Critical care nursing quarterly
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Triage nurses in the emergency department are in a unique position to screen for domestic violence. This study, using Orlando's theory with a focus on two of her five major concepts, identifies barriers that prevent effective screening for domestic violence. ⋯ Education on abuse and resources should be essential in nursing school curricula. Policy development and review should be part of an annual, mandatory inservice for all emergency nurses.
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Currently, more than 1,200 advanced practice nurses have sought certification as acute care nurse practitioners (ACNPs). Surveys of practicing ACNPs have shown that the role is expanding in terms of practice settings and role components. This article reports on the results of ongoing survey with ACNPs that portray the role of the ACNP as an evolving career opportunity for advanced practice nurses.
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Modern engineering and space-age technology introduce innovations in thermometry at a crucial time in critical care history. Today's assessment and care decisions are based, in part, on emerging scientific evidence about thermoregulatory responses. ⋯ Confusion exists as to which instrument or site is "ideal." Interpretation of temperature correlations, between temperature sites or without consideration of linearity, has little meaning outside the clinical context. This article discusses hemodynamic and thermal conditions influencing regional body temperatures along with instrument accuracy, reliability, linearity, precision, safety, comfort, and need for staff training.
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Nutritional assessment can be incorporated into the assessments performed daily by the critical care nurse for every patient. Identification of nutritional deficits will lead to timely interventions and will facilitate recovery and early discharge. The metabolic responses to starvation and stress are reviewed, and bedside techniques for nutritional assessment are outlined. General guidelines for nutritional support and parameters for monitoring the effectiveness of nutritional therapies are defined.
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Perfusion status of the critically ill and injured has, in the past, been assessed by indices such as blood pressure (BP), heart rate, and urine output. These indices represent global perfusion and may not reflect regional blood-flow abnormalities. ⋯ The gastrointestinal (GI) tract remains one of these tissue beds that is extremely sensitive to low-flow states. Gastric tonometry is a noninvasive means in which these early symptoms of low flow may be monitored with early interventions to optimize tissue perfusion and patient outcome.