Critical care nurse
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Critical care nurse · Jun 2014
Case ReportsHarlequin syndrome as a complication of epidural anesthesia.
Harlequin syndrome is a rare neurological condition that results in unilateral facial flushing and sweating. Although the syndrome is generally a benign condition with complete resolution if appropriate treatment is initiated, unilateral facial flushing can be a sign of several serious conditions and should be thoroughly investigated. ⋯ Differential diagnosis includes neurovascular disease (acute stroke), malignant neoplasm of brain or lung, Horner syndrome, idiopathic hyperhidrosis, and Frey syndrome. Harlequin syndrome is often easily treated by discontinuing the anesthetic or adjusting placement of the epidural catheter.
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Critical care nurse · Jun 2014
ReviewNasogastric Tube Placement and Verification in Children: Review of the Current Literature.
Placement of a nasogastric enteral access device (NG-EAD), often referred to as a nasogastric tube, is common practice and largely in the domain of nursing care. Most often an NG-EAD is placed at the bedside without radiographic assistance. Correct initial placement and ongoing location verification are the primary challenges surrounding NG-EAD use and have implications for patient safety. ⋯ Its mission is to identify and promote best practices with the potential of technology development that will enable accurate determination of NG-EAD placement for both the inpatient and outpatient pediatric populations. This article presents the challenges of bedside NG-EAD placement and ongoing location verification in children through an overview of the current state of the science. It is important for all health care professionals to be knowledgeable about the current literature, to be vigilant for possible complications, and to avoid complacency with NG-EAD placement and ongoing verification of tube location.
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Critical care nurse · Jun 2014
ReviewNeuromonitoring indications and utility in the intensive care unit.
Information on the use of neuromonitoring in intensive care units is scattered but significant. Nurses who do not care for neurologically impaired patients on a daily basis may not have a strong understanding of the utility of various neuromonitoring techniques, why they are used, or how they are interpreted. ⋯ Information on these 2 techniques tends to be either superficial with limited applicability to the critical care setting or very technical. This review provides information about neuromonitoring to help guide critical care nurses providing care to neurologically impaired patients.
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Critical care nurse · Jun 2014
Case ReportsCardiac diagnostic testing: what bedside nurses need to know.
Coronary artery disease affects more than 385000 persons annually and continues to be a leading cause of death in the United States. Recently, the number of available noninvasive cardiac diagnostic tests has increased substantially. ⋯ The common noninvasive cardiac diagnostic testing procedures used to diagnose coronary heart disease are transthoracic echocardiography, stress testing (exercise, pharmacological, and nuclear), multidetector computed tomography, coronary artery calcium scoring (with electron beam computed tomography or computed tomographic angiography), and cardiac magnetic resonance imaging. Objectives include (1) describing available methods for noninvasive assessment of coronary artery disease, (2) identifying which populations each test is most appropriate for, (3) discussing advantages and limitations of each method of testing, (4) identifying nursing considerations when caring for patients undergoing various methods of testing, and (5) describing outcome findings of various methods.