Critical care nurse
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Critical care nurse · Aug 2016
Review Case ReportsConventional and Unconventional Lifesaving Therapies in an Adolescent With Amlodipine Ingestion.
Amlodipine, a dihydropyridine calcium channel blocker, is commonly prescribed for the treatment of hypertension. Ingestion of an overdose leads to severe hypotension; if the hypotension is not treated, death may be imminent. ⋯ Plasmapheresis has been described in only one other case of severe amlodipine overdose, and the use of a pneumatic antishock garment has never been described in the management of a calcium channel blocker overdose. Because short-term use of a pneumatic antishock garment has associated risks, the critical care nurse's anticipation of side effects and promotion of safe use of the garment were instrumental in the patient's care and outcome. (Critical Care Nurse 2016; 36[4]:64-69).
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Critical care nurse · Aug 2016
Preparing Drugs for Infusion Via Syringe Pump: A Key Step to Ensure Homogeneous Concentration.
Preparation of drug solutions used with electronic syringe infusion pumps plays a crucial role in the delivery of an accurate drug concentration. Is there a correlation between drug concentrations during syringe pump infusion and preparation protocols? ⋯ Without mixing, the concentrations of all drug solutions varied widely when administered via an electronic syringe infusion pump. Mixing syringe contents should be made part of the compulsory curriculum for administering medications at all levels of medical education. (Critical Care Nurse. 2016;36[4]:36-45).
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Critical care nurse · Aug 2016
Treating Central Catheter-Associated Bacteremia Due to Methicillin-Resistant Staphylococcus aureus: Beyond Vancomycin.
Methicillin-resistant Staphylococcus aureus is a frequent cause of hospital-associated infections, including central catheter-associated bacteremia. Vancomycin has been the drug of choice for treating this type of bacteremia for decades in patients who have no contraindications to the antibiotic. ⋯ Newer antibiotics approved by the Food and Drug Administration have activity against methicillin-resistant S aureus Some of the antibiotics also have activity against strains of S aureus that are intermediately susceptible or resistant to vancomycin. This article uses a case study to highlight the clinical signs of vancomycin failure and describes the indications for and appropriate use of alternative antimicrobials such as ceftaroline, daptomycin, linezolid, tigecycline, and telavancin. (Critical Care Nurse 2016;36[4]:46-57).
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Ingestion of laundry detergent packets is an important threat to young children. Because of their developmental stage, toddlers are prone to place these small, colorful packets in their mouths. ⋯ Critical care nurses should anticipate these clinical effects and facilitate prompt intervention. Increased understanding of the risks and clinical effects of ingestion of laundry detergent packets will better prepare critical care nurses to provide care for these children. (Critical Care Nurse 2016; 36[4]:70-75).