Dimensions of critical care nursing : DCCN
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Dimens Crit Care Nurs · May 2006
Case ReportsAbdominal pain due to acute intermittent porphyria: when is the sound of hoof-beats not horses, but zebras? A case report.
Acute intermittent porphyria is a rare autosomal dominant hereditary inborn error of metabolism of the heme biosynthetic pathway that can be exacerbated through a multitude of environmental factors. This article is a case study describing the pathophysiology, clinical presentation management, and exacerbation prevention of acute intermittent porphyria. ⋯ Supportive treatment includes opiate analgesia, monitoring for and treating complications such as hypertension and hyponatremia. Follow-up should include family counseling regarding genetic defects and individual counseling regarding lifestyle changes including avoidance of environmental factors that have been implicated in the exacerbation of the disease.
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Dimens Crit Care Nurs · Mar 2006
ReviewThe role of noninvasive ventilation: CPAP and BiPAP in the treatment of congestive heart failure.
Congestive heart failure (CHF) is a common cause of respiratory failure for which patients seek emergency care. Mechanical ventilation is commonly used in the treatment for severe CHF. ⋯ When NIV is chosen for a patient in CHF, the critical care nurse needs to be vigilant in assessing and monitoring these patients, especially those in severe CHF. This article evaluates the differences between the 2 types of NIV, the controversies that may exist, practice issues for the critical care nurse, and any financial considerations.
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Recent evidence supports the use of therapeutic hypothermia after cardiac arrest. This article reviews recent published studies and describes the pathophysiology of hypothermia. Nurses need to understand the physiology of hypothermia to provide care for patients receiving therapeutic hypothermia. A suggested protocol is included to help manage the care of these patients.
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Dimens Crit Care Nurs · Mar 2006
Innovative solutions: development and implementation of a tight blood glucose management protocol: one community hospital's experience.
Blood glucose monitoring and control are an important component of nursing care for the critically ill patient. This article discusses the efforts of one community hospital in the development of a tight blood glucose management protocol for cardiopulmonary bypass patients.
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With the increasing amount of violence prevalent in our society, it is inevitable that this violence will enter emergency departments. Nurses are increasingly likely to see guns and other deadly weapons in the emergency department. The purpose of this article is to explain how a firearm works and how to safely handle and store the weapon until someone with more training can take possession of the weapon.