Critical care nurse
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Critical care nurse · Apr 2013
Review Case ReportsAortic stenosis: pathophysiology, diagnosis, and medical management of nonsurgical patients.
As the average lifespan continues to increase, nurses are managing more patients with aortic stenosis. When an asymptomatic patient begins to manifest signs and symptoms due to progressive narrowing and stiffening of the aortic valve, the only effective therapy is surgical replacement of the valve. ⋯ Understanding the complex normal anatomy and physiology of the aortic valve can help nurses appreciate the consequences of this type of stenosis. Nursing care for patients with aortic stenosis requires advanced skills in patient assessment and an appreciation of the hemodynamic responses to activities of daily living and to nursing interventions such as administration of medications.
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Critical care nurse · Apr 2013
Putting evidence into nursing practice: four traditional practices not supported by the evidence.
Evidence-based nursing practice is essential to the delivery of high-quality care that optimizes patients' outcomes. Studies continue to show improved outcomes when best evidence is used in the delivery of patient care. ⋯ The topics addressed are (1) noninvasive measurement of blood pressure in children, (2) oxygen administration for patients with chronic obstructive pulmonary disease, (3) intravenous catheter size and blood administration, and (4) infection control practices to prevent infections. The related beliefs, current evidence, and recommendations for practice related to each topic are described.
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Critical care nurse · Apr 2013
ReviewAlteplase treatment of acute pulmonary embolism in the intensive care unit.
Acute pulmonary embolism accounts for 50 000 to 100 000 deaths each year in the United States. Because of the wide spectrum of clinical manifestations, ranging from massive pulmonary embolism to small peripheral emboli, stratifying and treating patients according to their signs and symptoms is important when an acute embolism is suspected. ⋯ This article reviews the classifications of acute peripheral emboli, explains the treatment of acute peripheral emboli, reviews the pharmacology of alteplase, and presents an assessment of the literature evaluating alteplase for the treatment of acute peripheral emboli. Clinical pearls for the administration, monitoring, and care of a patient receiving alteplase in an intensive care unit also are discussed.
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Critical care nurse · Apr 2013
Case ReportsPharmacological considerations in human immunodeficiency virus-infected adults in the intensive care unit.
According to estimates, 1.2 million Americans are infected with human immuno deficiency virus (HIV). Because of antiretroviral therapy, persons who have HIV infection or have progressed to AIDS are living longer. ⋯ When persons who have HIV disease or AIDS are admitted to the intensive care unit, nurses must be prepared to provide care, especially management of complexities associated with antiretroviral therapy. Therefore, this article examines critical care nurses' role in initiating and administering antiretroviral therapy in the intensive care unit and reducing the risk of drug interactions associated with the therapy.