Critical Care Nursing

Monitoring and Treatment for Advanced Nursing Practice
Herausgegeben von Booker, Kathy

• Broschiertes Buch

Produktbeschreibung

Providing an easy-to-use reference, Critical Care Nursing outlines best practice for the assessment, monitoring and treatment of critically ill adult patients. Each chapter includes research and evidence-based strategies for treating commonly-seen conditions.

Initial chapters introduce ICU set-up and operation, the rapid response team, vitals measurement and shock management strategies. Subsequent chapters, structured by organ system, focus on care relating to specific organ function and dysfunction, including the respiratory, cardiovascular, neurologic, renal and gastrointestinal systems. Key information on monitoring for overdoses, special considerations in traumatic injury and end-of-life concerns is also included.

Critical Care Nursing is a comprehensive and informative resource for experienced staff nurses and advanced practice nurses working with critically ill patients on ICUs, PCUs, transitional care units and within emergency care departments.

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Produktdetails

• Verlag: Wiley & Sons
• 1. Auflage
• Seitenzahl: 290
• Erscheinungstermin: 30. März 2015
• Englisch
• Abmessung: 242mm x 168mm x 15mm
• Gewicht: 572g
• ISBN-13: 9780470958568
• ISBN-10: 0470958561
• Artikelnr.: 41430524

Autorenporträt

Kathy Booker is Director and Professor, Millikin University School of Nursing, Illinois, USA. She has held former positions as Specialty Director of the Adult Advanced Practice Program in the School of Nursing, Yale University, Connecticut, USA, and Dean of the College of Professional Studies at Millikin University. She has been certified as a Critical Care Registered Nurse (CCRN) for over twenty years, currently holding alumnus status CCRN. She practiced as a critical care RN and Clinical Nurse Specialist for over twenty-five years.

Inhaltsangabe

Contributors, xv
Critical Care Nursing: Monitoring and Treatment for Advanced Nursing
Practice, xvii
Kathy J. Booker
1 Philosophy and treatment in US critical care units, 1
Kathy J. Booker
US critical care units, 1
Organization of critical care delivery, 1
Monitoring and surveillance in critical care, 2
Surveillance, 2
Nursing certification and competency in critical care units, 3
US national critical care organizations, 4
American Association of Critical Care Nurses, 4
Society of Critical Care Medicine, 5
Acute care advanced practice nursing, 5
Clinical nurse specialists, 6
Acute care nurse practitioners, 6
Critical care and ACNP outcomes research, 7
Evolution of families in the critical care unit, 8
Progression and development of rapid response teams, 9
2 Vital measurements and shock syndromes in critically ill adults, 13
Kathy J. Booker and Laura Kierol Andrews
Monitoring basic vital signs, 13
Temperature monitoring, 14
Hypothermia, 14
Complications of cooling, 15
Hyperthermia, 17
Heatstroke management, 17
Malignant hyperthermia, 17
Heart rate monitoring, 18
Blood pressure monitoring, 19
Oscillometric blood pressure measurement, 20
Aneroid measurement, 20
Arterial pressure measurement, 20
Respiratory monitoring, 21
Capnography, 21
Shock conditions in critically ill adults, 22
Cardiogenic shock, 23
Anaphylactic shock, 24
Hypovolemic shock, 24
Sepsis syndromes, 26
SIRS, sepsis, and septic shock, 26
Monitoring and treatment priorities in sepsis syndromes, 28
Sepsis diagnosis, 28
Body temperature, 29
Cultures, 29
Intravascular catheters, 29
Other infectious complications in critically ill adults, 29
Pulmonary infections, 29
Urinary tract infections, 30
Monitoring during transport, 30
3 Monitoring for respiratory dysfunction, 35
Alexander P. Johnson and Jennifer Abraham
Acid-base disturbances & anion gap, 35
Metabolic acidosis, 35
Metabolic alkalosis, 37
Respiratory acidosis, 37
Respiratory alkalosis, 38
Mixed acid-base disorders, 38
Oxygenation, 38
Estimation of the PaO2, 38
A-a Gradient, 39
PaO2/FiO2 (P/F) ratio, 39
Acute respiratory failure, 40
Capnography, 40
Monitoring ventilation with PetCO2, 40
Monitoring blood flow, 41
Modes of mechanical ventilation, 41
Continuous positive airway pressure (CPAP) with pressure support, 41
Synchronized intermittent mandatory ventilation (SIMV), 42
Assist/control ventilation (AC), 42
Pressure control ventilation, 42
Airway pressure release ventilation (APRV), 42
Pressure-regulated volume control (PRVC), 42
Inverse ratio ventilation, 43
Oscillatory ventilation, 43
Overview of protective lung ventilation in ARDS, 43
ARDSNet protocol goals, 43
Monitoring for complications during mechanical ventilation, 43
High peak airway pressures on mechanical ventilation, 43
Response to bagging-monitoring and treatment, 44
Auto-PEEP effect, 44
Weaning from mechanical ventilation, 44
Postextubation stridor: monitoring and treatment, 46
Noninvasive positive pressure ventilation, 47
Tension pneumothorax, 47
Emergent treatment-needle thoracostomy, 47
Chest radiograph interpretation, 48
Sleep-disordered breathing in the critical care unit, 48
Obstructive sleep apnea, 50
Central sleep apnea, 50
Obesity hypoventilation syndrome, 51
CPAP and BiPAP therapy, 51
Approach to cardiogenic dyspnea in acute heart failure, 52
4 Electrocardiographic monitoring for cardiovascular dysfunction, 57
Catherine Winkler
Physiologic guidelines, 57
Goals of monitoring, 58
Post cardiopulmonary resuscitation, 59
Evidence-based treatment guidelines, 60
Acute coronary syndromes, 60
Evidence-based treatment guidelines, 62
Cardiac arrhythmias, 64
Evidence-based treatment guidelines, 65
Acute heart failure, 67
Electrolyte abnormalities, 67
Monitoring elements, 68
Evidence-based treatment guidelines, 68
Critical illnesses, 68
Evidence-based treatment guidelines, 68
Drug overdose, 69
Evidenced-based guidelines, 69
Unnecessary arrhythmia monitoring and underutilization of ischemia and
QT-interval monitoring, 69
5 Hemodynamic monitoring in critical care, 73
Kathy J. Booker
Hemodynamic monitoring overview, 73
Hemodynamic monitoring systems, 75
Pulmonary artery catheter monitoring, 75
Central venous pressure monitoring and management, 76
Central venous pressure trending limitations, 77
Arterial line monitoring and management, 78
Hemodynamic monitoring guidelines and outcomes, 78
Functional indicators of hemodynamic monitoring, 79
Perioperative optimization, 79
Transesophageal monitoring, 79
Volume responsiveness, 80
Pulse contour analysis, 81
FloTrac/Vigileo®, 82
Transpulmonary dilution techniques, 82
Passive leg raising, 83
SVV protocols for management, 84
6 Monitoring for neurologic dysfunction, 87
Janice L. Hinkle and Carey Heck
Physiological guidelines, 87
Increased intracranial pressure, 87
Decreased cerebral blood flow, 88
Cerebral response to increased intracranial pressure, 88
Rapid assessment of neurologic dysfunction in intensive care unit patients,
89
Evidence-based treatment guidelines, 90
Intracranial pressure monitoring, 93
Evidence-based treatment guidelines, 93
Measuring brain temperature, 94
Evidence-based treatment guidelines, 95
Brain tissue O2 monitoring, 95
Monitoring elements, 95
Evidence-based treatment guidelines, 95
Microdialysis, 95
Monitoring elements, 95
Evidence-based treatment guidelines, 95
Electrophysiological monitoring, 96
Monitoring elements, 96
Evidence-based treatment guidelines, 96
The BiSpectral index monitoring, 96
Monitoring elements, 96
Evidence-based treatment guidelines, 96
Transcranial Doppler ultrasonograpy, 97
Monitoring elements, 97
Evidence-based treatment guidelines, 97
Shunts, 98
Monitoring elements, 98
Evidence-based treatment guidelines, 98
Neuromuscular transmission, 98
Monitoring elements, 98
Evidence-based treatment guidelines, 98
Management of cervical stabilization devices, 98
Monitoring elements, 98
Evidence-based treatment guidelines, 99
Induced coma and sedation protocols, 100
Monitoring elements, 100
Evidence-based treatment guidelines, 100
Research-based neurologic protocols, 100
7 Monitoring for renal dysfunction, 104
Dawn Cooper
Acute kidney injury, 104
Physiological guidelines, 105
Prerenal injury, 105
Intrarenal injury, 106
Acute tubular necrosis, 107
Acute intersitial nephritis, 107
Post renal injury, 108
Monitoring elements, 108
History and physical assessment, 108
Laboratory analysis and data trending, 109
Diagnostic imaging, 111
Renal biopsy, 111
Evidenced-based treatment guidelines, 112
Prevention, 112
Hemodynamic monitoring, 112
Volume expansion, 112
Management of electrolyte and acid-base imbalance, 112
Pharmacologic interventions, 113
Prevention of radiocontrast nephropathy, 114
Nutrition, 114
Renal replacement therapy, 114
Intermittant hemodialysis, 114
Continuous renal replacement therapies, 114
Peritoneal dialysis, 115
8 Monitoring for blood glucose dysfunction in the intensive care unit, 119
Laura Kierol Andrews
Diabetes management in the ICU, 119
Effects of hyperglycemia, 119
Hyperglycemia management recommendations, 120
Glucose monitoring, 120
Carbohydrate administration, 120
Insulin therapy, 121
Hypoglycemia management, 121
9 Monitoring for hepatic and GI dysfunction, 126
Eleanor R. Fitzpatrick
Physiologic guidelines, 126
Gastrointestinal dysfunction, 126
Gastrointestinal bleeding, 128
Monitoring elements: nasogastric decompression, 128
Evidence-based treatment guidelines, 129
Gastric pH, 129
Evidence-based treatment guidelines, 130
Monitoring elements: laboratory tests for GI bleeding, 130
Evidence-based treatment guidelines, 130
Endoscopic procedures, 130
Evidence-based treatment guidelines, 131
Evidence-based treatment guidelines for stress ulcers, 132
Monitoring elements: gastric tonometry and capnometry, 133
Evidence-based treatment guidelines, 134
Radiographic diagnostics, 134
Evidence-based treatment guidelines, 135
Ultrasonography, 135
Evidence-based treatment guidelines, 135
Intraabdominal pressure management, 135
Intraabdominal pressure measurement, 136
Treatment of abdominal compartment syndrome, 137
Diagnostics for liver function, 137
Evidence-based treatment guidelines, 138
Liver support devices, 138
Evidence-based treatment guidelines, 139
Balloon tamponade therapy, 139
Evidence-based treatment guidelines, 140
ICP monitoring in acute liver failure, 140
Evidenced-based treatment guidelines, 140
Ascites management, 141
Evidence-based treatment guidelines: paracentesis, 141
Nutritional assessment and treatment, 142
Evidence-based treatment guidelines, 142
Critical monitoring in acute pancreatitis, 142
Evidence-based treatment guidelines for acute pancreatitis, 143
Monitoring elements: pancreatitis, 143
Evidence-based treatment guidelines for acute pancreatitis, 143
10 Traumatic injuries: special considerations, 146
Catherine Bond and Mary Beth Voights
Primary, secondary, and tertiary surveys, 146
Fluid resuscitation, 151
Fluid choice, 151
End points of resuscitation, 152
Intracompartmental monitoring, 152
Complications, 153
Thromboembolic events, 153
Anticoagulation, 154
Pain management, 154
Early mobilization, 154
Thoracic injury management, 154
Abdominal trauma, 155
Abdominal compartment syndrome, 158
Musculoskeletal injuries and management, 159
Ongoing hemorrhage, 160
Pelvic fractures, 161
Crush syndrome management, 161
Pain management in orthopedic injury, 162
Burns, 162
Burn classification, 162
Fluid management in burn therapy, 164
11 Oncologic emergencies in critical care, 167
Lisa M. Barbarotta
Evolution of oncology critical management, 167
Sepsis in the immunocompromised host, 167
Physiologic guidelines, 167
Assessment and monitoring in neutropenic patients, 168
Neutropenia management, 168
Evidence-based guidelines, 169
Research, 171
Stem cell transplant, 171
Infection, 172
Graft-versus-host disease, 172
Hepatic veno-occlusive disease, 173
Pulmonary complications, 174
Hematologic complications, 175
Hemorrhagic complications, 175
Thrombocytopenia, 175
Management, 176
Thrombotic microangiopathy, 177
Physiologic guidelines, 177
Management, 179
Hyperviscosity syndromes, 179
Physiologic guidelines, 179
Management, 180
Hyperleukocytosis and leukostasis, 180
Physiologic guidelines, 180
Management, 181
Tumor lysis syndrome, 181
Physiologic guidelines, 181
Treatment, 183
Management of electrolyte imbalances, 184
Hyperkalemia, 184
Hyperphosphatemia with secondary hypocalcemia, 184
Hyperuricemia, 185
Acute kidney injury, 186
Evidence-based treatment guidelines, 186
Structural emergencies, 186
Cardiac tamponade, 187
Physiologic guidelines, 187
Management, 189
Malignant airway obstruction, 189
Physiologic guidelines, 189
Management, 190
Carotid blowout syndrome, 192
Physiologic guidelines, 192
Management, 194
12 End-of-life concerns, 201
Kathy J. Booker
Introduction, 201
Assessment and communication issues, 201
Family presence, 202
Advanced directives, 202
Surrogate decision making, 202
Delivering bad news, 204
Palliative care in the ICU, 204
Symptom management, 206
Brain death, 206
13 Monitoring for overdoses, 210
Linda M. Dalessio
Introduction, 210
General management of drug overdoses, 210
Drug screening, 210
New and emerging therapies, 211
Indexing of drug and toxins seen in overdoses, 212
Acetaminophen, 213
Drug overview, 213
Symptoms of overdose, 213
Diagnostic testing and monitoring, 213
Antidotes/binding agents, 213
Salicylates and nonsteroidal anti-inflammatory drugs, 214
Drug overview, 214
Symptoms of overdose, 214
Monitoring, 214
Antidotes/binding agents/treatment, 215
Methemoglobin, 215
Drug overview, 215
Symptoms of overdose, 215
Diagnostic testing and monitoring, 216
Antidotes/binding agents/treatment, 216
Iron, 217
Drug overview, 217
Symptoms of overdose, 217
Diagnostic testing and monitoring, 217
Antidotes/binding agents/treatment, 217
Drugs of abuse, 218
Overview, 218
Symptoms of overdose, 218
Diagnostic testing, 218
Benzodiazepines, 218
Drug overview, 218
Symptoms of overdose, 218
Diagnostic testing and monitoring, 219
Antidotes/binding agents/treatments, 219
Opiods, 219
Drug overview, 219
Symptoms of overdose, 219
Diagnostic testing and monitoring, 220
Antidotes/binding agents/treatment, 220
Cocaine, 220
Drug overview, 221
Symptoms of overdose, 221
Diagnostic testing and monitoring, 221
Antidotes/binding agents/treatment, 222
Amphetamines, 222
Drug overview, 222
Symptoms of overdose, 222
Diagnostic testing and monitoring, 222
Antidotes/binding agents/treatments, 223
Phencyclidine, 223
Drug overview, 223
Symptoms of overdose, 223
Diagnostic testing and monitoring, 223
Antidotes/binding agents/treatments, 223
Barbituates, 224
Drug overview, 224
Symptoms of overdose, 224
Diagnostic testing and monitoring, 224
Antidotes/binding agents/treatments, 224
Hallucinogens, 224
Drug overview, 224
Symptoms of overdose, 225
Monitoring and treatment, 225
Club drugs/date rape drugs, 225
Drug overview, 225
Symptoms of overdose, 225
Diagnostic testing and monitoring, 226
Antidotes/binding agents/treatments, 226
Ketamine, 226
Drug overview, 226
Symptoms of overdose, 226
Diagnostic testing and monitoring, 227
Antidotes/binding agents/treatments, 227
Fake marijuana, 227
Drug overview, 227
Symptoms, 227
Diagnostic testing, 227
Antidote, 228
Dextromethorphan, 228
Drug overview, 228
Symptoms of overdose, 228
Diagnostic testing and monitoring, 228
Antidotes, 229
Bath salts, 229
Drug overview, 229
Symptoms of overdose/use, 229
Diagnostic testing and monitoring, 229
Antidotes/binding agents/treatments, 229
Skeletal muscle relaxants, 230
Drug overview, 230
Symptoms of overdose, 230
Diagnostic testing and monitoring, 230
Antidotes/binding agents/treatments, 231
Psychiatric drugs, 231
Drug overview, 231
Selective serotonin reuptake inhibitors, 231
Drug overview, 231
Symptoms, 231
Diagnostic testing and monitoring, 234
Antidotes/binding agents/treatments, 234
Monoamine oxidase inhibitors, 234
Drug overview, 234
Symptoms of overdose, 235
Diagnostic testing and monitoring, 235
Antidotes, 235
Lithium, 236
Drug overview, 236
Symptom of overdose, 236
Diagnostic testing and monitoring, 236
Antidotes/binding agents/treatments, 236
Neuroleptics, 237
Drug overview, 237
Symptoms of overdose, 237
Diagnostic testing and monitoring, 237
Antidotes/binding agents/treatments, 237
Tricyclic antidepressants, 238
Drug overview, 238
Symptoms of overdose, 238
Diagnostic testing and monitoring, 238
Antidotes/binding agents/treatments, 238
Carbon monoxide, 239
Drug overview, 239
Pharmacology, 239
Symptoms, 239
Diagnostic testing and monitoring, 239
Antidotes/binding agents/treatments, 240
Hydrocarbons and toxic inhalants, 240
Drug overview, 240
Pharmacology, 240
Diagnostic testing and monitoring, 241
Signs and symptoms, 241
Antidotes/treatment, 241
Cardiac medications, 241
Drug overview, 241
Antiarrhythmic agents, 246
Toxic alcohols, 248
Drug overview, 248
Anticholinergics/Cholinergics/Antihistamines (ACA), 251
Drug overview, 251
ACA symptoms of overdose, 252
ACA diagnostic testing and monitoring, 252
ACA antidotes/binding agents/treatment, 252
Anticonvulsants, 252
Drug overview, 252
Anticonvulsants symptoms of overdose, 253
Anticonvulsants diagnostic testing and monitoring, 253
Anticonvulsants antidotes/binding agents, 253
Common toxidromes and treatments for poisoning conditions, 253
Anticholinergic toxidrome, 255
Benzodiazepine toxidrome, 255
Cholinergic toxidrome, 256
Opioid toxidrome, 256
Sympathomimetic toxidromes, 256
Rhabdomyolysis syndromes, 257
Treatment of hyperkalemia, 257
Packidrome, 257
Alcohol withdrawal syndrome, 258
Anion and non-anion gap acidosis and osmolar anion gap, 258
Non-anion gap acidosis, 259
Osmolar gap, 259
Osmolarity corrected for elevated ETOH level, 259
Index, 264