Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Dec 2005
ReviewNutritional assessment and enteral support of critically ill children.
Critical care nurses play an important role in feeding of critically ill children. Many procedures and caregiving interventions, such as placement of feeding tubes, registration of gastric retention, observation and care of the mouth, and administration of nutrition (enteral or parenteral), are within the nursing domain. This article discusses nutritional assessment techniques and enteral nutrition in critically ill children.
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Crit Care Nurs Clin North Am · Dec 2005
ReviewAdverse responses: sedation, analgesia and neuromuscular blocking agents in critically ill children.
Advanced practice nurses (APNs) prescribe sedation, analgesia, and neuromuscular blocking agents in the management of critically ill children. Although most children are unscathed from the use of the medications, some suffer adverse responses. This article elucidates adverse responses to these medications for the APN, including withdrawal syndrome, muscle weakness, decreased gastric motility, corneal abrasions, and costs associated with these morbidities.
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A significant percentage of pediatric patients admitted to an ICU have an infectious disease process. Many infants and children go on to develop sepsis, a major cause of death in the intensive care unit. Caring for these children presents a collaborative challenge because of the multifactorial etiology and the complicated pathophysiology. This article focuses on the specific implications of sepsis for infants and children.
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Crit Care Nurs Clin North Am · Dec 2005
ReviewSafety in the pediatric ICU: the key to quality outcomes.
Patient safety is a major concern in the pediatric ICU. The acuity has never been higher, patient needs are extremely complex, and the margin for error is small. ⋯ This article discusses communication, patient identification, catheter-related bloodstream infections, unplanned extubations, restraints and medication administration. The health care system of the future must be transparent, making safety information to insurers, patients and health care providers easily available.
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Crit Care Nurs Clin North Am · Dec 2005
ReviewLow cardiac output syndrome: identification and management.
Low cardiac output syndrome (LCOS) is a clinical condition that is caused by a transient decrease in systemic perfusion secondary to myocardial dysfunction. The outcome is an imbalance between oxygen delivery and oxygen consumption at the cellular level which leads to metabolic acidosis. Although LCOS is observed most commonly in patients after cardiac surgery, it may present in various disease processes resulting in cardiac dysfunction. This article provides an overview of the determinants involved in oxygen transport, the physiologic factors influencing cardiovascular function, the assessment of hemodynamic variables, the etiology of LCOS, and management strategies, including a brief review of some pharmacologic agents that are used in the treatment of low cardiac output.