self-esteem.

Shhh! Too much hospital noise slows recovery

Lim, Fidelindo A.

Nursing Critical Care . 9(2):43-47, March 2014.

Monotonous call bells, oscillating conversations, and clanking equipment disturb patients' rest, especially in the ICU and operating rooms. But besides being irritating, excessive noise causes sleep deprivation, which can lead to hypertension, an increase in cardiovascular disease, impaired immune function, attention and memory deficits, depression and even death.

Encephalitis in adults: Outcomes in critical care

Vacca, Vincent M. Jr.

Nursing Critical Care . 11(2):14-22, March 2016.

Encephalitis can lead to alterations in level of consciousness, cognition, and behavior as well as fever, headache, seizures, cranial nerve disorders, and motor deficits. Despite advances in technology and pharmacology, encephalitis remains challenging to diagnose and difficult to treat.

Coronary Artery Bypass Grafting

Plitnick, Katherine R.

Nursing Critical Care . 9(6):32-37, November 2014.

Coronary artery disease is the most common type of heart disease and heart disease is the leading cause of death in the U.S. Of the 4.7 million in-patient heart-related procedures performed on approximately 4.7 million people annually in the United States, 395,000 of those are coronary artery bypass grafting.

In-hospital cardiac arrest

Leary, Marion

Nursing Critical Care . 10(1):34-40, January 2015.

Hospital teams need experienced leadership, with members filling defined roles to properly treat patients in cardiac arrest. Overcrowding can cause poor communication, prevent task delegation and potentially risk patients' lives. Healthcare professionals are more confident when they have “rolling refreshers” periodically practicing CPR skills, using CPR training manikins, and CPR feedback devices.

Basics of general anesthesia for the critical care nurse

Greenberg, Kendra; Morrison, Suzanne

Nursing Critical Care . 12(4):36-42, July 2017.

Critical care nurses play an integral role in the care of surgical patients. A more thorough understanding of what general anesthesia entails may enable the critical care nurse to tailor care to patients following surgery. This article describes the stages of general anesthesia, along with related medications, potential adverse reactions, and what nurses need to know to provide optimal care.

Postoperative pulmonary complications

Thanavaro, Joanne L.; Foner, Barbara J.

Nursing Critical Care . 11(1):38-47, January 2016.

Postoperative pulmonary complications are a major contributor to the overall risk of noncardiac surgery. They can cause deleterious clinical outcomes after surgery, may lead to serious health issues, and contribute to long-term mortality.

Avoiding legal risks in critical care nursing

Catalano, Lori A.; Werdman, Eileen

Nursing Critical Care . 12(4):30-35, July 2017.

Critical care nursing requires critical thinking and quick actions. Because of this, nurses may exceed their scope of practice or utilize workarounds that risk patient safety, both of which can lead to malpractice. This article provides nurses with information on how to avoid legal risks in critical care.

The nurse as the patient

Nursing Critical Care . 9(2):4, March 2014.

What happens when the nurse is the patient? Don't ignore warning signs that your own health needs attention because if you're in pain, even with friends in the business, you could have to wait for appointments, prescriptions, precertification, and follow-up visits – just like your patients.

Managing vasoactive infusions to restore hemodynamic stability

Timmerman, Rosemary A.

Nursing Critical Care . 11(2):35-43, March 2016.

Critically ill patients frequently suffer circulatory disturbances necessitating the use of vasoactive medications. Critical care nurses must know the actions and possible adverse reactions of vasoactive agents and be able to titrate hemodynamic medications to achieve therapeutic endpoints indicating adequate perfusion.

Maintaining healthy work environments

Samoya, Alissa; Crutcher, Terri D.; Pilon, Bonnie A.

Nursing Critical Care . 10(6):1-7, November 2015.

Learn about the development of an evidence-based, best practice toolkit that supports nurse leaders in incorporating the AACN's six essential standards of a healthy work environment into current practice settings.

Aortic stenosis

Townsend, Terri

Nursing Critical Care . 10(1):15-17, January 2015.

Aortic stenosis occurs when the aortic valve opening becomes narrowed, resulting in left ventricular outflow obstruction. The most common cause of this progressive disorder is calcification of the valve leaflets. Risk factors for calcification include: hypertension, dyslipidemia, metabolic syndrome, and smoking.

Zika virus: What nurses need to know

Coyle, Amanda L.

Nursing Critical Care . 11(4):30-34, July 2016.

Local, state, national, and international healthcare organizations are rapidly scaling up their response to the recent Zika virus outbreak. Nurses must stay abreast of the evolving body of knowledge surrounding Zika virus infection in order to provide optimal care to their patients.

Sepsis-3: The new definitions

Seckel, Maureen A.

Nursing Critical Care . 12(2):37-43, March 2017.

Sepsis definitions were recently revised by the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) to better align with current understanding of the research, physiology, and management of patients with sepsis. This article reviews the new definitions and other recent changes in sepsis management.

Updating your nutrition care practice

McCarthy, Mary S.; Martindale, Robert G.

Nursing Critical Care . 10(1):18-26, January 2015.

About 65% of ICU patients aren't receiving enough nutrition. When their survival is threatened, nutrition taken orally, topically, through inhalation, or by injection helps improve outcomes. Active nutrients reduce damage to cells, control inflammation, decrease the metabolic response to stress, and improve feeding tolerance.

Measuring quality care with HCAHPS

Villanueva, Perfecto “Mac; McCall, Levida Dawn

Nursing Critical Care . 7(5):18-21, September 2012.

As hospitals transition to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey as a meaningful measure of patient satisfaction, healthcare leaders are asking if their organizations are prepared.

Managing hemodynamics

Gibson, Jennifer A.; Nordby, Dione Breht

Nursing Critical Care . 9(4):12-16, July 2014.

Healthcare professionals administer medications that stimulate or inhibit the sympathetic nervous system achieving a desired physiologic effect such as increasing blood pressure or decreasing peripheral vascular resistance.

A review of novel oral anticoagulants

O'Leary, Geraldine M.

Nursing Critical Care . 12(3):32-39, May 2017.

Recently, a new class of anticoagulant drugs has emerged, called novel oral anticoagulants (NOACs), which have significant advantages over warfarin. This article provides a review of the actions, indications, contraindications, adverse reactions, and reversal agents for four new drugs. Nursing considerations and teaching strategies for patients taking NOACs are also discussed.

Posttraumatic stress disorder in critical care nurses

Danella, Nicole; Hamilton, Sharece; Heinrich, Chelsea

Nursing Critical Care . 12(3):40-46, May 2017.

This article summarizes the research on and evidence-based practice for posttraumatic stress disorder in critical care nurses. Precipitating factors and diagnostic criteria as well as best practices for prevention and treatment are addressed. The authors also look to military history and research to illustrate potential solutions.

What's new in sepsis?

Foran, Catherine K.

Nursing Critical Care . 8(5):16-21, September 2013.

Is your facility up to date with the new Surviving Sepsis Campaign guidelines for managing severe sepsis and septic shock? Read about the changes and how to improve best practices and outcomes in adults.

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