AACN clinical issues in critical care nursing
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Dysrhythmias in infants and children are, in many ways, similar to those in adults, yet several important differences exist in their presentation and management. Complex dysrhythmias most frequently encountered in pediatrics include sinus node dysfunction, chaotic atrial rhythm, atrial flutter, supraventricular tachycardia (including Wolff-Parkinson-White syndrome and junctional ectopic tachycardia), complete atrioventricular block (congenital and acquired), and ventricular dysrhythmias (premature ventricular contractions and ventricular tachycardia). Newer approaches to the diagnosis and management of these dysrhythmias are addressed in this paper.
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Wolff-Parkinson-White (WPW) syndrome is a cardiac conduction disorder that presents with potentially life-threatening consequences. Wolff-Parkinson-White syndrome-induced dysrhythmias account for 20% of all supraventricular tachycardias that occur in the general population. ⋯ Current diagnostic modalities are accurate in identifying patients with WPW syndrome, but lack the sensitivity to predict sudden cardiac death. This article reviews the history of WPW syndrome, as well as its general characteristics, diagnostic criteria, treatment modalities, and nursing implications.
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AACN Clin Issues Crit Care Nurs · Nov 1991
Case ReportsBenzodiazepine sedation in critically ill patients.
Agitation is a common phenomenon in critically ill patients. This multidimensional challenge can prolong illness, interfere with treatment, and harm the patient. The nurse must assess the cause of the agitation and provide effective, timely intervention. ⋯ With astute assessment and intervention, agitation can be prevented and treated to enhance recovery from critical illness. Benzodiazepines are an effective treatment intervention for agitation. With thorough knowledge of the actions and potential effects of these drugs, the nurse can provide the best pharmacologic intervention to treat agitation in the critically ill patient.
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AACN Clin Issues Crit Care Nurs · Nov 1991
ReviewNeuromuscular blocking agents in the critically ill patient: neither sedating nor pain relieving.
Although neuromuscular blocking agents (NMBAs), such as pancuronium bromide and succinylcholine, are widely used in the management of critically ill patients, many misconceptions regarding the agents' clinical effects and indications persist. This article will discuss these misconceptions and review the indications for the use of NMBAs in the critically ill patient, how these potent agents work, and strategies to effectively manage critically ill patients who are receiving NMBAs as a part of their treatment regimen.