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Critical Care Nursing Clinics of North America

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https://www.readbyqxmd.com/read/29413224/gastrointestinal-issues-and-complications
#1
EDITORIAL
Deborah Weatherspoon, Debra Henline Sullivan
No abstract text is available yet for this article.
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413219/gastrointestinal-issues-and-complications
#2
Deborah Weatherspoon, Debra Henline Sullivan
No abstract text is available yet for this article.
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413218/evidence-based-practice-in-the-treatment-for-antibiotic-associated-diarrhea-in-the-intensive-care-unit
#3
REVIEW
Robin Squellati
Unit nurses provide care to patients with serious health conditions. Often antibiotics are recommended to fight infections. Sometimes patients are on proton pump inhibitors (PPI). Antibiotics and PPIs may lead to diarrhea, causing the patient more discomfort, and possibly leading to a more serious infection. One serious infection is caused by Clostridium difficile, which causes death in some cases. About 75% of patients on antibiotics may not need antibiotics. Several studies showed less diarrhea in patients on probiotics...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413217/educating-nurses-in-the-intensive-care-unit-about-gastrointestinal-complications-using-an-algorithm-embedded-into-simulation
#4
REVIEW
Loretta Bond, Beth Hallmark
It can be a challenge to prepare intensive care unit (ICU) nurses to recognize and care for the complex needs of deteriorating patients, especially in patients with gastrointestinal (GI) complications, who often present with vague but serious issues. Tools such as the sequential organ failure assessment tool and the GI failure tool have been used to assist nurses in decision making. This article discusses how to incorporate such tools into an algorithm for simulation training for ICU nurses that integrates a clinical judgment model to shape care for patients with GI complications...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413216/acute-diverticulitis-management
#5
REVIEW
Deborah L Ellison
Diverticular disease accounts for approximately 300,000 hospitalizations per year in the United States, resulting in 1.5 million days of inpatient care. Diverticulitis is defined as an inflammation of the diverticulum, which can be asymptomatic or symptomatic. This disease is the third most common gastrointestinal illness that requires hospitalization and the leading indication for elective colon resection. Abdominal pain is the most common complaint in patients with acute diverticulitis. The pain can be described as cramping, constant, and persistent for several days...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413215/management-of-acute-gastrointestinal-bleed
#6
REVIEW
Francisca Cisneros Farrar
Acute gastrointestinal bleeding is a common problem found in critically ill patients that can range from self-limited bleeding to a hemorrhaging emergency. Patients can quickly develop shock and altered mental status when they develop hemodynamic instability. Therefore, it is essential that the frontline critical care nurse develop self-efficacy for management of these disorders. This article overviews standards of practice for the management of upper and lower acute gastrointestinal bleeding. Common bleeding disorders are reviewed with expanded focus on peptic ulcer, acute variceal hemorrhage, colonic diverticular bleeding, and angiodysplasias, which are commonly found in the critical care setting...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413214/clostridium-difficile-more-challenging-than-ever
#7
REVIEW
Shelley C Moore
Clostridium difficile infection is not new, but it is posing more problems than ever before, described by the Centers for Disease Control and Prevention as an urgent threat. Its pathophysiology allows C difficile to be very difficult to manage, both within the hospital environment and in a patient's body. This article reviews clinical manifestations of the infection, outlines both medical and surgical treatment options, and discusses risk factors and predictors. Implications for nurses are thoroughly described...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413213/mesenteric-ischemia
#8
REVIEW
Robin M Lawson
Mesenteric ischemia is an uncommon disease most often seen in the elderly. This disease results from blood flow in the mesenteric circulation that inadequately meets metabolic needs of the visceral organs and, if untreated, eventually leads to necrosis of the bowel wall. Mesenteric ischemia is divided into 2 types: acute mesenteric ischemia (AMI) and chronic mesenteric ischemia (CMI). Delayed diagnosis of CMI can lead to AMI. AMI is associated with extremely high mortalities. Early diagnosis via computed tomography angiography and prompt revascularization via endovascular therapy are recommended for symptomatic patients who have not developed bowel ischemia and necrosis...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413212/gastroesophageal-reflux-regurgitation-in-the-infant-population
#9
REVIEW
Teresa D Ferguson
Gastroesophageal reflux (GER) is common in infancy and mainly treated through nonpharmacological interventions. Knowing the early warning signs of GER is important for nursing assessment. Untreated GER can become acute when an infant fails to gain weight and has recurrent, forceful vomiting. Further investigation of gastroesophageal reflux disease (GERD) is indicated when failure to gain weight, irritability, swallowing difficulties, regurgitation, and respiratory complications occur and should trigger referral to pediatric specialists...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413211/gastrointestinal-traumatic-injuries-gastrointestinal-perforation
#10
REVIEW
Maria A Revell, Marcia A Pugh, Melanie McGhee
The abdomen is a big place even in a small person. Gastrointestinal trauma can result in injury to the stomach, small bowel, colon, or rectum. Traumatic causes include blunt or penetrating trauma, such as gunshot wounds, stabbings, motor vehicle collisions, and crush injuries. Nontraumatic causes include appendicitis, Crohn disease, cancer, diverticulitis, ulcerative colitis, blockage of the bowel, and chemotherapy. The mechanism of injury will affect both the nature and severity of any resulting injuries. Treatment must address the critical and emergent nature of these injuries as well as issues that affect all trauma situations, which include management of hemodynamic instability...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413210/escherichia-coli-complications-in-pediatric-critical-care
#11
REVIEW
Suzanne S Puentes, Michele Dunstan
Escherichia coli is a bacterium that is an important part of the intestinal tract; however, it has the potential to become pathogenic. Shiga toxin-producing E coli (STEC) is a leading cause of E coli infections and has led to outbreaks in North America. Transmission is through ingestion of contaminated food sources, and via infected humans and animals. Young children infected with STEC are at high risk for developing hemolytic uremic syndrome (HUS). HUS is a clinical syndrome characterized by macroangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413209/adults-with-liver-failure-in-the-intensive-care-unit-a-transplant-primer-for-nurses
#12
REVIEW
Cheryl W McGinnis, Stacia M Hays
Liver transplant is the standard of care for treatment of many liver diseases. Patients with acute liver failure or end-stage liver disease may require intensive care management. Nurses play a vital role in the care of these patients before and immediately after transplant. Optimal patient outcomes depend on intensive care nurses being able to understand the process of liver failure and the necessary patient management during the pretransplant and early posttransplant periods. This article provides critical care nurses with an overview of liver disease and transplant for adult patients with a diagnosis of liver failure...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413208/nutrition-options-in-critical-care-unit-patients
#13
REVIEW
Teresa D Welch
Critically ill patients have increased metabolic requirements and must rely on the administration of nutritional therapy to meet those demands. Yet, according to research almost half of all hospitalized patients are not fed, are underfed, or are malnourished while in the hospital. This article demonstrates the importance of early feedings in critical care unit, and the available options open to nurses supporting initiation and management of early feedings. Enteral nutrition has proven to be an important therapeutic strategy for improving the outcomes of critically ill patients and the critical care nurse plays an integral role in their success...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413207/gastroesophageal-reflux-in-the-intensive-care-unit-patient
#14
REVIEW
Cathy A Cooper, Patti P Urso
The incidence of gastroesophageal reflux disease (GERD) in the critically ill patient in the intensive care unit is unknown. Interventions used in critically ill patients, such as sedation, tracheal tubes, mechanical ventilation, enteral feedings, positioning, and medications, along with specific patient characteristics and comorbid conditions contribute to an increased risk for gastroesophageal reflux (GER) in this population. Critical care nurses have an integral role in helping identify critically ill patients at risk for GER or with known GERD, in preventing complications associated with these conditions...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413206/gastrointestinal-motility-problems-in-critically-ill-patients
#15
REVIEW
Christine Frazer, Leslie Hussey, Mary Bemker
Gastrointestinal (GI) motility problems are common complications in critical care patients. GI problems contribute to an increased risk of morbidity and mortality. Toxic megacolon (TM) is a type of acquired megacolon categorized as a medical emergency and includes severe inflammation affecting all layers of the colon wall. The high incidence of GI complications in critically ill patients requires the critical care nurse to provide close monitoring of patients at risk and an acute awareness of the causation, signs and symptoms, and treatment of various GI motility disorders, including gastroparesis, ileus, and TM...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413205/common-gastrointestinal-complications-associated-with-human-immunodeficiency-virus-aids-an-overview
#16
REVIEW
Vincent P Hall
Highly active antiretroviral therapy (HAART) has transformed human immunodeficiency virus (HIV)/AIDS into a manageable chronic illness. People living with HIV/AIDS (PLWHA) can experience multiple physical symptoms or problems related to HIV infection and treatment. A common problem for PLWHA continues to be diarrhea and nausea and vomiting (NV). Diarrhea and NV can negatively impact the quality of life and adherence to medication therapy among PLWHA and are common reasons to change or discontinue HAART regimens...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413204/gastrointestinal-manifestations-of-autoimmune-diseases-requiring-critical-care
#17
REVIEW
Angela Collins-Yoder
Proper functioning within the gastrointestinal (GI) system is essential to immune integrity. Autoimmune diseases (ADs) can disrupt GI integrity and cause serious derangements of organ function. ADs exist on a continuum of mild to severe. Life-threatening presentations of ADs can lead to rapid clinical demise. Additionally, the medications used to control ADs can precipitate gastric bleeding and predispose patients to sepsis in critical care. AD treatment focuses on diminishing symptoms through reducing autoantibody production that leads to cytokine release...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29107313/pain-today
#18
EDITORIAL
Stephen D Krau, Maria Overstreet
No abstract text is available yet for this article.
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29107312/using-complementary-and-alternative-medicine-to-treat-pain-and-agitation-in-dementia-a-review-of-randomized-controlled-trials-from-long-term-care-with-potential-use-in-critical-care
#19
REVIEW
Alison R Anderson, Jie Deng, Robert S Anthony, Sebastian A Atalla, Todd B Monroe
The risk of pain in adults with dementia worsens with advancing age. Painful comorbidities may be underassessed and inadequately treated. Receiving treatment in critical care settings may indicate greater occurrences of pain and complications. Pain may exacerbate behavioral and psychological symptoms of dementia (BPSD), such as agitation. Complementary and alternative medicine (CAM) therapies may alleviate pain and BPSD, and continuity of therapy may bolster these therapeutic effects. This review did not reveal an apparent benefit of aromatherapy; however, improvements in BPSD have been shown previously...
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29107311/the-use-of-remifentanil-as-the-primary-agent-for-analgesia-in-parturients
#20
REVIEW
Bryan Anderson
Pain control in parturients can be particularly challenging for the hospital staff. To achieve optimal outcomes in anesthesia patients, it is important to consider multiple options for pain control, especially when traditional options pose a problem or are not options. In particular, there are parturient clients for whom the use of neuraxial anesthesia (epidural and spinal blockade) is not an option. One option that warrants consideration for patient centered anesthesia practice is the use of remifentanil.
December 2017: Critical Care Nursing Clinics of North America
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