Critical care nurse
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Knowledge of how oxygen is dissolved in the blood, transmitted through the bloodstream, and factors that affect oxygen delivery to body cells, is essential to the nursing management of the critically ill patient whose inherent physiologic mechanisms have been compromised by life-threatening illness. This article begins with a simplified review of respiration, progresses through a discussion of oxygen tension in the blood and hemoglobin transport of oxygen, and ends with a discussion of factors that affect the oxyhemoglobin dissociation curve.
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Care of the critically ill has become increasingly challenging due to demands from external sources to measure the quality and appropriateness of care provided. Quality assurance is the responsibility of every critical care nurse and requires vigilance as well as a knowledge of the principles of standards, monitoring and evaluation. Through quality assurance activities, the contribution of critical care nurses in the achievement of patient outcomes can be measured. Quality assurance challenges us to evaluate the way we practice, and assists us to continuously improve the way we provide care to critically ill patients.
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Critical care nurse · Sep 1991
EditorialThe revised JCAHO nursing care standards: areas of emphasis.
The 1991 JCAHO nursing care standards represent a fundamental shift in the focus of the survey and accreditation processes from specifying the means to clarifying the ends of nursing services and from prescribing structures and processes to clarifying the intended outcomes of nursing care. As critical care nurses prepare to meet the compliance requirements of these new accreditation standards, it will be helpful to keep in mind that our services are nursing care, nursing management, and nursing education or research, but our purpose is quality nursing care.
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Pulmonary contusion, known as the most common potentially lethal chest injury seen in this country, necessitates aggressive nursing assessment and diagnosis if treatment is to be effective and prognosis improved. Initial chest x-rays will usually not display the severity of the contusion. ⋯ By monitoring ventilatory parameters to assess oxygenation, the nurse acknowledges that hypoxemia is the hallmark clinical sign. Through comprehension of the different mechanisms of injury, the role of chest compliance, and the pathologic alterations, the critical care nurse delivers skillful and knowledgeable care to the patient with a pulmonary contusion.