Dynamics (Pembroke, Ont.)
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Hypothermia can result from exposure to a cold environment (e.g., accidental drowning) or it can be induced and used as a brain protection strategy (e.g., therapeutic hypothermia). One common ECG presentation with hypothermia is the J wave, which is related to the altered cellular activities during hypothermia. A case study is used in this article to illustrate the presentation of a J wave with a patient experiencing hypothermia.
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Dynamics (Pembroke, Ont.) · Jan 2005
ReviewImproving pain management for critically ill and injured patients.
The under-treatment of pain continues to be a problem in patient care. Evidence shows a significant percentage of patients suffering with acute and chronic pain, despite the treatment options available. ⋯ As health care professionals, nurses have a responsibility to advocate for patients and provide the best pain management possible. Efforts to improve pain management will help avoid complications, such as chronic pain syndrome, while improving comfort, function, and quality of life.
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Dynamics (Pembroke, Ont.) · Jan 2004
ReviewManaging diabetic ketoacidosis: the role of the ICU nurse in an endocrine emergency.
Diabetic ketoacidosis is an endocrine emergency that requires intensive management and monitoring. Eight per cent of diabetic-related admissions are for the management of diabetic ketoacidosis and, prior to the discovery of insulin, all of these patients died (Delaney, Zisman & Kettyle, 2000). In this article, the author reviews the pathophysiology of the classic presentation of diabetic ketoacidosis: hyperglycemia and ketoacidosis. The management of the acute situation is described in order to enable the critical care nurse to provide and advocate for best patient care practices.
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Caring for the patient in the post-anesthetic period requires an understanding of the intubation and extubation process. The nurse must be knowledgeable of the numerous tracheal extubation-related complications that can occur. ⋯ After reviewing extubation criteria and the safe extubation process, the nurse can apply this knowledge to patient care. Although nurses are excellent initiators of tracheal extubation, the procedure is ideally performed by an anesthetist or internist who can treat complications that arise, or re-intubate the patient, if required.
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Dynamics (Pembroke, Ont.) · Jan 2004
ReviewAnalgesic and sedative pharmacology in the intensive care unit.
Sedation and analgesia are central elements in the care of critically ill, mechanically-ventilated patients. The goal of analgesic therapy is to provide relief from pain and physical discomfort which may lead to poor sleep, agitation, or a stress response. Opioids, such as morphine, fentanyl, and hydromorphone, are considered first-line agents for treating pain. ⋯ The benzodiazepines and propofol are the primary sedative agents used in the intensive care unit (ICU). Agents such as clonidine and haloperidol may have a role in the ICU when used concomitantly with sedatives and analgesics. An understanding of the pharmacotherapy of sedation and analgesia in the ICU will help support appropriate usage of these agents and improve patient care.