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Critical Care Nursing Clinics of North America

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https://www.readbyqxmd.com/read/28160961/preface
#1
EDITORIAL
Todd M Tartavoulle, Jennifer Manning
No abstract text is available yet for this article.
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160960/infections-in-the-intensive-care-unit-posttransplant-infections
#2
REVIEW
Fiona Winterbottom, Misty Jenkins
Solid organ transplantation has become a well-established standard of care for end-organ failure, and the nurse in the intensive care unit may be exposed to these patients at any stage in the care continuum of pretransplant or posttransplant care. Knowledge of risk factors, timing, and treatments for infections may help to enhance clinical practices and optimize patient safety and clinical outcomes.
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160959/wound-infections-in-critical-care
#3
REVIEW
Jean E Cefalu, Kendra M Barrier, Alison H Davis
Patients admitted to critical care units are at high risk for increased morbidity and mortality from skin and deep wound infections. Despite considerable progress, wound healing remains a challenge to many clinicians. Nurses working in critical care environments need to understand the anatomic and physiologic basis for wound healing, distinguish wound inflammation from wound infection, recognize the presence of biofilms, and implement evidence-based wound care in order to promote successful outcomes in this patient population...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160958/opportunistic-fungal-infections-in-critical-care-units
#4
REVIEW
Deborah D Garbee, Stephanie S Pierce, Jennifer Manning
Fungal infections are rare compared with bacterial infections, but they are on the increase in critical care units. Diagnosis can be difficult, resulting in increased mortality. Immunocompromised patients are at higher risk for fungal infections, including organ transplant, oncology, and HIV/AIDS patients. Fatigue and fever are common symptoms that require critical care nurses to remain vigilant in assessment to identify at-risk patients and promote use of timely cultures and appropriate treatments for fungal infections...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160957/hospital-acquired-infections-current-trends-and-prevention
#5
REVIEW
Christine Boev, Elizabeth Kiss
Health care-associated infections (HAIs) are the primary cause of preventable death and disability among hospitalized patients. According to the Centers for Disease Control and Prevention (CDC), complications or infections secondary to either device implantation or surgery are referred to as HAIs. Specifically, the CDC monitors surgical site infections, central-line-associated bloodstream infection, catheter-associated urinary tract infections, and ventilator-associated pneumonias. This article explores HAIs specific to pathophysiology, epidemiology, and prevention, and how nurses can work together with other health care providers to decrease the incidence of these preventable complications...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160956/the-role-of-liver-function-in-the-setting-of-cirrhosis-with-chronic-infection-and-critical-illness
#6
REVIEW
Susan Lee, Latanja Divens, Leanne H Fowler
The patient with sepsis in the setting of hepatitis C virus (HCV)-related cirrhosis can have a more rapid decline in other organ dysfunction during critical illness and faces further increase in the risk for death. This article discusses the role of liver function in the patient with a systemic critical illness in contrast to the worsened pathophysiology of the patient with cirrhosis secondary to chronic HCV infection and critical illness, inpatient and posthospitalization management of the critically ill patient with chronic HCV-related cirrhosis, and the nursing implications and recommendations for future research for this population...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160955/infection-in-the-critically-ill-older-adult
#7
REVIEW
Jennifer Manning, Jean E Cefalu
Many challenges exist in caring for older adults with infection in critical care environments. Older adults are at high risk due to diminished reserve, age-related changes, comorbidities, subtle clinical presentations, and institutionalization. Additional risks include infections, such as pneumonia, influenza, and nosocomial infections. Age-related changes contribute to the increased risk of infection in older adults. Nursing assessments should be tailored to the needs of the older patient. To improve health care outcomes in this population, nursing care of the critically ill older adult with infection should include comprehensive assessment, surveillance for risks, and strategies aimed to aggressively treat infection...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160954/management-of-sepsis-in-patients-with-pulmonary-arterial-hypertension-in-the-intensive-care-unit
#8
REVIEW
Todd M Tartavoulle
Pulmonary arterial hypertension is a lethal condition, and the management of sepsis in patients with pulmonary arterial hypertension is challenging. As the disease progresses, the right ventricle is susceptible to failure due to a high pulmonary vascular resistance. The limited ability of the right ventricle to increase cardiac output in septic shock makes it difficult to deliver oxygen to the organ and tissues. Intravascular volume replacement and vasoactive drugs should only be considered after a thorough assessment...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160953/interpreting-laboratory-tests-in-infection-making-sense-of-biomarkers-in-sepsis-and-systemic-inflammatory-response-syndrome-for-intensive-care-unit-patients
#9
REVIEW
Jennifer B Martin, Jennifer E Badeaux
Sepsis and severe sepsis are leading causes of death in the United States and the most common causes of death among critically ill patients in noncoronary intensive care units. Diagnosis of infection and sepsis is a subjective clinical judgment based on the criteria for systemic inflammatory reaction, which is highly sensitive, not specific, and often misleading in intensively treated patients. Biomarkers are emerging as adjuncts to traditional diagnostic measures. No biomarkers have sufficient specificity or sensitivity to be routinely used in clinical practice, but they can aid in the diagnosis and treatment of infection versus inflammation...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160952/antibiotic-trends-amid-multidrug-resistant-gram-negative-infections-in-intensive-care-units
#10
REVIEW
Leanne H Fowler, Susan Lee
Isolates from ICUs most commonly find multidrug-resistant (MDR) gram-negative bacteria. The purpose of this article is to discuss the significant impact MDR gram-negative infections are having on ICUs, the threat on health and mortality, and effective and new approaches aimed to combat MDR gram-negative infections in critically ill populations. Inappropriate antibiotic therapies for suspected or documented infections are the leading cause of the emergence of bacterial resistance. A variety of strategies are aimed at combatting this international burden via antibiotic stewardship programs...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160951/an-interprofessional-team-approach-to-decreasing-surgical-site-infection-after-coronary-artery-bypass-graft-surgery
#11
REVIEW
Nicole J Jones, Chloe D Villavaso
The incidence of surgical site infections (SSIs) has a significant negative impact on health care. SSIs are associated with increased mortality, cost, readmissions, and prolonged length of stay. Although recent data show a 17% decrease in the incidence of SSIs among acute care hospitals in the United States, mortality related to SSIs remains clinically significant. The interprofessional team is a critical structure in evaluating surgical practices and outcomes and new evidence-based practices to direct education, interventions, and communication of SSI prevention strategies...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/27968948/mechanical-ventilation-in-the-critically-ill-patient-international-nursing-perspectives
#12
Sandra Goldsworthy
No abstract text is available yet for this article.
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/27484666/cardiac-arrhythmias
#13
EDITORIAL
Mary G Carey
No abstract text is available yet for this article.
September 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/27484665/in-hospital-cardiac-arrest-an-update-on-pulseless-electrical-activity-and-asystole
#14
REVIEW
Mina Attin, Rebecca G Tucker, Mary G Carey
Nonshockable rhythms, including pulseless electrical activity (PEA) and asystole, precede more than 70% of in-hospital cardiac arrests (I-HCA). Compared with shockable rhythms (ventricular fibrillation and ventricular tachycardia), nonshockable rhythms have higher mortality and morbidity. Therefore, investigating the underlying mechanisms of these arrhythmias to improve the quality of care and outcome for patients who suffer cardiac arrest is a priority. As the first responders to I-HCA, nurses must have the proper knowledge and training to provide timely and efficient cardiopulmonary resuscitation therapy...
September 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/27484664/arrhythmias-and-cardiac-bedside-monitoring-in-the-neonatal-intensive-care-unit
#15
REVIEW
Sherri L McMullen
Cardiac physiology is unique in neonates and infants; there are several physiologic changes that occur in the first weeks of life. Important changes can be captured on the bedside monitor and provide vital data in a noninvasive way to providers. The importance of diligent observation cannot be overstated. Bedside monitoring has improved in the last decade, which has enhanced the ability to detect changes in heart rates and rhythms. The purpose here is to review cardiac physiology, describe those arrhythmias able to be observed on bedside monitors, and highlight heart rate changes that can be early signs of sepsis...
September 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/27484663/basic-cardiac-electrophysiology-and-common-drug-induced-arrhythmias
#16
REVIEW
Aimee Lee, David Pickham
Drugs can be a double-edged sword, providing the benefit of symptom alleviation and disease modification but potentially causing harm from adverse cardiac arrhythmic events. Proarrhythmia is the ability of a drug to cause an arrhythmia, the number one reason for drugs to be withdrawn from the patient. Drug-induced arrhythmias are defined as the production of de novo arrhythmias or aggravation of existing arrhythmias, as a result of previous or concomitant pharmacologic treatment. This review summarizes normal cardiac cell and tissue functioning and provides an overview of drugs that effect cardiac repolarization and the adverse effects of commonly administered antiarrhythmics...
September 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/27484662/acute-coronary-syndrome-and-st-segment-monitoring
#17
REVIEW
Mary G Carey
Acute coronary syndrome (ACS) is caused by a critical obstruction of a coronary artery because of atherosclerotic coronary artery disease. Three specific conditions are included: ST elevation myocardial infarction, non-ST elevation myocardial infarction, and unstable angina. The ST segment on the electrocardiogram is a sensitive and specific marker of myocardial ischemia and infarction; however, ST segment deviation is regional not global, thus the ECG lead must be placed over the affected region of the myocardium...
September 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/27484661/cardiac-monitoring-in-the-emergency-department
#18
REVIEW
Jessica K Z├Ęgre-Hemsey, J Lee Garvey, Mary G Carey
Patients present to the emergency department (ED) with a wide range of complaints and ED clinicians are responsible for identifying which conditions are life threatening. Cardiac monitoring strategies in the ED include, but are not limited to, 12-lead electrocardiography and bedside cardiac monitoring for arrhythmia and ischemia detection as well as QT-interval monitoring. ED nurses are in a unique position to incorporate cardiac monitoring into the early triage and risk stratification of patients with cardiovascular emergencies to optimize patient management and outcomes...
September 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/27484660/ventricular-tachycardias-characteristics-and-management
#19
REVIEW
Aksana Baldzizhar, Ekaterina Manuylova, Roman Marchenko, Yury Kryvalap, Mary G Carey
Ventricular tachycardias include ventricular tachycardia, ventricular fibrillation, and torsades de pointes; although these rhythms may be benign and asymptomatic, others may be life threatening and lead to increased morbidity and mortality. To optimize patient outcomes, ventricular tachycardias need to be rapidly diagnosed and managed, and often the electrocardiogram (ECG) is the first and only manifestation of a cardiac defect. Understanding of the initial electrocardiographic pattern and subsequent changes can lead to early intervention and an improved outcome...
September 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/27484659/paroxysmal-supraventricular-tachycardia-pathophysiology-diagnosis-and-management
#20
REVIEW
Salah S Al-Zaiti, Kathy S Magdic
Paroxysmal supraventricular tachycardia (PSVT) is a well-known and thoroughly studied clinical syndrome, characterized by regular tachycardia rhythm with sudden onset and abrupt termination. Most patients present with palpitations and dizziness, and their electrocardiogram demonstrates a narrow QRS complex and regular tachycardia with hidden or inverted P waves. PSVT is caused by re-entry due to the presence of inhomogeneous, accessory, or concealed conducting pathways. Hemodynamically stable patients are treated by vagal maneuvers, intravenous adenosine, diltiazem, or verapamil, hemodynamically unstable patients are treated by cardioversion...
September 2016: Critical Care Nursing Clinics of North America
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