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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.

Getting involved in policy and politics

Oestberg, Fredrik

Nursing Critical Care. 8(3):48, May 2013.

By knowing how the political system works and which strategies can effectively influence policy, any nurse can become an advocate at the local, state, or federal level.

Myasthenia gravis and myasthenic crisis

Vacca, Vincent M. Jr.

Nursing Critical Care. 12(5):38-46, September 2017.

Myasthenia gravis (MG) is the most commonly encountered autoimmune disease of the postsynaptic neuromuscular junction of skeletal muscles, affecting an estimated 700,000 individuals worldwide. Approximately 15% to 20% of patients with MG will experience a myasthenic crisis (MC), typically within 2 years of diagnosis. Nurses must be knowledgeable about this disease and prepared to assist with pharmacologic testing and/or MC to ensure maximum safety for patients with MG before, during, and after evaluation.

Nursing management for adult recipients of CAR T-19 therapy

Morrison, Felicia

Nursing2019 Critical Care. 14(2):31-36, March 2019.

The recent FDA approvals of tisagenlecleucel and axicabtagene ciloleucel, have given patients with certain types of advanced or recurrent acute lymphoblastic leukemia and certain types of non-Hodgkin lymphoma new therapy options. This article explores the science behind CAR T-cell therapy and nursing management considerations for two life-threatening adverse reactions associated with this new therapy.

How to recognize and respond to refeeding syndrome

Yantis, Mary Ann; Velander, Robyn

Nursing Critical Care. 4(3):14-20, May 2009.

Restarting nutrition in malnourished patients can pose lethal consequences. Here's what you need to know about assessing your patient and avoiding problems.

When can you say no?

Brooke, Penny S.

Nursing Critical Care. 6(5):48, September 2011.

Because of understaffing and other pressures, you need to know when (and how) to say no so you can manage your time efficiently, keep patients safe, and protect yourself from burnout and legal repercussions.

Prone positioning for patients with ARDS

Hudack, Michael E.

Nursing Critical Care. 7(2):20-24, March 2012.

Although not common in ICUs, proning may help improve oxygenation for patients with acute respiratory distress syndrome. Find out about the science behind this technique and how to incorporate it into a plan of care.

Caring for a patient after coronary artery bypass graft surgery

Mullen-Fortino, Margaret; O'Brien, Noreen

Nursing Critical Care. 4(1):22-27, January 2009.

Every year, some 427,000 patients in the United States have coronary artery bypass graft (CABG) surgery. A patient undergoing CABG has complex healthcare needs. We'll outline your role in patient care by body system.

Delivering LGBTQ-sensitive care

Lim, Fidelindo; Paguirigan, Medel; Cernivani, Daniel

Nursing2019 Critical Care. 13(4):14-19, July 2018.

The historic and lingering stigma faced by members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community is a major contributor to health risks. Learn the best practices critical care nurses can employ to combat the health disparity that challenges this patient population.

Caring for the patient with schizophrenia

Iannaco, Dodi

Nursing Critical Care. 6(5):20-22, September 2011.

Caring for a patient with schizophrenia includes ensuring that prescribed medications are administered as directed. You'll also monitor for adverse drug reactions, in addition to addressing the medical problem that brought the patient to the ICU.

Gender confirmation surgery: Critical considerations

Kroning, Maureen; Listopad, Katerina

Nursing Critical Care. 13(2):32-37, March 2018.

The number of transgender patients electing to undergo gender confirmation surgery (GCS) is growing. Still, many healthcare providers are unfamiliar with these procedures and their potential complications. This article explores GCS and postsurgical complications, and provides up-to-date terminology and educational resources.

Improve your professional etiquette

Pagana, Kathleen D.

Nursing Critical Care. 5(6):48, November 2010.

Professional etiquette is critical for presenting yourself as a polished, confident, and professional nurse. These seven tips can help you stand out and improve your chances for career success.

Emergency coronary artery bypass grafting: An overview

MacLeod, Carrie E.

Nursing2019 Critical Care. 14(3):8-13, May 2019.

Framed around a patient case study, this article reviews the preoperative, operative, and postoperative aspects of nursing care surrounding emergency coronary artery bypass grafting. Patient education, postoperative complications, and interventions are discussed.

Mechanical ventilation weaning: An evidence-based review

Hetland, Breanna; Heusinkvelt, Jennifer; Krabbenhoft, Lisa; More

Nursing2018 Critical Care. 13(6):5-16, November 2018.

Mechanical ventilation weaning is an ongoing challenge in critical care nursing. This article reviews evidence-based guidelines on common ventilator modes and settings, the weaning process, complications, and symptom management.

Postoperative sternal wound infection

Flick, Sarah

Nursing Critical Care. 10(2):31-36, March 2015.

After open cardiac surgery, postoperative sternal wound infections (SWIs) lead to as high as 40% mortality. Risk factors for SWIs include: obesity, diabetes, blood transfusions, prolonged ICU stay, tracheostomy, and smoking history.

Deceased donor organ donation: The critical care nurse's role

O'Leary, Geraldine M.

Nursing2019 Critical Care. 13(4):27-32, July 2018.

Critical care nurses are instrumental in the process of identifying potential organ donors. As such, nurses must be familiar with the criteria used to determine brain death and best practices when communicating with the families of potential donors.

Pulmonary arterial hypertension

Leeper, Barbara; Powell, Brook

Nursing2019 Critical Care. 14(3):14-22, May 2019.

Pulmonary arterial hypertension is a rare and progressive disease that leads to right ventricular failure and death. This article examines the pathophysiology, risk factors, management guidelines, pharmacologic therapies, and nursing considerations associated with this disease.

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.

Burn injuries in the ICU: A case scenario approach

Simko, Lynn Coletta; Culleiton, Alicia L.

Nursing2019 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.

Delirium in critical care patients

Laske, Rita Ann; Stephens, Barbara

Nursing Critical Care. 11(1):18-23, January 2016.

Delirium can impact up to 80% of CCU patients and increases their length of stay and cost of hospitalization. Often, delirium may be misdiagnosed as dementia, depression, or other psychiatric disorders.

Getting in sync with intra-aortic balloon pump therapy

Goldich, Guy

Nursing Critical Care. 6(3):14-19, May 2011.

Patients may need IABP therapy for a variety of reasons, including unstable angina or to improve myocardial oxygen delivery during cardiac procedures. Find out how to manage a patient who's receiving this therapy.

Reaching out to lesbian, gay, bisexual, transgender, queer, and questioning patients

Eliason, Michele J.; DeJoseph, Jeanne; Dibble, Suzanne; More

Nursing Critical Care. 8(4):14-19, July 2013.

Learn about family structures, legal issues, and ethical concerns for these patients. Examine your beliefs, values, and practices and review policies on the unit to make sure they're culturally appropriate.

Animal-assisted therapy and activities in the critical care setting

Rugari, Susan M.; Hunter, Cheryl L.; Carswell, B. Michele

Nursing Critical Care. 12(6):32-40, November 2017.

Animal-assisted therapy (AAT) and animal-assisted activities (AAA) are different dimensions in the field of human-animal interaction that incorporate various species of animals in diverse manners to benefit humans. Research shows physiologic and psychological benefits of AAT/AAA but is limited in the area of critical care. Current guidelines discourage the use of AAT/AAA in CCUs because of infection control concerns. However, these concerns can be addressed with the right policies.

Reducing your liability risk

Nursing Critical Care. 7(4):4, July 2012.

Are you doing everything you can to reduce your liability risk? A recent report sheds light on areas where you must stay vigilant to keep yourself and your patients safe.

The art of nursing

Palatnik, AnneMarie

Nursing Critical Care. 6(3):4, May 2011.

Nursing is as much art as science, but are younger generations learning that? Caring mentors can help pass the torch to tomorrow's nurses.

Music helps heal mind, body, and spirit

Thomas, Linda S.

Nursing Critical Care. 9(6):28-31, November 2014.

Heart rate, blood pressure, and oxygen consumption decease when the right type of music is played. This auditory stimulus positively affects the patient physiologically and psychologically.

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.

Hyperglycemia management in patients with acute ischemic stroke

MacIntyre, Rebecca; Ciechanowski, Mary

Nursing2019 Critical Care. 13(3):14-19, May 2018.

Hyperglycemia can lead to poor outcomes in patients with acute ischemic stroke. This article examines the latest glucose targets and management techniques, as well as nursing assessments and interventions for this patient population.

Dying with dignity

Privette, Krystal; Kautz, Donald D.

Nursing Critical Care. 9(1):48, January 2014.

Part of an ICU nurse's job is to help family members understand what to expect when a loved one wants to die with dignity.

Recognition, management, and prevention of burn sepsis in pediatric patients

Comeau, Nicholas P.

Nursing Critical Care. 11(6):24-30, November 2016.

Learn about the signs and symptoms of burn sepsis in pediatric patients, diagnostic and therapeutic interventions, evaluation, and prevention of this potentially fatal invasive infection.

Break through your fears

Langlois, Barb

Nursing Critical Care. 6(6):48, November 2011.

By using empowerment activities and a four-step process of dealing with fears and difficult coworkers, you can gain new courage in the workplace.

A guide to critical appraisal of evidence

Fineout-Overholt, Ellen

Nursing2019 Critical Care. 14(3):24-30, May 2019.

How do nurses assess the quality of clinical research? This article outlines a stepwise approach to critical appraisal of research studies' worth to clinical practice: rapid critical appraisal, evaluation, synthesis, and recommendation. When critical care nurses apply a body of valid, reliable, and applicable evidence to daily practice, patient outcomes are improved.

Fatigue and critical care nurses: Considerations for safety, health, and practice

Hobbs, Barbara B.; Wightman, Lori

Nursing Critical Care. 13(1):6-13, January 2018.

Physical fatigue is a major concern for critical care nurses. This article reviews how sleep loss affects fatigue, the dangers of shift work, safer scheduling practices, and countermeasures critical care nurses can take to avoid feeling fatigued on the unit. Resources to help address fatigue level and manage symptoms are also listed.

Mass shootings: A call for nursing awareness and action

Glasofer, Amy; Laskowski-Jones, Linda

Nursing2018 Critical Care. 13(5):14-20, September 2018.

Critical care nurses need to be prepared to care for the victims of a mass shooting. This article reviews survival and hemorrhage control recommendations as well as hospital preparedness lessons learned by facilities that have previously experienced this type of emergency.

Craniosynostosis

Blake, Stephanie M.; Bradshaw, Wanda T.

Nursing Critical Care. 10(1):27-33, January 2015.

This article discusses the birth defect in which one or more of the joints between the bones of a baby's skull prematurely closes. Cranial growth and brain development are influenced. Neurologic and physiologic after effects can include: auditory and visual impairment, seizures, swallowing dysfunction, heart and lung abnormalities, developmental delays, speech impairments, self-esteem issues, and learning disabilities.

Patient education in 5 easy pieces

Overgaard, Penny Morgan

Nursing Critical Care. 5(3):48, May 2010.

Try these 5 easy steps to add education to every patient encounter. Good teaching can help improve patient outcomes and may even save a life.

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.

Take a rapid treatment approach to cardiogenic shock

Gorman, Diane; Calhoun, Kim; Carassco, Maria; More

Nursing Critical Care. 3(4):18-27, July 2008.

Cardiogenic shock is a major and frequently fatal complication of a variety of acute and chronic disorders. Recognition of early signs and symptoms of cardiogenic shock and rapid interventions enable the nurse and treatment team to prevent complications and assist the patient to recovery.

Glycemic control in hospitalized patients

Kubacka, Beata

Nursing Critical Care. 10(1):8-14, January 2015.

Read about the latest evidence-based guidelines for treating hospitalized adult patients with diabetes. Nurses should make sure patients obtain appropriate monitoring and treatment, avoid hypo- and hyperglycemia, and receive timely follow-up care.

Fluid balance and resuscitation: Critical aspects of ICU care

Stevens, Wendy J.

Nursing Critical Care. 3(2):12-21, March 2008.

Critically ill patients are at great risk for volume depletion that may be secondary to internal and external fluid losses. Daily fluid balance assessments may be inaccurate, as total volume losses aren't always recognized or measurable.

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.

How to save a life: A suicide prevention protocol for critical care

Maclay, Tammy

Nursing Critical Care. 7(4):17-21, July 2012.

About half of the adults who attempt suicide stay overnight or longer in a hospital for their suicide attempts, but general hospitals aren't designed to care for patients at risk of suicide. Learn how one facility developed a protocol to help a critical care unit keep these patients safe.

Acquired autoimmune thrombotic thrombocytopenic purpura

Vacca, Vincent M. Jr.

Nursing2018 Critical Care. 13(5):22-30, September 2018.

Acquired autoimmune thrombotic thrombocytopenic purpura is life threatening if left untreated. Learn how to recognize this hematologic disease early so that therapeutic plasma exchange can begin as soon as possible.

Pharmacotherapy management in critically ill older adults

Kaplow, Roberta; Griffiths, Carrie L.

Nursing2019 Critical Care. 13(4):20-26, July 2018.

Complex pharmacotherapy management is a particular challenge in the care of critically ill older adults. Explore the science of pharmacokinetics and pharmacodynamics, as well as nursing implications.

Five steps to reduce bullying

Langlois, Barb

Nursing Critical Care. 7(1):48, January 2012.

Nurse-to-nurse bullying is widespread, infiltrates most nursing units, and creates a harmful work environment. Follow these five easy steps to ensure you're not one of the culprits.

The importance of patient advocacy

Maine, Jillian

Nursing Critical Care. 10(4):48, July 2015.

As a student nurse, the author learned two powerful lessons: addressing concerns gets results, and you always need to be a voice for your patients, whether it's for their physical health or getting their meal requests right!

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.

Understanding ventilator waveforms—and how to use them in patient care

Lian, Jin Xiong

Nursing Critical Care. 4(1):43-55, January 2009.

Ventilator waveforms provide real-time information about patient ventilator interaction and ventilator function. Learn the basics of ventilator waveforms, how they're interpreted, and how you can use this information when caring for your patient.

Inhaled epoprostenol for acute respiratory distress syndrome

Schroeder, Nicole M.; Castiello, Danielle R.; Siemianowski, Laura A.

Nursing2019 Critical Care. 13(4):6-13, July 2018.

This article describes the safe and effective use of inhaled epoprostenol in patients with acute respiratory distress syndrome (ARDS) by examining the current literature published on this topic.

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.

Recognizing cerebral venous thrombosis in adults

Vacca, Vincent M. Jr.

Nursing2019 Critical Care. 13(3):6-13, May 2018.

Review the anatomy and physiology, pathophysiology, risk factors, and complications of cerebral venous thrombosis (CVT). Because this serious thrombotic disorder can be mistaken for a migraine, critical care nurses need to be familiar with the clinical presentation of CVT so that treatment can begin as soon as possible.

More nurses asked to get baccalaureate degrees

Specht, Dawn M.

Nursing Critical Care. 10(5):40-46, September 2015.

Why should RNs get a BSN? This article focuses on what's required for the degree and how additional education helps nurses advance in their careers and reduces patient mortality.

What's hot in patient satisfaction

Palatnik, AnneMarie

Nursing Critical Care. 6(5):4, September 2011.

External forces such as the Hospital Consumer Assessment of Healthcare Providers and Services are affecting practice. Providing top-notch patient care can help your facility achieve a culture of "always."

Nursing2019 Skin and wound care survey

Ayello, Elizabeth A.; Baranoski, Sharon

Nursing2019 Critical Care. 14(2):38-40, March 2019.

Help us gather new information on current skin care and wound prevention and treatment practices by completing a confidential and anonymous survey. Participants will be entered into a drawing to win an iPad Mini.

The neurologic assessment toolbox: Key assessments at critical times

Mink, Janice

Nursing Critical Care. 7(3):12-17, May 2012.

Brush up on five popular screening tools used to assess patients with neurologic disorders and find out what these assessments actually tell you about your patient's neurologic function.

#Blacklivesmatter: Leveraging family collaboration in pain management

Booker, Staja Q.

Nursing Critical Care. 11(2):1-7, March 2016.

Pain may be more difficult to manage in ethnically diverse patients, such as Black Americans. Learn how family collaboration can assist nurses to effectively assess and treat pain while also respecting and incorporating personal and cultural preferences.

Does a high WBC count guarantee infection?

George, Elisabeth L.; Panos, Angela

Nursing Critical Care. 1(1):14-16, January 2006.

Taken alone, the WBC count may have little value unless nurses correlate it to the patient's clinical condition and analyze the WBC differential.

Critical care of a patient after CABG surgery

Mullen-Fortino, Margaret; O'Brien, Noreen; Jones, Maryann

Nursing Critical Care. 4(4):46-53, July 2009.

Your patient's just had coronary artery bypass grafting surgery. Learn more about your role in hemodynamic monitoring and mechanical ventilation in the crucial early postoperative hours.

Waterworld, part 2: Understanding diabetes insipidus in adults

Crawford, Ann; Harris, Helene

Nursing Critical Care. 7(1):12-16, January 2012.

Refresh your understanding of the pathophysiology and treatment of DI, a disorder of excess water excretion.

Genetics & Genomics in critical care nursing

Pestka, Elizabeth L.; Dretsch, Margaret F.

Nursing Critical Care. 5(6):12-16, November 2010.

This article provides an overview of the importance of genetics and genomics for nurses and uses hypertrophic cardiomyopathy, a commonly inherited cardiovascular disorder, as an example of a genetic disorder with implications for nursing care.

Psychoactive bath salts: An emerging crisis

Wieland, Diane M.

Nursing Critical Care. 10(3):22-27, May 2015.

Increasingly, critical care nurses are admitting aggressive patients who are withdrawing from psychoactive bath salts and may be dangerous to themselves and others. Symptoms may take days to improve or could worsen, leading to multi-system organ failure and admission to the ICU.

Acute hyperglycemic emergencies: Diabetic ketoacidosis and hyperosmolar hyperglycemic state

Kubacka, Beata T.

Nursing2019 Critical Care. 14(2):10-21, March 2019.

As diabetes prevalence rises, critical care nurses must be prepared to encounter acute hyperglycemic emergencies in the ED or ICU. This article discusses the diagnosis, treatments, and nursing considerations associated with diabetic ketoacidosis and hyperosmolar hyperglycemic state.

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.

Six steps to ABG analysis

Woodruff, David W.

Nursing Critical Care. 2(2):48-52, March 2007.

The arterial blood gas (ABG) analysis is a lab test that measures the acid-base balance and oxygenation of an arterial blood sample, usually obtained by direct arterial puncture. Nurses can learn valuable information about their patients by analyzing the ABG results.

Is your mechanically ventilated patient getting enough oxygen?

Lian, Jin Xiong

Nursing Critical Care. 6(3):20-24, May 2011.

Flow dyssynchrony occurs when the inspiratory flow delivered by a ventilator doesn't match the patient's needs. Although flow dyssynchrony is rare in pressure target ventilation, by examining the patient's ventilator waveforms, you can recognize the problem and respond appropriately to improve your patient's oxygenation.

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.

Recognizing and managing traumatic brain injury

Wittenberg, Carla J.

Nursing Critical Care. 13(1):20-27, January 2018.

Traumatic brain injury (TBI) is a serious condition that can lead to high healthcare costs for and significant disabilities in patients. After reviewing the epidemiology and classification of TBI, this article covers clinical care recommendations and medication management strategies. Learn evidence-based guidelines for patient care surrounding TBI.

Change your appetite: Stop “eating the young” and start mentoring

Echevarria, Ilia M.

Nursing Critical Care. 8(3):20-24, May 2013.

Nurses have an obligation to mentor colleagues and to treat them with respect, trust, and dignity. Learn about the destructive cycle of horizontal violence and how to break the cycle.

Using pain to assess neurologic response

Lower, Judith "Ski"

Nursing Critical Care. 5(4):11-12, July 2010.

This illustrated guide explains various techniques for assessing a patient's neurologic response through painful stimuli, which are used when a patient doesn't respond to verbal stimuli or gentle shaking.

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