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AACN Advanced Critical Care

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https://www.readbyqxmd.com/read/30185504/wellens-syndrome
#1
Karen M Marzlin
No abstract text is available yet for this article.
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/30185500/clinical-presentation-and-treatment-of-amniotic-fluid-embolism
#2
Anne-Marie McBride
Obstetric emergencies often require intensive care intervention. Amniotic fluid embolism is a rare, unpredictable, and often catastrophic complication of pregnancy that is suspected in a woman who experiences cardiac arrest after a cesarean section. The condition occurs in approximately 1 in 40‚ÄČ000 births and has an average case-fatality rate of 16%. This complication may result from activation of an inflammatory response to fetal tissue in the maternal circulation. Risk factors may include maternal age over 35 years and conditions in which fluid can exchange between the maternal and fetal circulations...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/30185499/pulmonary-edema-in-obstetrics-essential-facts-for-critical-care-nurses
#3
Rebecca L Cypher
Pulmonary edema is an acute pregnancy complication that, if uncorrected, can result in increased maternal and fetal morbidity and mortality. Although pulmonary edema is relatively rare in the general obstetrics population, pregnant patients are at increased risk for pulmonary edema because of the physiologic changes of pregnancy. The risk may be exacerbated by certain pregnancy-related diseases, such as preeclampsia. Prompt identification and appropriate clinical management of pulmonary complications is critical to prevent adverse outcomes in pregnant patients...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/30185498/preeclampsia-acute-complications-and-management-priorities
#4
Patricia M Witcher
Acute complications of preeclampsia contribute substantially to maternal and fetal morbidity and mortality. The considerable variation in onset, clinical presentation, and severity of this hypertensive disease that is unique to pregnancy creates challenges in identifying risk factors for clinical deterioration. Delivery of the fetus remains the only definitive treatment for preeclampsia. Surveillance of signs and symptoms and laboratory parameters consistent with progression in severity requires an appreciation of the dynamic and progressive nature of the disease...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/30185497/recognition-and-management-of-sepsis-in-the-obstetric-patient
#5
Sheryl E Parfitt, Sandra L Hering
Sepsis is one of the principal causes of maternal mortality in obstetrics. Physiologic changes that occur during pregnancy create a vulnerable environment, predisposing pregnant patients to the development of sepsis. Furthermore, these changes can mask sepsis indicators normally seen in the nonobstetric population, making it difficult to recognize and treat sepsis in a timely manner. The use of maternal-specific early warning tools for sepsis identification and knowledge of appropriate interventions and their effects on the mother and fetus can help clinicians obtain the best patient outcomes in acute care settings...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/30185496/cardiac-disease-in-pregnancy
#6
Stephanie Martin, Julie Arafeh
In the United States, cardiac disease is a leading contributor to maternal mortality and morbidity. This review addresses the impact of cardiac disease on management of pregnancy and how the physiological changes of pregnancy complicate patient treatment. Approaches to assessing risk in pregnant women with cardiac disease are reviewed. Key elements of a successful disease management strategy are reviewed. Management of cardiac arrest in a pregnant patient is discussed.
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/30185495/evidence-based-strategies-for-maternal-stabilization-and-rescue-in-obstetric-hemorrhage
#7
Carol J Harvey
Obstetric hemorrhage is one of the most frequent causes of maternal death in the United States. More than 70% of maternal deaths from hemorrhage are preventable. State and professional quality care organizations have reduced severe maternal morbidity by more than 20% by implementing evidence-based guidelines. Successful hemorrhage management requires collaborative, multidisciplinary teams of trained health care personnel. Hemorrhage management's primary goal is to stop the bleeding before the occurrence of maternal hypovolemia, acidosis, coagulopathy, and death...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/30185494/physiologic-and-hemodynamic-changes-during-pregnancy
#8
Nan H Troiano
Substantial physiologic changes accompany pregnancy, the most profound of which involve the cardiovascular system. These changes affect maternal hemodynamic and oxygen transport status. This article describes cardiovascular changes that occur during pregnancy including blood volume, heart rate, stroke volume, cardiac output, vascular resistance, and colloid osmotic pressure. Alterations in factors related to maternal oxygen transport including oxygen affinity, delivery, and consumption also are described. Concepts related to fetal oxygen transport and adaptive responses to hypoxemia are presented...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/30185492/impact-of-coaching-on-the-nurse-physician-dynamic
#9
Fayyadh R Yusuf, Ambuj Kumar, Wendi Goodson-Celerin, Tracey Lund, Janet Davis, Mary Kutash, Charles N Paidas
BACKGROUND: Limited resources and increased patient care demands have strained nurse-physician relationships in our hospital's neurosurgical intensive care unit, leading to low morale and adversarial dynamics. Studies exploring benefits of coaching interprofessional teamwork demonstrate performance improvements. Therefore, a coaching program designed to improve nurse-physician teamwork was initiated by the neurosurgery department of the hospital's affiliated university. OBJECTIVE: To assess the impact of a coaching program for nurses and physicians on workplace performance in a neurosurgical intensive care unit at a level 1 trauma center...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/30185491/pharmacokinetics-and-extracorporeal-membrane-oxygenation-in-adults-a-literature-review
#10
Monika Tukacs
Extracorporeal membrane oxygenation is a rapidly emerging treatment for respiratory or cardiac failure and is used as a bridge to recovery, transplant, or destination therapy. Adult patients receiving extracorporeal membrane oxygenation also receive significant amounts of pharmacotherapy. Although the body of literature on extra-corporeal membrane oxygenation in general is extensive, only a few publications focus on pharmacokinetic changes related to extracorporeal membrane oxygenation in adults. Understanding pharmacokinetics in adult patients receiving extracorporeal membrane oxygenation is important to correctly select and dose medications in this patient population...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875119/distress-debriefings-after-critical-incidents-a-pilot-project
#11
Kerry P Appleton, Suzanne Nelson, Shawn Wedlund
No abstract text is available yet for this article.
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875118/science-of-improvement-versus-science-of-implementation-integrating-both-into-clinical-inquiry
#12
Bradi B Granger
No abstract text is available yet for this article.
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875116/evidence-based-review-of-clinical-trials-in-neurocritical-care
#13
Molly McNett, Cristina Moran, Halee Johnson
Neurocritical care is a rapidly growing specialty of complex care for the critically ill patient with neurological injury. This rapid growth has led to an increase in the number of important clinical trials to guide clinical practice and evidence-based care of the critically ill patient with neurological injury. Specialty-trained critical care nurses and advanced practice providers are integral members of neurocritical care teams and must remain informed about pivotal trials shaping practice recommendations...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875115/multimodal-neuromonitoring-in-neurocritical-care
#14
Sarah H Peacock, Amanda D Tomlinson
Neuromonitoring is important for patients with acute brain injury. The bedside neurologic examination is standard for neurologic monitoring; however, a clinical examination may not reliably detect subtle changes in intracranial physiology. Changes found during neurologic examinations are often late signs. The assessment of multiple physiological variables in real time can provide new clinical insights into treatment decisions. No single monitoring modality is ideal for all patients. Simultaneous assessment of cerebral hemodynamics, oxygenation, and metabolism, such as in multimodal monitoring, allows an innovative approach to individualized patient care...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875114/critical-care-transport-of-patients-with-brain-injuries
#15
Rachel Zayas
Critical care transport began in the 1970s as a response to the growing need to be able to transport critically ill and injured patients to tertiary care centers for higher levels of care or specialized treatments. Patients in critical condition now are transported great distances to receive potentially lifesaving treatment and interventions. Modes of critical care transport include ambulances, helicopters, and airplanes. Critical care transport teams consist of highly skilled paramedics, registered nurses, respiratory therapists, nurse practitioners, and physicians...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875113/aneurysmal-subarachnoid-hemorrhage-and-vasospasm
#16
Shannon K Burns, Kacie J Brewer, Courtney Jenkins, Sally Miller
Aneurysmal subarachnoid hemorrhage is potentially fatal and is associated with poor outcomes in many patients. Advances in neurosurgical and medical management of ruptured aneurysms have improved mortality rates in patients with aneurysmal subarachnoid hemorrhage. Surgical and endovascular interventions, such as external ventricular drain placement, aneurysm clipping, and endovascular coiling, have been developed over the past few decades. Patients with aneurysmal subarachnoid hemorrhage are also at risk for cerebral vasospasm and delayed cerebral ischemia...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875112/acute-ischemic-stroke
#17
Bryan Boling, Katie Keinath
Acute ischemic stroke is a major cause of mortality and morbidity in the United States and worldwide. Despite the development of specialized stroke centers, mortality and morbidity as a result of acute ischemic strokes can and do happen anywhere. These strokes are emergency situations requiring immediate intervention. This article covers the fundamentals of care involved in treating patients with acute ischemic stroke, including essentials for the initial evaluation, basic neuroimaging, reperfusion therapies, critical care management, and palliative care, as well as current controversies...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875111/neurocritical-care-the-continued-evolution
#18
Diane C McLaughlin
No abstract text is available yet for this article.
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875110/nurse-practitioners-and-interdisciplinary-teams-in-pediatric-critical-care
#19
Kristin H Gigli, Mary S Dietrich, Peter I Buerhaus, Ann F Minnick
OBJECTIVE: To describe the members of pediatric intensive care unit interdisciplinary provider teams and labor inputs, working conditions, and clinical practice of pediatric intensive care unit nurse practitioners. METHODS: A national, quantitative, crosssectional, descriptive postal survey of pediatric intensive care unit medical directors and nurse practitioners was administered to gather information about provider-team members, pediatric intensive care unit nurse practitioner labor inputs, working conditions, and clinical practice...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875109/hemodynamics-and-perfusion-in-premature-infants-during-transfusion
#20
Barbara Weaver, Kelsey Guerreso, E Alexander Conner, Kendra Russell, Robert Vogel, Mitch Rodriguez
BACKGROUND: Premature infants may require packed red blood cell transfusions, but current guidelines lack empirical evidence and vary among institutions and prescribers. OBJECTIVE: To compare the physiological changes in cardiovascular hemodynamics and oxygen delivery between premature infants with anemia who receive packed red blood cell transfusions and premature infants without anemia. METHODS: The study was a prospective observational cohort investigation of 75 premature infants...
2018: AACN Advanced Critical Care
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