Critical care nurse
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Critical care nurse · Dec 2011
A nurse's experience being intubated and receiving mechanical ventilation.
A nurse with a history of childhood asthma describes her experiences with intubation and mechanical ventilation. It is important for nurses to recognize that mechanical ventilation is very stressful for patients and for the patients' families. It is essential for nurses to keep the patient as the focus of their care. A key part of that focus is to reorient patients who are receiving mechanical ventilation frequently.
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Critical care nurse · Dec 2011
ReviewLow-dose corticosteroids to treat septic shock: a critical literature review.
Septic shock is the 13th leading cause of death in the United States. The rate of severe sepsis nearly doubled and mortality increased more than 60% during the 10-year period ending in 2003. Systemic inflammatory response syndrome has noninfectious and infectious causes. ⋯ As an infectious injury progresses, host activation of the coagulation, immunological, and stress response systems ensues, resulting in tissue hypoperfusion and organ failure. Early studies with small numbers of patients suggest that treatment with low-dose corticosteroids has marked beneficial effects on shock reversal, the immune system, and the hemodynamic profile. Low-dose corticosteroids should only be administered to a subset of patients with septic shock who are unresponsive to fluid replacement and vasopressor therapy.
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Critical care nurse · Dec 2011
ReviewInhaled treprostinil for the treatment of pulmonary arterial hypertension.
Pulmonary arterial hypertension is a progressive disease characterized by vascular proliferation and vasoconstriction of the small pulmonary arteries that eventually leads to right-sided heart failure and death. Patients often initially have symptoms such as shortness of breath, fatigue, and edema; later in the disease, presyncope and syncope are common. ⋯ Inhaled treprostinil was approved by the Food and Drug Administration in July 2009. This article provides a brief overview of the pathophysiology of pulmonary arterial hypertension and reviews the mechanism of action, key clinical data, and the practical management of inhaled treprostinil in patients with pulmonary arterial hypertension.
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Critical care nurse · Dec 2011
Nurse-led implementation of a safe and effective intravenous insulin protocol in a medical intensive care unit.
Recent evidence has linked tight glucose control to worsened clinical outcomes among adults in intensive care units. ⋯ Implementation of a nurse-led, conservative intravenous insulin protocol in the medical intensive care unit is effective and safe and markedly reduces the rate of hypoglycemia.