Pub Date : 2020-01-01DOI: 10.1097/01.CCN.0000612864.78965.12
Keegan Corbett, Amelia Dugan, C. Vitale, Tammy Gravel
{"title":"Long-term effects of opioids on the cardiovascular system","authors":"Keegan Corbett, Amelia Dugan, C. Vitale, Tammy Gravel","doi":"10.1097/01.CCN.0000612864.78965.12","DOIUrl":"https://doi.org/10.1097/01.CCN.0000612864.78965.12","url":null,"abstract":"","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000612864.78965.12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43984854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/01.CCN.0000602736.89712.d4
Mary Ann Wietbrock
M r. G is a 55-yearold male with a left ventricular ejection fraction of 10% (normal, 50%70%).1 He was transported to the ED last evening due to unintentional weight gain, fatigue, orthopnea, paroxysmal nocturnal dyspnea, and dyspnea on exertion. His oxygen saturations on room air were 89% sitting upright and 80% supine. He was admitted to the coronary care unit (CCU) with a diagnosis of heart failure with reduced ejection fraction (HFrEF) and started on a continuous infusion of I.V. furosemide. He is currently on supplemental oxygen to keep his SpO2 above 95%. Mr. G is spending most of his time in the hospital resting in his bed or chair.
{"title":"Enhancing post-CCU functional endurance with physical activity","authors":"Mary Ann Wietbrock","doi":"10.1097/01.CCN.0000602736.89712.d4","DOIUrl":"https://doi.org/10.1097/01.CCN.0000602736.89712.d4","url":null,"abstract":"M r. G is a 55-yearold male with a left ventricular ejection fraction of 10% (normal, 50%70%).1 He was transported to the ED last evening due to unintentional weight gain, fatigue, orthopnea, paroxysmal nocturnal dyspnea, and dyspnea on exertion. His oxygen saturations on room air were 89% sitting upright and 80% supine. He was admitted to the coronary care unit (CCU) with a diagnosis of heart failure with reduced ejection fraction (HFrEF) and started on a continuous infusion of I.V. furosemide. He is currently on supplemental oxygen to keep his SpO2 above 95%. Mr. G is spending most of his time in the hospital resting in his bed or chair.","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000602736.89712.d4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41900939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/01.CCN.0000602748.09013.9d
K. Francis
H Y W A R D S / S H U T T E R S TO C K Skin injuries such as incontinence-associated dermatitis (IAD) and pressure injuries are increasingly monitored and benchmarked as a quality indicator for hospitals and nursing facilities.1-4 Pressure injuries are documented by Medicare and Medicaid-certified skilled nursing facilities in the Minimum Data Set, and pressure injury incidence rates are publicly reported as a quality measure in the Nursing Home Compare website.5 Many clinicians have difficulty distinguishing superficial skin injuries from early-stage pressure injuries because the differences can be very subtle. Mistaking IAD for an early-stage pressure injury can result in ineffective treatment and possible deterioration to full-thickness injury.6,7 This is particularly true in patients with dark skin tones because visual cues associated with these types of skin injuries may
{"title":"Damage control","authors":"K. Francis","doi":"10.1097/01.CCN.0000602748.09013.9d","DOIUrl":"https://doi.org/10.1097/01.CCN.0000602748.09013.9d","url":null,"abstract":"H Y W A R D S / S H U T T E R S TO C K Skin injuries such as incontinence-associated dermatitis (IAD) and pressure injuries are increasingly monitored and benchmarked as a quality indicator for hospitals and nursing facilities.1-4 Pressure injuries are documented by Medicare and Medicaid-certified skilled nursing facilities in the Minimum Data Set, and pressure injury incidence rates are publicly reported as a quality measure in the Nursing Home Compare website.5 Many clinicians have difficulty distinguishing superficial skin injuries from early-stage pressure injuries because the differences can be very subtle. Mistaking IAD for an early-stage pressure injury can result in ineffective treatment and possible deterioration to full-thickness injury.6,7 This is particularly true in patients with dark skin tones because visual cues associated with these types of skin injuries may","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000602748.09013.9d","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43949854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/01.ccn.0000602720.59218.7d
{"title":"A time for reflection and growth","authors":"","doi":"10.1097/01.ccn.0000602720.59218.7d","DOIUrl":"https://doi.org/10.1097/01.ccn.0000602720.59218.7d","url":null,"abstract":"","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.ccn.0000602720.59218.7d","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47292062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/01.CCN.0000602712.74465.f7
T. Maxwell
www.nursingcriticalcare.com Acute kidney injury (AKI) occurs in approximately 20% of patients admitted to the ICU and is associated with increased morbidity and mortality.1,2 The prevalence of renal replacement therapy (RRT) for AKI is approximately 23%.2 RRT can be applied intermittently with intermittent hemodialysis, or continuously with continuous renal replacement therapy (CRRT). CRRT is the preferred mode of RRT in critically ill patients, especially in patients with hemodynamic instability.2,3 (See CRRT treatment modes.)4 Indications for CRRT include hyperkalemia, metabolic acidosis, fluid overload, and signs of uremia.2,5 CRRT removes metabolic waste, solutes, and excess fluid over a 24-hour period while the native kidneys recover. The patient’s healthcare provider orders the treatment mode, therapy fluid type, treatment intensity, and blood and ultrafiltrate rates based on the patient’s individualized needs.6 The nurse is responsible for acknowledging the CRRT order; gathering all supplies; setting up and discontinuing the dialysis circuit; monitoring lab values, acid-base imbalances, electrolyte replacement, hemodynamic parameters, and fluid balance; and titrating blood flow and ultrafiltrate rates as prescribed. Other nurse Abstract: Continuous renal replacement therapy (CRRT) is a high-risk therapy used to treat acute kidney injury. Community hospitals lack the patient volume to adequately develop staff CRRT competency. This article will cover lessons learned developing a CRRT program at a small community hospital with low patient census requiring CRRT.
{"title":"Building a continuous renal replacement therapy program in a community hospital","authors":"T. Maxwell","doi":"10.1097/01.CCN.0000602712.74465.f7","DOIUrl":"https://doi.org/10.1097/01.CCN.0000602712.74465.f7","url":null,"abstract":"www.nursingcriticalcare.com Acute kidney injury (AKI) occurs in approximately 20% of patients admitted to the ICU and is associated with increased morbidity and mortality.1,2 The prevalence of renal replacement therapy (RRT) for AKI is approximately 23%.2 RRT can be applied intermittently with intermittent hemodialysis, or continuously with continuous renal replacement therapy (CRRT). CRRT is the preferred mode of RRT in critically ill patients, especially in patients with hemodynamic instability.2,3 (See CRRT treatment modes.)4 Indications for CRRT include hyperkalemia, metabolic acidosis, fluid overload, and signs of uremia.2,5 CRRT removes metabolic waste, solutes, and excess fluid over a 24-hour period while the native kidneys recover. The patient’s healthcare provider orders the treatment mode, therapy fluid type, treatment intensity, and blood and ultrafiltrate rates based on the patient’s individualized needs.6 The nurse is responsible for acknowledging the CRRT order; gathering all supplies; setting up and discontinuing the dialysis circuit; monitoring lab values, acid-base imbalances, electrolyte replacement, hemodynamic parameters, and fluid balance; and titrating blood flow and ultrafiltrate rates as prescribed. Other nurse Abstract: Continuous renal replacement therapy (CRRT) is a high-risk therapy used to treat acute kidney injury. Community hospitals lack the patient volume to adequately develop staff CRRT competency. This article will cover lessons learned developing a CRRT program at a small community hospital with low patient census requiring CRRT.","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000602712.74465.f7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47306514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1097/01.CCN.0000578852.69314.be
Staci L. Abernathy, Rebecca D Martin
www.nursingcriticalcare.com Pediatric critical care nurses witness profound human suffering. Although they may reap personal satisfaction through the care they provide, repeated exposure to critically ill and terminally ill patients can put them at risk for compassion fatigue. Current research suggests that compassion fatigue affects just over half of all nurses across the clinical spectrum.1 Compassion fatigue involves changes in behavior and emotions after witnessing another person’s trauma.2 Nurses may experience compassion fatigue when providing care to traumatized patients and associated family members who have experienced acute and chronic illness, lifethreatening events, patient death, and significant emotional distress.3 Compassion fatigue is characterized by emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment.2 It can manifest itself through a number of psychological and physical symptoms, including numbness, hopelessness, anxiety, depression, anger, poor concentration, gastrointestinal distress, muscle tension, headache, and sleep disturbances.4 In addition to health problems, it can lead to lack of social interaction, emotional strain, and spiritual dilemma. Further, it can bring about Abstract: To fill a gap in the literature on reducing compassion fatigue in pediatric ICU nurses, the authors conducted a nonrandomized pre-post intervention study on the impact mindfulness and meditation can have on reducing compassion fatigue. Participants experienced statistically significant improvement in levels of compassion satisfaction.
{"title":"Reducing compassion fatigue with self-care and mindfulness","authors":"Staci L. Abernathy, Rebecca D Martin","doi":"10.1097/01.CCN.0000578852.69314.be","DOIUrl":"https://doi.org/10.1097/01.CCN.0000578852.69314.be","url":null,"abstract":"www.nursingcriticalcare.com Pediatric critical care nurses witness profound human suffering. Although they may reap personal satisfaction through the care they provide, repeated exposure to critically ill and terminally ill patients can put them at risk for compassion fatigue. Current research suggests that compassion fatigue affects just over half of all nurses across the clinical spectrum.1 Compassion fatigue involves changes in behavior and emotions after witnessing another person’s trauma.2 Nurses may experience compassion fatigue when providing care to traumatized patients and associated family members who have experienced acute and chronic illness, lifethreatening events, patient death, and significant emotional distress.3 Compassion fatigue is characterized by emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment.2 It can manifest itself through a number of psychological and physical symptoms, including numbness, hopelessness, anxiety, depression, anger, poor concentration, gastrointestinal distress, muscle tension, headache, and sleep disturbances.4 In addition to health problems, it can lead to lack of social interaction, emotional strain, and spiritual dilemma. Further, it can bring about Abstract: To fill a gap in the literature on reducing compassion fatigue in pediatric ICU nurses, the authors conducted a nonrandomized pre-post intervention study on the impact mindfulness and meditation can have on reducing compassion fatigue. Participants experienced statistically significant improvement in levels of compassion satisfaction.","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000578852.69314.be","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43479214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1097/01.CCN.0000578828.37034.c2
Dolores Y. Elliott
{"title":"Caring for hospitalized patients with alcohol withdrawal syndrome","authors":"Dolores Y. Elliott","doi":"10.1097/01.CCN.0000578828.37034.c2","DOIUrl":"https://doi.org/10.1097/01.CCN.0000578828.37034.c2","url":null,"abstract":"","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000578828.37034.c2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49592633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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