Critical care nurse
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Background Parents' stress resulting from hospitalization of their infant in the neonatal intensive care unit (NICU) produces emotional and behavioral responses. The National Institutes of Health-sponsored Patient Reported Outcomes Measurement Information System (PROMIS) offers a valid and efficient means of assessing parents' responses. Objective To examine the relationship of stress to anxiety, depression, fatigue, and sleep disruption among parents of infants hospitalized in the NICU. ⋯ Results PSS total score was significantly correlated with anxiety (r = 0.61), depression (r = 0.36), and sleep disturbance (r = 0.60). Scores for NICU Sights and Sounds were not significantly correlated with parents' outcomes; however, scores for Alteration in Parenting Role were correlated with all 4 outcomes, and scores for Infant Appearance were correlated with all except fatigue. Conclusion Stress experienced by parents of NICU infants is associated with a concerning constellation of physical and emotional outcomes comprising anxiety, depression, fatigue, and sleep disruption.
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Critical care nurse · Aug 2013
Case ReportsPlasmapheresis in the management of severe hypertriglyceridemia.
Plasmapheresis can benefit a variety of critically ill patients. A woman with diabetic ketoacidosis and severe hypertriglyceridemia was treated with plasmapheresis when conventional treatments did not markedly reduce her triglyceridemia. The patient was admitted to a medical intensive care unit because of diabetic ketoacidosis with severe lipemia. ⋯ Severe lipemia interferes with photometric laboratory studies, yielding an underestimation of serum levels of electrolytes. Plasmapheresis is safe, rapid, and effective for emergent management of severe hypertriglyceridemia in critically ill patients. The impact of the procedure on critical care nursing is growing as nurses become involved in the treatment and follow-up care of patients who have plasmapheresis.
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Craniosynostosis is a developmental anomaly with premature closure of the cranial sutures causing an abnormally shaped skull in an infant. Recommended surgical treatment involves cranial vault reconstruction to open the closed suture, increase intracranial volume, and allow the brain to grow normally. ⋯ Critical care nurses can improve the care of the infants and their families by being knowledgeable about the anatomy, assessment, and surgical and nursing management of infants with this anomaly and its impact on the patients' families. This article discusses the definitions, diagnosis, and treatment of craniosynostosis and support for parents of infants with this malformation.
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Critical care nurse · Aug 2013
Tales from the sea: critical care nurses serving aboard the USNS Comfort and USNS Mercy.
During the springs and summers of 2009 to 2012, military and nongovernment organization nurses served side by side on hospital ships USNS Comfort and USNS Mercy to offer free humanitarian clinical services to developing nations in Central and South America and Southeast Asia. Translators were engaged to facilitate communication on shore and off. Host nation patients came on board for prearranged surgery and then were returned to land within a few days for follow-up care with local clinicians. ⋯ Professional and personal preparedness and flexibility were essential for operational effectiveness. The authors, both critical care nurses, learned many lessons in teamwork, education, and life at sea. Readers are encouraged to consider the challenges, hard work, and vast rewards of hospital ship service.