Dimensions of critical care nursing : DCCN
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Dimens Crit Care Nurs · Jan 2006
ReviewA current conflict: use of isotonic sodium chloride solution on endotracheal suctioning in critically ill patients.
The use of isotonic sodium chloride on endotracheal suctioning is still commonly performed in intensive care units (ICUs). According to the studies, isotonic sodium chloride instillation may decrease oxygen saturation, increased intracranial pressure, arterial blood pressure, and cause cardiac dysrhythmias, cardiac arrest, respiratory arrest, and nosocomial infection. Endotracheal suctioning should not be used as a routine or standard clinical practice because of these negative effects. This article reviews effects of isotonic sodium chloride solution before endotracheal suctioning of mechanically ventilated patients.
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Dimens Crit Care Nurs · Jan 2006
Review Case ReportsMultiple dimensions of caring for a patient with acute necrotizing fasciitis.
Critical care nurses within acute care settings are responsible for providing healthcare to a wide variety of patients and, consequently, knowledge regarding how to care for a patient with acute necrotizing fasciitis is imperative. A case study is presented to evidence the need for a multidisciplinary approach. Necrotizing fasciitis is defined and treatment options are presented. Caring for this patient is very challenging and demands a multidisciplinary team to coordinate all aspects of care to promote better patient outcomes.
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Conflict is found in all aspects of society and nursing is not immune. Conflict is also found in critical care units. However, conflict within the nursing profession has traditionally generated negative feelings and many nurses use avoidance as a coping mechanism. This article will provide an overview of conflict, conflict management, and conflict resolution.
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A pulse oximetry (SpO2) knowledge survey was conducted with 551 experienced critical care nurses at the 2002 American Association of Critical Care Nurses National Teaching Institute in Atlanta, GA. Results of this survey indicated an increased level of knowledge about SpO2 technology and monitoring compared to that reported in previous studies. ⋯ In addition, critically ill patients are also the most likely group of patients to exhibit the clinical conditions that adversely affect pulse oximetry signal quality, including low perfusion and patient motion artifact. The ability of critical care nurses to correctly assess pulse oximetry values within the context of the technology limitations and the critical care environment is important in providing optimal care to critically ill patients.
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Dimens Crit Care Nurs · Nov 2005
Review Case ReportsAlpha1-antitrypsin deficiency: incidence and implications.
Alpha1-antitrypsin (AAT) deficiency is an underrecognized inherited disorder with pulmonary and hepatic implications for both adults and neonates. Clinical expressions of AAT deficiency are seen in the lung, liver, and the skin, with considerable variability in the severity of clinical disease. AAT deficiency accounts for nearly 3% of all cases of chronic obstructive pulmonary disease and is responsible for early-onset emphysema in nonsmokers. ⋯ Panniculitis, a rare skin complication of AAT deficiency, is characterized by acute inflammatory infiltrate and fat necrosis. While we concentrate on the pulmonary aspect of AAT deficiency, we have included discussion of liver disease and panniculitis. Critical care and advanced practice nurses will benefit from gaining a better understanding of the causes, pathophysiology, diagnosis, and treatment of this disorder.