Critical Care Nursing

Providing an easy-to-use reference, Critical Care Nursing
outlines best practice for the assessment, monitoring and treatment
of critically ill adult patients. Each chapter includes research
and evidence-based strategies for treating commonly-seen
conditions.

Initial chapters introduce ICU set-up and operation, the rapid
response team, vitals measurement and shock management
strategies. Subsequent chapters, structured by organ system,
focus on care relating to specific organ function and dysfunction,
including the respiratory, cardiovascular, neurologic, renal and
gastrointestinal systems. Key information on monitoring for
overdoses, special considerations in traumatic injury and
end-of-life concerns is also included.

Critical Care Nursing is a comprehensive and informative
resource for experienced staff nurses and advanced practice nurses
working with critically ill patients on ICUs, PCUs, transitional
care units and within emergency care departments.

Autorentext

Kathy Booker is Director and Professor, Millikin University School of Nursing, Illinois, USA. She has held former positions as Specialty Director of the Adult Advanced Practice Program in the School of Nursing, Yale University, Connecticut, USA, and Dean of the College of Professional Studies at Millikin University. She has been certified as a Critical Care Registered Nurse (CCRN) for over twenty years, currently holding alumnus status CCRN. She practiced as a critical care RN and Clinical Nurse Specialist for over twenty-five years.

Klappentext

Providing an easy-to-use reference, Monitoring and Treatment in Critical Care Nursing outlines best practice for the assessment, monitoring and treatment of critically ill adult patients. Each chapter includes research and evidence-based strategies for treating commonly-seen conditions.

Initial chapters introduce ICU set-up and operation, the rapid response team, vitals measurement and shock management strategies. Subsequent chapters, structured by organ system, focus on care relating to specific organ function and dysfunction, including the respiratory, cardiovascular, neurologic, renal and gastrointestinal systems. Key information on monitoring for overdoses, special considerations in traumatic injury and end-of-life concerns is also included.

Monitoring and Treatment in Critical Care Nursing is a comprehensive and informative resource for experienced staff nurses and advanced practice nurses working with critically ill patients on ICUs, PCUs, transitional care units and within emergency care departments.

Zusammenfassung

Providing an easy-to-use reference, Critical Care Nursing outlines best practice for the assessment, monitoring and treatment of critically ill adult patients. Each chapter includes research and evidence-based strategies for treating commonly-seen conditions.

Initial chapters introduce ICU set-up and operation, the rapid response team, vitals measurement and shock management strategies. Subsequent chapters, structured by organ system, focus on care relating to specific organ function and dysfunction, including the respiratory, cardiovascular, neurologic, renal and gastrointestinal systems. Key information on monitoring for overdoses, special considerations in traumatic injury and end-of-life concerns is also included.

Critical Care Nursing is a comprehensive and informative resource for experienced staff nurses and advanced practice nurses working with critically ill patients on ICUs, PCUs, transitional care units and within emergency care departments.

Inhalt
Contributors, xv Critical Care Nursing: Monitoring and Treatment for Advanced Nursing Practice, xvii
Kathy J. Booker

1 Philosophy and treatment in US critical care units, 1
Kathy J. Booker

US critical care units, 1

Organization of critical care delivery, 1

Monitoring and surveillance in critical care, 2

Surveillance, 2

Nursing certification and competency in critical care units, 3

US national critical care organizations, 4

American Association of Critical Care Nurses, 4

Society of Critical Care Medicine, 5

Acute care advanced practice nursing, 5

Clinical nurse specialists, 6

Acute care nurse practitioners, 6

Critical care and ACNP outcomes research, 7

Evolution of families in the critical care unit, 8

Progression and development of rapid response teams, 9

2 Vital measurements and shock syndromes in critically ill adults, 13
Kathy J. Booker and Laura Kierol Andrews

Monitoring basic vital signs, 13

Temperature monitoring, 14

Hypothermia, 14

Complications of cooling, 15

Hyperthermia, 17

Heatstroke management, 17

Malignant hyperthermia, 17

Heart rate monitoring, 18

Blood pressure monitoring, 19

Oscillometric blood pressure measurement, 20

Aneroid measurement, 20

Arterial pressure measurement, 20

Respiratory monitoring, 21

Capnography, 21

Shock conditions in critically ill adults, 22

Cardiogenic shock, 23

Anaphylactic shock, 24

Hypovolemic shock, 24

Sepsis syndromes, 26

SIRS, sepsis, and septic shock, 26

Monitoring and treatment priorities in sepsis syndromes, 28

Sepsis diagnosis, 28

Body temperature, 29

Cultures, 29

Intravascular catheters, 29

Other infectious complications in critically ill adults, 29

Pulmonary infections, 29

Urinary tract infections, 30

Monitoring during transport, 30

3 Monitoring for respiratory dysfunction, 35
Alexander P. Johnson and Jennifer Abraham

Acid-base disturbances & anion gap, 35

Metabolic acidosis, 35

Metabolic alkalosis, 37

Respiratory acidosis, 37

Respiratory alkalosis, 38

Mixed acidbase disorders, 38

Oxygenation, 38

Estimation of the PaO2, 38

Aa Gradient, 39

PaO2/FiO2 (P/F) ratio, 39

Acute respiratory failure, 40

Capnography, 40

Monitoring ventilation with PetCO2, 40

Monitoring blood flow, 41

Modes of mechanical ventilation, 41

Continuous positive airway pressure (CPAP) with pressure support, 41

Synchronized intermittent mandatory ventilation (SIMV), 42

Assist/control ventilation (AC), 42

Pressure control ventilation, 42

Airway pressure release ventilation (APRV), 42

Pressure-regulated volume control (PRVC), 42

Inverse ratio ventilation, 43

Oscillatory ventilation, 43

Overview of protective lung ventilation in ARDS, 43

ARDSNet protocol goals, 43

Monitoring for complications during mechanical ventilation, 43

High peak airway pressures on mechanical ventilation, 43

Response to baggingmonitoring and treatment, 44

Auto-PEEP effect, 44

Weaning from mechanical ventilation, 44

Postextubation stridor: monitoring and treatment, 46

Noninvasive positive pressure ventilation, 47

Tension pneumothorax, 47

Emergent treatmentneedle thoracostomy, 47

Chest radiograph interpretation, 48

Sleep-disordered breathing in the critical care unit, 48

Obstructive sleep apnea, 50

Central sleep apnea, 50 Obesity hypoventilat...