Critical care nursing clinics of North America
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With the understanding that parents are the vital link to the child, nurses can develop plans of care based on research. Family functioning must be assessed as families attempt to deal with the stress involved in the hospitalization of a child with sepsis. ⋯ The stress of hospitalization may have long-term effects on children and families. Future research is needed to develop additional interventions that can be applied while the child is hospitalized and after discharge to aid the family in coping with stress.
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Severe sepsis and septic shock are among the most complex and challenging conditions treated by critical care practitioners. Although the pathophysiology of severe sepsis and septic shock is not fully understood, bacteria and immune responses are known to trigger the release of cytokines. These cytokines initiate a cascade of events that lead to illness behaviors such as fever, anorexia, and sleepiness, as well as a host of physiologic events such as activation of the coagulation cascade, vasodilation, hypotension, and increased vessel permeability. As research advances the understanding of severe sepsis and septic shock, practitioners must become aware of the cellular basis of events so that treatments can be implemented knowledgeably and evaluated.
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Crit Care Nurs Clin North Am · Mar 2003
ReviewThe role of the critical care nurse in the assessment and management of the patient with severe sepsis.
Sepsis with acute organ dysfunction is common, frequently fatal, and expensive. The critical care nurse is involved in the continuous bedside care of the critically ill patient; consequently, he or she has the opportunity to prevent sepsis through infection control practices and general nursing care, to identify patients at risk for the disease, to monitor these patients for the clinical signs of sepsis, and to detect developing organ dysfunction as a manifestation of severe sepsis. ⋯ Drotrecogin alfa (activated) is a promising new therapy in the treatment of severe sepsis. Nurses caring for patients with this disease need to understand the issues related to the administration of drotrecogin alfa (activated) and the monitoring of patients receiving this drug to promote optimal and appropriate use of this innovative therapy.