Critical care nursing clinics of North America
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Patients over the age of 65 years are the most rapidly growing segment of the critical care population, occupying about two thirds of all ICU beds. The critical care nurse must have an acute awareness of the nutritional requirements and the physiologic impact of age and the stress of illness on the nutritional status of the elderly critically ill patient. This knowledge is essential to implement appropriate nutritional support to prevent or manage malnutrition. Adequate nutritional screening and interventions have been demonstrated to be cost effective, resulting in fewer complications, faster recovery, shorter hospital stays, and reduced hospital expenditures.
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Crit Care Nurs Clin North Am · Dec 2004
ReviewNutritional status: assessing and understanding its value in the critical care setting.
The nutritional assessment is a key determinant in establishing risk for malnutrition and is also valuable in predicting outcomes in the critical care setting. Studies have demonstrated that nurses who are aware of the impact of nutrition and have operational aptitude can influence patient outcomes through early intervention. This intervention can result in shortened recovery time and decreased lengths of stay. Knowledge of nutrition's effect in the acute and critically ill patient is integral for nursing to predict and promote outcomes successfully in the critical care setting.
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Crit Care Nurs Clin North Am · Dec 2004
Review Case ReportsMeeting the nutritional needs of the bariatric patient in acute care.
Meeting the nutritional needs of the bariatric (severely obese) patient in acute and critical care can be a challenge. Assessment of metabolic needs and energy expenditure is imperative to calculate nutritional needs. Achieving adequate nutrition is a result of multidisciplinary team collaboration, with the nurse providing important data for the dietitian to calculate needs. This article reviews aspects of nutritional support of the bariatric patient including assessment, planning, implementation, and evaluation.
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Crit Care Nurs Clin North Am · Dec 2004
Review Case ReportsNutritional support in the critically injured.
Nutritional support must be an integral part of the management of trauma victims. This article compares the stress response, a maladaptive response, and starvation, an adaptive process, examines the clinical research regarding total parenteral nutrition and total enteral nutrition, provides an evidence-based approach to initiating nutritional support in critically injured patients, and discusses considerations in selecting nutritional formulas.
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When gastric intubation is the chosen method of providing enteral nutrition, a variety of factors must be considered. To choose the proper tube, whether it resides in the gastric area or is postpyloric, it is important to consider the patient's level of consciousness, the duration of feeding, and the patient's overall status. Proper assessment, confirmation of tube placement, and nursing vigilance greatly reduce the likelihood of complications.