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Most Popular Articles

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Tactile stimulation improves consciousness and vital signs in patients with traumatic brain injury

YekeFallah, Leili; Aghae, Fatemeh; Azimian, Jalil; More

Nursing2018 Critical Care. 13(6):18-22, November 2018.

A study of 60 ICU patients with traumatic brain injury in Qazvin, Iran, showed that tactile stimulation could increase the level of consciousness and decrease systolic BP, diastolic BP, and respiratory rate in these patients, adding to the previous literature on this topic.

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.

What is urine specific gravity?

Flasar, Cathy

Nursing Critical Care. 3(6):9, November 2008.

Measuring urine specific gravity is an easy and convenient way to gauge a patient's hydration status, as well as the functional ability of the kidneys.

How low should you go? The latest on targeted temperature management

Ng, Yuenhung

Nursing Critical Care. 11(4):35-40, July 2016.

Targeted temperature management can improve neurologic outcomes and survival rates for adults with return of spontaneous circulation after cardiac arrest. This article examines the evidence to determine what temperature results in fewer complications and is the best option for select high-risk patients.

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.

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.

Patient readiness for PACU discharge

Pusey-Reid, Eleonor

Nursing2018 Critical Care. 13(5):31-34, September 2018.

Prematurely discharging patients from the postanesthesia care unit (PACU) can lead to poor patient outcomes. To achieve optimal patient outcomes, nurses need to be familiar with evidence-based practices surrounding safe patient discharge from the PACU.

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.

Measuring serum lactate

Antinone, Richard; Kress, Terri

Nursing Critical Care. 4(5):56, September 2009.

A serum lactate level, which measures the level of lactic acid in the blood, is a fairly reliable and accurate indication of tissue hypoperfusion and hypoxia. Learn about this test, how to interpret results, and what your patient needs to know.

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.

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.

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.

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.

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."

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.

Meningitis: the inflamed brain

Burnet, Sophary; Huntley, Ann; Kemp, Kelda M.

Nursing Critical Care. 2(4):28-36, July 2007.

Meningitis is an inflammation of the meninges of the brain, which is caused by various pathogens. Critical care nurses are the first-line clinicians to observe these patients in the ICU, thus, they're an integral part of the prevention of major complications. Therefore, revisit the anatomy, epidemiology, and types of meningitis, as well as prevention, nursing care, and treatment for the disease.

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!

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.

Music therapy: Nursing interventions with a beat

Crowley, Jessica

Nursing Critical Care. 8(2):15-17, March 2013.

Research has shown that older adults can benefit from music therapy and that this therapy doesn't need to be formal to be effective. This article focuses on interventions you can use to help patients.

Angiotensin II for septic shock treatment: An update

Griffiths, Carrie L.; Jackson, Matthew R.; Hoke, Tanner J.; More

Nursing2018 Critical Care. 13(6):30-37, November 2018.

Septic shock can lead to life-threatening hypoperfusion, which often requires vasopressor therapy. Last year, the FDA approved angiotensin II for use in septic shock. This article explores the literature and nursing considerations surrounding this septic shock treatment.

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.

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.

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.

Palliative care in a critical setting: A case study

Burdette-Taylor, Shelly R.

Nursing Critical Care. 2(5):64, September 2007.

Nurses are using more discretion when suggesting curtailing aggressive care for cure and instead are focusing on promoting aggressive care for comfort.

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.

Uncontrolled atrial fibrillation in adults

Wietbrock, Mary Ann

Nursing Critical Care. 10(4):6-11, July 2015.

Atrial fibrillation (AF) is a chaotic, rapid, irregular heartbeat that often causes poor perfusion. The atria can beat above 400 times/minute. Currently, 33.5 million people worldwide suffer from AF.

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.

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.

Assessing the anion gap

Campana, Theresa

Nursing Critical Care. 4(2):15-17, March 2009.

Arterial blood gas results and serum electrolyte values let you assess the anion gap so you can diagnose and treat acid-base imbalances in critically ill patients.

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.

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.

New technologies to enhance nursing practice

Ramundo, Debby

Nursing Critical Care. 7(3):40-42, May 2012.

Embracing technology can help free nurses from routine tasks so they have more time to assess and interpret signs and symptoms and provide direct patient care. Learn about several new technologies that are enhancing healthcare.

Thank you, Kelley Johnson, Miss Colorado!

Nursing Critical Care. 10(6):4, November 2015.

Nurses united on social media to support their profession after hosts of a morning TV show made fun of the monologue given by Miss Colorado 2015 Kelley Johnson in the Miss America pageant.

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.

Managing PICCs

Argame, Jerome

Nursing Critical Care. 9(2):48, March 2014.

Learn about using, maintaining and removing peripherally inserted central catheters or PICCs and who benefits most from using them and who should avoid them.

Is this patient a candidate for ultrafiltration?

Streets, Kara W.; Vickers, Sharon M.

Nursing Critical Care. 8(2):31-38, March 2013.

Similar to dialysis, ultrafiltration is a type of renal replacement therapy that may be indicated for patients with heart failure who have significant volume overload despite outpatient diuretic therapy. Here's what you need to know about this therapy, which can be safely managed in any telemetry unit or even in an outpatient treatment area that has appropriately trained personnel.

Three simple strategies for a healthy workplace

Langlois, Barb

Nursing Critical Care. 7(4):48, July 2012.

When each nurse takes responsibility for how she or he responds to others, the workplace begins to shift to a more positive environment. Here are 3 easy strategies that will help you begin.

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.

Inhaled epoprostenol for acute respiratory distress syndrome

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

Nursing2018 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.

What is medical futility?

Angelucci, Patricia A.

Nursing Critical Care. 2(1):20-21, January 2007.

Confusion surrounds the concept of medical futility. Conflicts persist as to how to determine what's really futile in particular circumstances.

Tegmen tympani defect: A hidden danger

Vacca, Vincent M. Jr.

Nursing Critical Care. 10(4):43-47, July 2015.

A tegmen tympani defect is a tear in either the right or left side of the tegmen tympani, or the roof of the middle ear, which disrupts communication between the intracranial and extracranial sections. Any delay in diagnosis increases the risk of seizures, meningitis, encephalitis, or cerebral abscess.

Sedation in the ICU: A mindful approach to achieving a balance

Griffiths, Carrie L.; Livengood, Spencer J.; Hertel, Kristie A.

Nursing Critical Care. 13(3):28-33, May 2018.

Sedation is commonly required in the ICU. Critical care nurses need to be familiar with strategic sedation management techniques, including patient monitoring, appropriate sedative selection, and nonpharmacologic interventions. Multidisciplinary patient-centered care is key to achieving optimal patient outcomes.

Time management for the nurse leader

Hackworth, Terry

Nursing Critical Care. 3(2):10-11, March 2008.

Creating an effective time management plan and utilizing time management techniques will enable nurses to keep the scales balanced in their favor.

Brugada syndrome: Unmasking a silent killer

Lee, Leslie Foran; Felmlee, Nancy

Nursing Critical Care. 4(3):11-13, May 2009.

Brugada syndrome is a genetic cardiac defect that can lead to sudden cardiac death in apparently healthy young people (usually men). Although not fully understood, Brugada syndrome appears to be linked to an ion channel disorder. Careful history-taking and ECG analysis may help you save a patient's life.

Critical care drugs: Dofetilide

Simmons, Susan

Nursing Critical Care. 6(2):8-9, March 2011.

Learn about the indications and administration guidelines for dofetilide, an antiarrhythmic drug for converting atrial fibrillation and atrial flutter to normal sinus rhythm.

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.

Epidural analgesia in the critically ill

Hader, Christine Flickinger

Nursing Critical Care. 2(5):20-30, September 2007.

With advances in pain management approaches and techniques, clinicians need to be aware of comprehensive and contemporary approaches to pain management for the critically ill patient. Epidural analgesia is a pharmacologic approach to pain management that should be considered following an appropriate assessment of a patient's pain.

BIS monitoring migrates from OR to ICU

Franges, Ellie Z.

Nursing Critical Care. 1(5):58-61, September 2006.

Bispectral index (BIS) monitoring has recently been used in the ICU to provide objective measures of the level of sedation in patients.

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.

Wellens syndrome: Subtle clues to big trouble

Geiter, Henry B. Jr.

Nursing Critical Care. 5(1):5-7, January 2010.

About 15% of patients admitted for unstable angina demonstrated ECG changes diagnostic for Wellens syndrome, a critical stenosis of the proximal left anterior descending coronary artery. Here's how to recognize this potentially fatal condition and intervene appropriately.

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.

Calming patient agitation with dexmedetomidine

Boyer, Jeanne

Nursing Critical Care. 5(1):30-34, January 2010.

An ICU stay can make patients agitated, delirious, and anxious. This drug may help calm patients without causing respiratory depression, and has a fast onset and analgesic action.

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.