AACN clinical issues in critical care nursing

Publisher: American Association of Critical-Care Nurses

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Other titles AACN clinical issues in critical care nursing, American Association of Critical Care Nurses clinical issues in critical care nursing, American Association of Critical-Care Nurses clinical issues in critical care nursing, Clinical issues in critical care nursing
ISSN 1046-7467
OCLC 20502221
Material type Periodical
Document type Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Critically ill patients experience a multitude of metabolic derangements in response to sepsis, shock, and severe injury. The result of extreme stress is characterized by alterations in carbohydrate and fat metabolism and persistent catabolism of lean body mass. Total parenteral nutrition is an important therapeutic modality in the care of critically ill patients. In this article, the author identifies the patient at risk, defines the appropriate time to initiate parenteral nutrition, and outlines current recommendations for energy and protein prescription. The author also briefly reviews administration issues, discusses possible complications of therapy, and defines effective strategies to monitor the response to therapy.
    AACN clinical issues in critical care nursing 12/1994; 5(4):476-84.
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    ABSTRACT: The increasing maturation of our population and the economic hardships in our nation have forced numerous elders to become dependent upon family members for survival. The tremendous strain of providing care for a dependent elder along with societal demands has caused the problem of elder abuse to flourish. Frequently, emergency rooms and intensive care units are the primary points of entry for the elderly victim of abuse. It is within these settings that abuse is detected initially and in which successful intervention should begin. In this article, the author presents a review of the basic theories that have been proposed to explain why abuse occurs. This is followed by a detailed description of the common characteristics of both the abuser and the abused. The article is concluded by an overview of the medical personnel's responsibilities for reporting cases of suspected abuse.
    AACN clinical issues in critical care nursing 12/1994; 5(4):507-15. DOI:10.1097/00044067-199405040-00012
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    ABSTRACT: The gastrointestinal tract is a major immunologic organ that must be maximally supported during critical illness. Gastrointestinal tissues require direct contact with nutrients to support their own rapid cellular turnover rate and carry out the multitude of metabolic and immunologic functions needed for successful adaptation to stress. Disruption in the ecologic equilibrium of the gastrointestinal tract often occurs during critical illness and the therapies provided. Problems encountered include stress ulcers, intestinal ischemia, bacterial overgrowth, aspiration pneumonia, bacterial translocation, sepsis, and the systemic inflammatory response syndrome. Early enteral nutrition has been shown to be a viable, economic, and physiologically beneficial way to support the gastrointestinal tract during critical illness. The fortification of enteral formulas with glutamine, arginine, or fiber is being studied to determine each one's unique role in the gut and immunologic changes that occur with severe stress.
    AACN clinical issues in critical care nursing 12/1994; 5(4):450-8. DOI:10.1097/00044067-199405040-00005
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    ABSTRACT: Terminal weaning is a clinical intervention for withdrawing mechanical ventilatory support when such support is an unacceptable outcome for a patient. Withdrawal of life support must be done in a humane manner for the patient, the family, and the patient's care providers. Research-based directions for clinical practice are limited because of the paucity of research in this area. Recommendations for future study are related to methods, facilitative therapy, patient, family, and caregiver responses, and care delivery models.
    AACN clinical issues in critical care nursing 12/1994; 5(4):523-33. DOI:10.1097/00044067-199405040-00014
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    ABSTRACT: Nutritional needs and management of critically ill infants and children are complex and fundamentally different from adults. In addition to common physiologic issues of nutrition during acute illnesses, infants and children have nutritional needs related to growth and development of the whole child as well as individual organ systems. Critical care nurses play a key role in assuring that both physiologic and developmental needs related to nutrition are met, to prevent long-term complications.
    AACN clinical issues in critical care nursing 12/1994; 5(4):485-92; quiz 539-41. DOI:10.1097/00044067-199405040-00008
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    ABSTRACT: The metabolic response to critical illness and injury increases the metabolic rate and increases mobilization of amino acids from the peripheral tissues. This is done through a neuroendocrine response with elevated levels of catecholamines, glucocorticoids, inflammatory cytokines, and other products of inflammation. Control of the injury, restoration of hemodynamic stability, and early nutrition can minimize the drain on the lean body mass and improve the chance of survival. In this article, the authors summarize the metabolic response to stress and injury.
    AACN clinical issues in critical care nursing 12/1994; 5(4):443-9. DOI:10.1097/00044067-199405040-00004
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    ABSTRACT: Liver transplantation has been an acceptable treatment for end-stage liver disease for many years. The greatest number of patients needing transplantation for survival are those suffering from alcohol-related end-stage liver disease. Throughout the years, many debates and much research have been completed looking at the medical and ethical responsibility to give transplants to these patients. In this article, the author looks at some of the arguments facing transplantation in patients with alcoholism and some of the related research published.
    AACN clinical issues in critical care nursing 12/1994; 5(4):501-6. DOI:10.1097/00044067-199405040-00011
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    ABSTRACT: Malnutrition in critically ill patients is caused by inadequate intake, absorption, and/or utilization of nutrients with a frequently compounding increased metabolic need. The nurse plays a pivotal role in the identification of patients at risk for nutritional deficits and collaborates with appropriate resources to obtain a comprehensive nutritional assessment and the required nutritional care. A five-step approach to nutritional support is presented and applied to three clinical situations. Through the use of a systematic decision-making process, the critical care practitioner ensures that patients receive adequate nutritional support for optimal organ function.
    AACN clinical issues in critical care nursing 12/1994; 5(4):436-42.
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    ABSTRACT: The recognition and treatment of malnutrition has been shown to improve the survival of patients. Current research to prevent and improve patient outcome with nutritional interventions in the critically ill is promising. Nurses are responsible for identifying the signs and symptoms of malnutrition, administering nutritional therapy while assessing for complications and side effects associated with these treatments, and monitoring the effectiveness of nutritional interventions. Enteral nutrition in the intensive care unit is addressed specifically in this article, whereas nutritional assessment and the recognition of malnutrition are discussed briefly. Salient points of providing enteral nutrition to intensive care unit patients are presented. Various feeding devices, products, and complications related to enteral nutrition are explained in detail. Comprehensive nursing care as related to the delivery of feeding products through various feeding devices is reviewed. Nursing research applicable to the practice of enteral nutrition in the intensive care unit is presented.
    AACN clinical issues in critical care nursing 12/1994; 5(4):459-75. DOI:10.1097/00044067-199405040-00006
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    ABSTRACT: As the incidence of HIV infection rises, so will cases of HIV positive intensive care unit admissions. Factors affecting nurses' care of these patients include fear of contagion, homophobia, and lack of knowledge. A multidimensional approach must be taken by the advanced practice nurse to decrease stigmatization by changing knowledge and attitudes of intensive care unit nurses.
    AACN clinical issues in critical care nursing 12/1994; 5(4):495-500.
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    ABSTRACT: Critical illness frequently leads to organ dysfunction. Nutritional support of individual organ function is an evolving area of nutritional support. Within the past several years, there was an increase in the number of nutritional products reported to improve organ function. In this article, the authors review disease/organ-specific nutritional support, including the theory behind therapy and the empiric data supporting or refuting these theories. It is hoped that this article will aid practitioners in their nutritional management of patients with organ dysfunction.
    AACN clinical issues in critical care nursing 12/1994; 5(4):421-35; quiz 536-8. DOI:10.1097/00044067-199405040-00015
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    ABSTRACT: In this article, the author explores the issue of violence in the inpatient and outpatient hospital setting. Only recently recognized as a significant occupational hazard to nurses, violence can lead not only to physical injury but also to prolonged and debilitating emotional, social, biophysiologic, and cognitive symptoms. The prevalence of the problem is presented, followed by a discussion of contributory factors and the effects violent incidents may have on victims. Strategies for prevention and topics for future research are identified.
    AACN clinical issues in critical care nursing 12/1994; 5(4):516-22; quiz 542-4. DOI:10.1097/00044067-199405040-00013
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    ABSTRACT: Much controversy has arisen in the last few decades regarding parental and family visitation in the intensive care setting. The greatest needs of parents while their child is in an intensive care unit include: to be near their child, to receive honest information, and to believe their child is receiving the best care possible. The barriers that exist to the implementation of open visitation mostly are staff attitudes and misconceptions of parental needs. Open visitation has been found in some studies to make the health-care providers' job easier, decrease parental anxiety, and increase a child's cooperativeness with procedures. To provide family-centered care in the pediatric intensive care unit, the family must be involved in their child's care from the day of admission. As health-care providers, the goal is to empower the family to be able to advocate and care for their child throughout and beyond the life crisis of a pediatric intensive care unit admission.
    AACN clinical issues in critical care nursing 09/1994; 5(3):289-95.

  • AACN clinical issues in critical care nursing 09/1994; 5(3):360-5.

  • AACN clinical issues in critical care nursing 09/1994; 5(3):340-5.

  • AACN clinical issues in critical care nursing 09/1994; 5(3):366-8.

  • AACN clinical issues in critical care nursing 09/1994; 5(3):329-32.
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    ABSTRACT: Meningococcemia is a true infectious emergency that requires tremendous skill and collaboration among health-care professionals to reduce the high morbidity and mortality associated with this disease. Complications and sequelae may effect virtually every body system with meningococcal disease. The critical care nurse plays a crucial role in preventing and recognizing complications to reduce serious consequences, including respiratory distress syndrome, myocarditis, cardiovascular collapse, coagulopathies, major skin loss, and limb amputations.
    AACN clinical issues in critical care nursing 09/1994; 5(3):278-88; quiz 411-3.
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    ABSTRACT: Transplantation in children has become a therapeutic option for several end stage organ diseases. The kidney, liver, and heart are the most common organs' transplanted; however, an increasing number of children are undergoing successful intestine, lung, and multiple organ transplant combinations. Through case study reports, emerging transplant options for the child experiencing end stage liver, intestine, heart, and lung failure are described. Critical care nurses play a crucial role in the postoperative recovery of these patients. An understanding of the transplant process and consequences of immunosuppression will help the critical care nurse identify signs of rejection, infection, and posttransplant lymphoproliferative disease.
    AACN clinical issues in critical care nursing 09/1994; 5(3):263-77.