Heart & lung : the journal of critical care
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Aberrant psychological behavior has become a frequent occurrence in the intensive care unit (ICU). In specifically considering postcardiotomy psychosis, health professionals puzzle whether the manifestations are motivated by physiological problems imposed by surgical considerations (cardiac status, pump perfusion) and/or by pre- and postoperative psychological factors. Current literature attempts to isolate elements which may predispose patients to develop these aberrant behaviors. This paper attempts to identify important areas and suggest concrete nursing interventions to decrease, delay, and assimilate these behaviors in the cardiotomy patient.
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A study has been made of the accuracy of a computerized system of arrhythmia monitoring in the coronary-care unit of the Palo Alto Veterans Administration Hospital. The system provides beat-to-beat analysis of cardiac rhythm and QRS morphology and stores information for display of incidence of abnormalities and trend curves. The variables monitored by the system include: (1) heart rate, (2) early beats, (3) late beats, (4) abnormal QRS waveforms, and combinations of 2, 3, and 4. ⋯ Computer classification accuracy was as follows: false positives (computer diagnosis abnormal but ECG diagnosis normal), 0.10 per cent (191 complexes) of all complexes and 1.56 per cent of true positives. False negatives (computer diagnosis normal but ECG diagnosis abnormal), 0.70 per cent (84 complexes) of abnormal beats. Computer monitoring and analysis of seven variables in cardiac rhythm and QRS waveform abnormalities can be performed with a high degree of accuracy using a compact computer system suitable for intensive-care units.