Pub Date : 2019-05-01DOI: 10.1097/01.CCN.0000553086.79399.F0
Leon L Chen
C ardiac tamponade (also known as pericardial tamponade) is a clinical syndrome in which the pressure from the excess pericardial fluid, or pericardial effusion, has increased to the point that the intrapericardial pressure exceeds the pressure within the cardiac chambers, resulting in inadequate cardiac filling, decreased cardiac output, and, ultimately, cardiogenic shock and death if not rapidly identified and appropriately treated.1-3
{"title":"Under pressure: Acute cardiac tamponade","authors":"Leon L Chen","doi":"10.1097/01.CCN.0000553086.79399.F0","DOIUrl":"https://doi.org/10.1097/01.CCN.0000553086.79399.F0","url":null,"abstract":"C ardiac tamponade (also known as pericardial tamponade) is a clinical syndrome in which the pressure from the excess pericardial fluid, or pericardial effusion, has increased to the point that the intrapericardial pressure exceeds the pressure within the cardiac chambers, resulting in inadequate cardiac filling, decreased cardiac output, and, ultimately, cardiogenic shock and death if not rapidly identified and appropriately treated.1-3","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":"14 1","pages":"35–37"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000553086.79399.F0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49343913","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 : 2019-05-01DOI: 10.1097/01.CCN.0000554829.05209.ca
B. Leeper, B. Powell
Abstract: Pulmonary arterial hypertension is a rare and progressive disease associated with high pulmonary vascular pressures leading to right ventricular failure and death. The exact incidence is unknown. This article provides a broad overview of the disease, including pathophysiology, risk factors, management guidelines, and pharmacologic therapies. Nursing considerations are discussed, with an emphasis on the continuum of care.
{"title":"Pulmonary arterial hypertension","authors":"B. Leeper, B. Powell","doi":"10.1097/01.CCN.0000554829.05209.ca","DOIUrl":"https://doi.org/10.1097/01.CCN.0000554829.05209.ca","url":null,"abstract":"Abstract: Pulmonary arterial hypertension is a rare and progressive disease associated with high pulmonary vascular pressures leading to right ventricular failure and death. The exact incidence is unknown. This article provides a broad overview of the disease, including pathophysiology, risk factors, management guidelines, and pharmacologic therapies. Nursing considerations are discussed, with an emphasis on the continuum of care.","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":"14 1","pages":"14–22"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000554829.05209.ca","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49294705","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 : 2019-03-01DOI: 10.1097/01.CCN.0000553079.71775.62
F. Morrison
Abstract: With limited cancer treatment options available for patients with certain types of advanced or recurrent acute lymphoblastic leukemia and certain types of non-Hodgkin lymphoma, the recent FDA approvals of tisagenlecleucel (Kymriah, formerly known as CTL019), and axicabtagene ciloleucel (Yescarta), CAR T-cell therapy provides a new opportunity to achieve cancer remission for many patients.1,2 These genetically enhanced T cells can destroy cancer cells. This article explores the science behind CAR T-cell therapy and ways critical care nurses can recognize and intervene in potentially life-threatening adverse reactions associated with this new therapy: cytokine release syndrome and CAR T-cell-related encephalopathy syndrome.3
{"title":"Nursing management for adult recipients of CAR T-19 therapy","authors":"F. Morrison","doi":"10.1097/01.CCN.0000553079.71775.62","DOIUrl":"https://doi.org/10.1097/01.CCN.0000553079.71775.62","url":null,"abstract":"Abstract: With limited cancer treatment options available for patients with certain types of advanced or recurrent acute lymphoblastic leukemia and certain types of non-Hodgkin lymphoma, the recent FDA approvals of tisagenlecleucel (Kymriah, formerly known as CTL019), and axicabtagene ciloleucel (Yescarta), CAR T-cell therapy provides a new opportunity to achieve cancer remission for many patients.1,2 These genetically enhanced T cells can destroy cancer cells. This article explores the science behind CAR T-cell therapy and ways critical care nurses can recognize and intervene in potentially life-threatening adverse reactions associated with this new therapy: cytokine release syndrome and CAR T-cell-related encephalopathy syndrome.3","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":"14 1","pages":"31–36"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000553079.71775.62","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47611782","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 : 2019-03-01DOI: 10.1097/01.CCN.0000553085.02271.9E
August Maggio, Kim Rossillo, Adriana Vélez, Vivian Norman
Many hospitals are experiencing increased noise levels due to technology, alarms, equipment, and voices. Quietness at night is one determinant of patient satisfaction that influences hospital reimbursement. Today, hospital workload pressures are equally as demanding at night as they are during the day, which makes it difficult to keep the unit quiet enough for patients to sleep. The World Health Organization recommends that sound levels be kept at 30 decibels (dB) or less in patient rooms, but hospital noises have been measured as high as 67 dB in the ICU.1 Studies link sleep deprivation with delirium, which can increase mortality.2 The importance of sleep has been well documented and is necessary for clear thinking, a healthy immune system, and general health.3 Sleep deprivation is linked to decreased immunity, impaired metabolism, decreased pain tolerance, and increased falls.4 In the hospital, cortical arousal, which disturbs sleep, can be caused by pain, nursing interventions, and noise.3 According to Florence Nightingale’s seminal work, Notes on Nursing, “Unnecessary noise, then, is the most cruel absence of care which can be inflicted on the sick or well.”5 A 30-bed medical telemetry unit in a Southern California community hospital responded to the challenge of improving the unit environment for patients by reducing noise levels at night with a nurse-led evidence-based Quietness Program. The initiative, which began in April 2015, successfully raised Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores related to patients’ satisfaction with quietness on the unit and sustained these higher scores.
{"title":"Implementing quiet hours on a medical telemetry unit","authors":"August Maggio, Kim Rossillo, Adriana Vélez, Vivian Norman","doi":"10.1097/01.CCN.0000553085.02271.9E","DOIUrl":"https://doi.org/10.1097/01.CCN.0000553085.02271.9E","url":null,"abstract":"Many hospitals are experiencing increased noise levels due to technology, alarms, equipment, and voices. Quietness at night is one determinant of patient satisfaction that influences hospital reimbursement. Today, hospital workload pressures are equally as demanding at night as they are during the day, which makes it difficult to keep the unit quiet enough for patients to sleep. The World Health Organization recommends that sound levels be kept at 30 decibels (dB) or less in patient rooms, but hospital noises have been measured as high as 67 dB in the ICU.1 Studies link sleep deprivation with delirium, which can increase mortality.2 The importance of sleep has been well documented and is necessary for clear thinking, a healthy immune system, and general health.3 Sleep deprivation is linked to decreased immunity, impaired metabolism, decreased pain tolerance, and increased falls.4 In the hospital, cortical arousal, which disturbs sleep, can be caused by pain, nursing interventions, and noise.3 According to Florence Nightingale’s seminal work, Notes on Nursing, “Unnecessary noise, then, is the most cruel absence of care which can be inflicted on the sick or well.”5 A 30-bed medical telemetry unit in a Southern California community hospital responded to the challenge of improving the unit environment for patients by reducing noise levels at night with a nurse-led evidence-based Quietness Program. The initiative, which began in April 2015, successfully raised Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores related to patients’ satisfaction with quietness on the unit and sustained these higher scores.","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":"14 1","pages":"46–48"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000553085.02271.9E","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43767631","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 : 2019-03-01DOI: 10.1097/01.CCN.0000553077.26034.e1
L. Simko, Alicia L. Culleiton
Abstract: Although acute respiratory distress syndrome is the most common cause of noncardiogenic pulmonary edema, critical care nurses also should be familiar with several other less common causes, including transfusion-related acute lung injury, neurogenic pulmonary edema, preeclampsia/eclampsia, opioid overdose, high-altitude pulmonary edema, and pulmonary embolism. This article addresses the pathophysiology, clinical presentation, diagnostics, treatment, and nursing considerations associated with each uncommon cause of noncardiogenic pulmonary edema.
{"title":"Uncommon causes of noncardiogenic pulmonary edema","authors":"L. Simko, Alicia L. Culleiton","doi":"10.1097/01.CCN.0000553077.26034.e1","DOIUrl":"https://doi.org/10.1097/01.CCN.0000553077.26034.e1","url":null,"abstract":"Abstract: Although acute respiratory distress syndrome is the most common cause of noncardiogenic pulmonary edema, critical care nurses also should be familiar with several other less common causes, including transfusion-related acute lung injury, neurogenic pulmonary edema, preeclampsia/eclampsia, opioid overdose, high-altitude pulmonary edema, and pulmonary embolism. This article addresses the pathophysiology, clinical presentation, diagnostics, treatment, and nursing considerations associated with each uncommon cause of noncardiogenic pulmonary edema.","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":"14 1","pages":"22–29"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000553077.26034.e1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49646741","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 : 2019-03-01DOI: 10.1097/01.CCN.0000553076.18411.12
Beata T. Kubacka
Abstract: As diabetes prevalence increases in the US, critical care nurses need to be familiar with the acute hyperglycemic emergencies they may encounter in the ED or ICU. This article focuses on the diagnosis of, various treatments for, and nursing considerations associated with two acute hyperglycemic emergencies: diabetic ketoacidosis and hyperosmolar hyperglycemic state. Patient self-management is key to prevention and requires thorough patient education efforts.
{"title":"Acute hyperglycemic emergencies: Diabetic ketoacidosis and hyperosmolar hyperglycemic state","authors":"Beata T. Kubacka","doi":"10.1097/01.CCN.0000553076.18411.12","DOIUrl":"https://doi.org/10.1097/01.CCN.0000553076.18411.12","url":null,"abstract":"Abstract: As diabetes prevalence increases in the US, critical care nurses need to be familiar with the acute hyperglycemic emergencies they may encounter in the ED or ICU. This article focuses on the diagnosis of, various treatments for, and nursing considerations associated with two acute hyperglycemic emergencies: diabetic ketoacidosis and hyperosmolar hyperglycemic state. Patient self-management is key to prevention and requires thorough patient education efforts.","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":"14 1","pages":"10–21"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000553076.18411.12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46481074","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 : 2019-01-01DOI: 10.1097/01.CCN.0000549627.98688.e2
M. Brennan, F. Lefèvre
Abstract: Necrotizing fasciitis is a life-threatening infection that can affect anyone. Early identification and intervention implementation are key to managing the infection's progression. An effective plan of care includes immediate assessment, antibiotic stewardship, and surgical intervention.
{"title":"Necrotizing fasciitis: Infection identification and management","authors":"M. Brennan, F. Lefèvre","doi":"10.1097/01.CCN.0000549627.98688.e2","DOIUrl":"https://doi.org/10.1097/01.CCN.0000549627.98688.e2","url":null,"abstract":"Abstract: Necrotizing fasciitis is a life-threatening infection that can affect anyone. Early identification and intervention implementation are key to managing the infection's progression. An effective plan of care includes immediate assessment, antibiotic stewardship, and surgical intervention.","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":"14 1","pages":"6–11"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000549627.98688.e2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61632580","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 : 2019-01-01DOI: 10.1097/01.CCN.0000549629.44430.26
S. Irving, P. Guenter, N. Mehta
Abstract:Optimal nutrition support in critically ill children is associated with improved outcomes and decreased mortality. Nutrition provision often competes with other care priorities in critically ill patients. The pediatric critical care nutrition support guidelines supplement clinician knowledg
{"title":"Incorporating the 2017 critical care pediatric nutrition support guidelines into clinical practice","authors":"S. Irving, P. Guenter, N. Mehta","doi":"10.1097/01.CCN.0000549629.44430.26","DOIUrl":"https://doi.org/10.1097/01.CCN.0000549629.44430.26","url":null,"abstract":"Abstract:Optimal nutrition support in critically ill children is associated with improved outcomes and decreased mortality. Nutrition provision often competes with other care priorities in critically ill patients. The pediatric critical care nutrition support guidelines supplement clinician knowledg","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000549629.44430.26","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43022082","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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