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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/28236399/preface
#12
EDITORIAL
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/28236396/challenges-in-sepsis-care-new-sepsis-definitions-and-fluid-resuscitation-beyond-the-central-venous-pressure
#13
REVIEW
Maureen A Seckel, Thomas Ahrens
There are two important recent changes in sepsis care. The first key change is the 2016 Sepsis-3 definitions from the recent consensus workgroup with new sepsis and septic shock definitions. Useful tools for assessing patients that have a greater risk of mortality include Sequential Organ Failure Assessment (SOFA) in intensive care units and quick SOFA outside intensive care units. The second change involves management of fluid resuscitation and measures of volume responsiveness. Measures such as blood pressure and central venous pressure are not reliable...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236395/nursing-strategies-for-effective-weaning-of-the-critically-ill-mechanically-ventilated-patient
#14
REVIEW
Darian Ward, Paul Fulbrook
The risks imposed by mechanical ventilation can be mitigated by nurses' use of strategies that promote early but appropriate reduction of ventilatory support and timely extubation. Weaning from mechanical ventilation is confounded by the multiple impacts of critical illness on the body's systems. Effective weaning strategies that combine several interventions that optimize weaning readiness and assess readiness to wean, and use a weaning protocol in association with spontaneous breathing trials, are likely to reduce the requirement for mechanical ventilatory support in a timely manner...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236394/special-considerations-in-neonatal-mechanical-ventilation
#15
REVIEW
Stacey Dalgleish, Linda Kostecky, Irina Charania
Care of infants supported with mechanical ventilation is complex, time intensive, and requires constant vigilance by an expertly prepared health care team. Current evidence must guide nursing practice regarding ventilated neonates. This article highlights the importance of common language to establish a shared mental model and enhance clear communication among the interprofessional team. Knowledge regarding the underpinnings of an open lung strategy and the interplay between the pathophysiology and individual infant's response to a specific ventilator strategy is most likely to result in a positive clinical outcome...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236393/special-considerations-in-the-nursing-care-of-mechanically-ventilated-children
#16
REVIEW
Karen Dryden-Palmer, Jason Macartney, Leanne Davidson, Faiza Syed, Cathy Daniels, Shaindy Alexander
Mechanical ventilation is often required to support the recovery of critically ill children. Critical care nurses must understand the unique needs of the children and design supportive care that is sensitive to their changing physiology, developmental stage, and socioemotional needs. This article describes the unique considerations in providing care for mechanically ventilated children. It addresses invasive and noninvasive ventilation and the needs of long-term ventilated children and family in critical care...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236392/patient-safety-identifying-and-managing-complications-of-mechanical-ventilation
#17
REVIEW
Heather Baid
Mechanical ventilation is a fundamental aspect of critical care practice to help meet the respiratory needs of critically ill patients. Complications can occur though, as a direct result of being mechanically ventilated, or indirectly because of a secondary process. Preventing, identifying, and managing these complications significantly contribute to the role and responsibilities of critical care nurses in promoting patient safety. This article reviews common ventilator-associated events, including both infectious (eg, ventilator-associated pneumonia) and noninfectious causes (eg, acute respiratory distress syndrome, pulmonary edema, pleural effusion, and atelectasis)...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236391/best-practices-for-managing-pain-sedation-and-delirium-in-the-mechanically-ventilated-patient
#18
REVIEW
Kitty M Garrett
Nursing management of pain, agitation, and delirium in mechanically ventilated patients is a challenge in critical care. Oversedation can lead to delayed extubation, prolonged ventilator days, unnecessary neurologic testing, and complications such as weakness and delirium. Undersedation can lead to self-extubation, invasive line removal, unnecessary patient distress, and injury to self or others. Acquiring an optimal level of sedation requires the bedside nurse to be more vigilant than ever with patient assessment and medication titration...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236390/optimizing-oxygenation-in-the-mechanically-ventilated-patient-nursing-practice-implications
#19
REVIEW
Glenn Barton, Brandi Vanderspank-Wright, Jacqueline Shea
Critical care nurses constitute front-line care provision for patients in the intensive care unit (ICU). Hypoxemic respiratory compromise/failure is a primary reason that patients require ICU admission and mechanical ventilation. Critical care nurses must possess advanced knowledge, skill, and judgment when caring for these patients to ensure that interventions aimed at optimizing oxygenation are both effective and safe. This article discusses fundamental aspects of respiratory physiology and clinical indices used to describe oxygenation status...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236389/early-mobilization-of-mechanically-ventilated-patients
#20
REVIEW
Pam Hruska
Critically ill patients requiring mechanical ventilation are least likely to be mobilized and, as a result, are at-risk for prolonged complications from weakness. The use of bed rest and sedation when caring for mechanically ventilated patients is likely shaped by historical practice; however, this review demonstrates early mobilization, with little to no sedation, is possible and safe. Assessing readiness for mobilization in context of progressing patients from passive to active activities can lead to long-term benefits and has been achievable with resource-efficient implementations and team work...
December 2016: Critical Care Nursing Clinics of North America
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