Critical care nursing quarterly
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Triage nurses in the emergency department are in a unique position to screen for domestic violence. This study, using Orlando's theory with a focus on two of her five major concepts, identifies barriers that prevent effective screening for domestic violence. ⋯ Education on abuse and resources should be essential in nursing school curricula. Policy development and review should be part of an annual, mandatory inservice for all emergency nurses.
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Currently, more than 1,200 advanced practice nurses have sought certification as acute care nurse practitioners (ACNPs). Surveys of practicing ACNPs have shown that the role is expanding in terms of practice settings and role components. This article reports on the results of ongoing survey with ACNPs that portray the role of the ACNP as an evolving career opportunity for advanced practice nurses.
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Critical care practice has greatly changed over the last three decades. This is partly due to the advent of the pulmonary artery catheter and subsequent advances in technologies associated with it. ⋯ Parameters that were once only available on an intermittent basis can now be obtained continuously. Addition of mixed venous oxygen saturation to the cardiorespiratory profile and other derived parameters provides the bedside clinician with important variables to assess the cardiorespiratory status of the critically ill.
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Modern engineering and space-age technology introduce innovations in thermometry at a crucial time in critical care history. Today's assessment and care decisions are based, in part, on emerging scientific evidence about thermoregulatory responses. ⋯ Confusion exists as to which instrument or site is "ideal." Interpretation of temperature correlations, between temperature sites or without consideration of linearity, has little meaning outside the clinical context. This article discusses hemodynamic and thermal conditions influencing regional body temperatures along with instrument accuracy, reliability, linearity, precision, safety, comfort, and need for staff training.
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Nutritional assessment can be incorporated into the assessments performed daily by the critical care nurse for every patient. Identification of nutritional deficits will lead to timely interventions and will facilitate recovery and early discharge. The metabolic responses to starvation and stress are reviewed, and bedside techniques for nutritional assessment are outlined. General guidelines for nutritional support and parameters for monitoring the effectiveness of nutritional therapies are defined.