Critical care nursing quarterly
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The number of people with diabetes is growing to epidemic proportions in the United States. There is a great deal of research on the evolving understanding of the pathogenesis of diabetes as compared to normoglycemia. The diagnostic criteria for diabetes have become streamlined to more appropriately and accurately diagnose the disease. ⋯ The complications of diabetes have implications for the increasing number of people with the diagnosis who are hospitalized and how they are treated. There are specific methods for recognition and treatment of both acute and chronic complications in the hospitalized patent with diabetes. Managing blood glucose control is essential for favorable outcomes.
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The purpose of this article was to provide an overview of the management of the hospitalized patient with diabetes. Having a basic knowledge of their needs is essential to maintain blood glucose control and reduce the risk of long-term complications. ⋯ The most frequent reason for hypoglycemia is insulin administration along with a reduction in the amount of carbohydrate consumed. Practical advice is included to aid the medical staff to help maintain consistency in the amount of carbohydrate in meals as well as increase the knowledge base of carbohydrate content of common foods.
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Diabetes mellitus (DM) is a common disease with serious microvascular and macrovascular complications. Individuals with DM have a higher rate of surgical procedures. A number of recent studies have demonstrated that poor perioperative glucose control is associated with adverse postoperative outcomes. ⋯ A variety of treatment options are now available for the management of DM. With judicious use of these regimens it should be possible to maintain good glycemic control in the perioperative period. A collaborative approach involving the surgical team, nursing professionals, primary care physicians, and specialists should be capable of successfully implementing effective regimens in the perioperative period.
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While considerable progress is being made in the medical management of heart failure, mortality for this disease process continues to be significant. Cardiac transplantation becomes the treatment of choice for those with end-stage diseases that are acceptable candidates. ⋯ This article provides an overview of the postoperative management of the cardiac transplant recipient while in the intensive care unit. Additionally, a brief description of the surgical techniques employed and the physiology related to cardiac denervation are presented.
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The purpose of this article is to discuss the pathogenesis, characteristics, and treatment modalities for heart transplant recipients with cardiac allograft vasculopathy (CAV). Cardiac transplantation has become an acceptable mainstream treatment for end-stage cardiac disease. ⋯ Currently, retransplantation is the only definitive treatment. Ethical concerns and the shortage of donor organs present a huge obstacle to retransplantation and the long-term outcome of heart transplant recipients.