Critical care nurse
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Critical care nurse · Feb 2013
Case ReportsAcute liver failure in an obstetric patient: challenge of critical care for 1 patient with 2 subspecialty needs.
Acute fatty liver of pregnancy is a rare and life-threatening disease associated with a defect in fatty acid metabolism in the fetus that causes liver disease in the mother. Prompt diagnosis and management are critical to the outcome of both the mother and the fetus and require involvement of several medical specialties, including hepatology, obstetrics, and, possibly, critical care. The included case study describes a woman with acute fatty liver of pregnancy decompensating to acute liver failure complicated by encephalopathy, cerebral edema, and intracranial hypertension. Subsequent management of these conditions, including the woman's progression to liver transplant, is provided.
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Critical care nurse · Feb 2013
Voices of family members and significant others in the tele-intensive care unit.
Research suggests that tele-intensive care units (tele-ICUs) are associated with decreases in mortality rates, length of stay, and health care costs. However, little is known about the awareness and perceptions of the tele-ICU among patients' significant others. ⋯ This pilot study demonstrated significant gaps in communication about the tele-ICU between staff and patients' significant others and revealed a preference to be informed about the tele-ICU by staff. Study findings will help define goals, objectives, and methods for further research to improve communication with patients' significant others about the tele-ICU.
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Critical care nurse · Feb 2013
Implementation of a nurse-driven burn resuscitation protocol: a quality improvement project.
Burn resuscitation, including titration of fluids and administration of colloids, is often driven by physicians' orders. Inconsistencies in burn resuscitation cause overresuscitation, which has adverse consequences. ⋯ Implementation of the nurse-driven burn resuscitation protocol improved nurses' awareness and assessment of fluid status during resuscitation and improved patients' outcomes.
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Critical care nurse · Feb 2013
Family presence in the adult burn intensive care unit during dressing changes.
To improve communication, discharge readiness, and satisfaction of burn patients and their families. ⋯ Allowing family presence during dressing changes provides an opportunity to educate and include patients' family members in care delivery.
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Critical care nurse · Feb 2013
Contrast-induced nephropathy: pathophysiology and preventive strategies.
Contrast-induced nephropathy is the third most common cause of hospital-acquired renal failure, after decreased renal perfusion and nephrotoxic medications. Identification of patients at risk and implementation of preventive strategies can decrease the incidence of this nephropathy. Prevention strategies focus on counteracting vasoconstriction, enhancing blood flow through the nephron, and providing protection against injury by oxygen free radicals. Knowledge of the adverse effects associated with infusion of contrast media, identification of patients at risk for contrast-induced nephropathy, and application of evidence-based prevention strategies allow nurses to assist in the prevention of contrast-induced nephropathy.