Critical care nursing quarterly
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The diagnosis and treatment of liver injury have changed dramatically in the past 30 years. Because abdominal computed tomography scan now refines the diagnosis of liver injury, the observation and nonsurgical treatment of stable patients with blunt liver injury is now the standard. ⋯ There is ample data that validate this assertion. Implications for nurses in critical care include patient/family education and advocacy of treatment decisions and astute monitoring of the patient while in critical care.
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A cursory evaluation of the Acute Physiology and Chronic Health Evaluation, commonly known as the APACHE scoring system, validates its relevancy as the most widely used method for assessing severity and prognosis in intensive care unit patients. The APACHE system works and the evolution from APACHE I to APACHE IV reveal that each version has its positives and negatives. It would behoove critical care nurses to know differences and how each could be best utilized.
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The postoperative management of a patient undergoing lung transplantation involves many components of care. These components include ventilatory and hemodynamic management, immunosuppression, wound care, rehabilitation, infection control and treatment, and early detection of rejection.
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Early volume resuscitation of a patient with sepsis has been shown to reduce morbidity, mortality, and healthcare resource consumption. Hypertonic saline offers a theoretically viable option for volume resuscitation. This article reviews the current information available regarding fluid resuscitation in patients with sepsis, with emphasis on the use of hypertonic saline.