Critical care nurse
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Critical care nurse · Feb 2020
Case ReportsCardiac Surgery: Beyond Conventional Sternotomy With Cardiopulmonary Bypass.
Minimally invasive cardiac surgery options, which originated with off-pump coronary artery bypass grafting and aortic valve procedures, continue to evolve in order to address complex conditions, including those requiring mitral and tricuspid valve repair. Although these procedures are primarily indicated for high-risk patient populations, favorable patient outcomes have resulted in recommendations being expanded to include intermediate-risk groups. This article increases nursing-related knowledge of minimally invasive cardiac procedures, providing an overview of current minimally invasive cardiac surgeries and their associated risks and benefits.
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Critical care nurse · Feb 2020
Randomized Controlled TrialEffect of Eye Masks on Pain and Sleep Quality in Patients Undergoing Cardiac Surgery: A Randomized Controlled Trial.
Impaired sleep is a common complaint among patients undergoing major surgery and may be a contributing factor in postoperative pain. The provision of eye masks to patients after cardiac surgery may reduce postoperative pain through improvements in sleep quality. ⋯ Nocturnal eye masks are a simple, low-risk, low-cost intervention that may contribute to reductions in perceived pain in cardiac surgery patients.
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Critical care nurse · Feb 2020
Preventing Catheter-Associated Urinary Tract Infections in the Pediatric Intensive Care Unit.
Catheter-associated urinary tract infections are common health care-associated infections and have been associated with increased mortality, morbidity, length of stay, and cost. Prevention strategies are grouped into bundles focused on reducing unnecessary catheter use and promptly removing urinary catheters. Before intervention in the study institution, no urinary catheters were unnecessarily used and compliance with the catheter-associated urinary tract infection bundle was 84%. ⋯ Targeted rounding for pediatric patients with an indwelling urinary catheter is an effective and sustainable strategy to reduce catheter-associated urinary tract infections. The ease of implementation for this intervention lends itself to generalizability to other patient populations.
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Critical care nurse · Feb 2020
Evaluation of a Nasoenteral Feeding Tube With Balloon to Facilitate Placement.
Enteral feeding is essential for critically ill, head trauma, and burn patients who are unable to swallow. ⋯ Early gastric or postpyloric feeding can be provided with this novel feeding tube. Its use facilitates quick bedside recognition of accidental misplacement in the trachea, reducing the chance of pneumothorax. The tip balloon reduces deeper placement into a lung and promotes distal migration into the small intestine. The design prevents occlusion from kinking, which is common with conventional feeding tubes. Nurses easily adopted the tube and insertion technique.
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Critical care nurse · Feb 2020
Junctional Ectopic Tachycardia: Recognition and Modern Management Strategies.
Junctional ectopic tachycardia is a common dysrhythmia after congenital heart surgery that is associated with increased perioperative morbidity and mortality. Risk factors for development of junctional ectopic tachycardia include young age (neonatal and infant age groups); hypomagnesemia; higher-complexity surgical procedure, especially near the atrioventricular node or His bundle; and use of exogenous catecholamines such as dopamine and epinephrine. ⋯ This article reviews the underlying mechanisms of junctional ectopic tachycardia, incidence and risk factors, and treatment options. Currently, amiodarone is the pharmacological treatment of choice, with dexmedetomidine increasingly used because of its anti-arrhythmic properties and sedative effect.