Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Dec 2004
Review Case ReportsThe metabolic response to stress: a case of complex nutrition support management.
The ICU patient with burns, neurotrauma, sepsis, or major surgery typifies the classic hypermetabolic patient. These patients have increased energy and nutrient needs as a result of their injuries and require early nutrition support. Although these patients are likely to benefit from nutritional intervention, the complexity of the stress response to injury and subsequent changes in nutrient metabolism make the design and implementation of nutrition care challenging. This article reviews the pathophysiology of common hypermetabolic conditions and provides strategies to manage the complications associated with nutrition support.
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Crit Care Nurs Clin North Am · Dec 2004
ReviewBenefits and methods of achieving strict glycemic control in the ICU.
Hyperglycemia, a frequent complication in critically ill patients, has been shown to have a negative influence on morbidity and mortality. Many factors contribute to hyperglycemia, including the stress response, diabetes, obesity, advanced age, corticosteroids, sepsis, pancreatitis, and the use of nutrition support. Application of intensive insulin therapy, when compared with conventional glycemic control measures, seems to improve outcomes in the critically ill patient. Therefore, effective insulin therapy along with appropriate nutrition support prescriptions provide a means for the critical care nurse and other health care team members to lower complications and enhance recovery in the ICU setting.
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Crit Care Nurs Clin North Am · Dec 2004
ReviewNutrition in critically ill adults: key processes and outcomes.
Malnutrition is a common problem that can have serious consequences for the already compromised critically ill adult. Nurses are often challenged to quantify the risk or degree of malnutrition, identify the amount or type of support needed, or measure the effectiveness of nutritional intervention. This article focuses on key processes used to provide nutrition therapy to critically ill adults. These processes and how nurses employ them have the greatest potential impact on outcomes related to nutrition in critically ill adults.