AACN clinical issues in critical care nursing
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AACN Clin Issues Crit Care Nurs · Nov 1991
ReviewIntracranial pressure monitoring: technical imperatives.
Intracranial pressure (ICP) monitoring provides extremely important information that is helpful in detecting intracranial hypertension and guiding therapeutic interventions that attempt to control this pathologic condition. This article reviews the purpose and rationale for monitoring ICP. ⋯ This article also explains how to interpret ICP, ICP waveforms, and cerebral perfusion pressure. In addition, it addresses the application of data retrieved from ICP monitoring to clinical nursing practice and implications for nursing research.
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AACN Clin Issues Crit Care Nurs · Nov 1991
ReviewUse of patient-controlled analgesia with critically ill patients: a risk/benefit analysis.
Patient-controlled analgesia (PCA), a system by which patients self-administer intravenous doses of narcotics using specially programmed infusion pumps, has been used for pain management in acute care settings for nearly two decades. The safety and effectiveness of PCA has been documented in many acutely ill patient populations. ⋯ However, intravenous narcotics of any type can provoke hemodynamic or respiratory complications in these compromised patients. Nursing expertise is a key factor in the successful implementation of PCA in critically ill patients.
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AACN Clin Issues Crit Care Nurs · Nov 1991
ReviewIssues regarding the use of analgesia and sedation in critically ill neonates.
Attitudes and beliefs of physicians and nurses have shifted during the past decade, resulting in more frequent administration of analgesics and sedatives to neonates. However, nurses caring for critically ill newborns have difficulty in determining appropriate interventions because of the lack of clear and complete knowledge related to the use of analgesia and sedation in this patient population. This chapter presents current information on six key issues related to the use of analgesia and sedation in neonates. An algorithm for determining appropriate intervention for neonates with pain, distress, or agitation is proposed to provide a more systematic approach to the use of analgesics and sedatives.
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AACN Clin Issues Crit Care Nurs · Nov 1991
ReviewAneurysmal subarachnoid hemorrhage: neurosurgical frontiers and nursing challenges.
Despite increases in survival beyond the initial hemorrhage, the devastating consequences of subarachnoid hemorrhage persist. Ruptured intracranial aneurysms are the most likely cause of subarachnoid hemorrhage, with morbidity and mortality rates approaching 75%. ⋯ In order to positively influence outcome after subarachnoid hemorrhage, preservation of an adequate cerebral blood flow and prevention of secondary aneurysmal rupture is essential. This article reviews aneurysmal subarachnoid hemorrhage, relating the management of complications to currently accepted treatment strategies.
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AACN Clin Issues Crit Care Nurs · Aug 1991
ReviewDyspnea in the weaning patient: assessment and intervention.
Dyspnea, the subjective sensation of uncomfortable breathing, is frequently experienced by patients during weaning from mechanical ventilation. As the clinical manifestation of increased work of breathing, dyspnea can be a valuable predictor and indicator of changes in patient respiratory status during the weaning process. ⋯ The most reliable physiologic variables that can be used to indirectly estimate dyspnea are discussed. Strategies such as positioning, coaching, "bagging," inspiratory muscle training, pressure support ventilation, oxygen, and relaxation/biofeedback techniques that can be used by the critical care nurse to decrease dyspnea are suggested.