Critical care nurse
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Hematologic assessment is part of the routine assessment of acute and critically ill patients. Nurses must be aware of the reference ranges for complete blood cell counts and common coagulation profiles. A case study is presented of an elderly patient, taking warfarin for atrial fibrillation, who falls and sustains a head laceration. The subsequent assessment, hospital course, and treatments required are outlined.
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Critical care providers are often privy to confidential information in the course of clinical practice. A dilemma can arise when confidential information is requested by family members or friends of the patient. Critical care nurses must be aware of the regulations regarding confidentiality, as well as situations where the use and disclosure of protected health information are permitted.
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Coagulopathy is a potential problem for many critically ill patients, placing them at risk for hemorrhage. Critical illness activates both hemostasis and the inflammatory-immune system, leading to both physiological and potentially pathophysiological responses. ⋯ Transfusion of blood and components has long been an important part of patient management, but is known to put patients at risk for transfusion-related complications. Current clinical practice guidelines provide blood conservation strategies and criteria to guide decisions on transfusion therapy.