Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Sep 2005
ReviewThe effects of liver and renal dysfunction on the pharmacokinetics of sedatives and analgesics in the critically ill patient.
In critically ill patients, the duration of effect and dose-response relationship of sedative and analgesic drugs can be significantly affected by the presence of renal or hepatic dysfunction. Alterations in pharmacokinetics and pharmacodynamics vary according to the degree of organ impairment and presence of comorbid illnesses. This article reviews the principals that govern the absorption, distribution, metabolism, and elimination of sedatives and analgesics during renal and hepatic impairment. By anticipating changes in pharmacokinetics, and by routinely assessing the clinical response to therapy, unintended adverse consequences of sedative and analgesic drug therapy may be avoided.
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Crit Care Nurs Clin North Am · Sep 2005
Review Case ReportsComplications of sedation and critical illness.
Critically ill patients require sedation to reduce anxiety, agitation, and achieve therapeutic goals. Over-sedation in combination with multiple causes for extreme muscle weakness, however, interferes with recovery from critical illness. This article describes contributing factors and explores methods of preventing over-sedation and related sequelae.
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The safety of patients receiving sedation and sedating analgesia therapies is a system property. There are multiple team members and processes needed to ensure safety that reside outside the purview of nursing. ⋯ Using this approach offers consistency in investigation and a framework for making sense of data. For this article, sedatives and analgesic medication related events are considered.
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People dependent on mechanical ventilation in an intensive care unit sleep poorly. Less than half of their sleep occurs at night. ⋯ Because most arousals are associated with caregiving activities or noise, caregivers should consolidate care and decrease environmental noise. More research is needed on sleep and sleep promotion in mechanically ventilated patients.
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Crit Care Nurs Clin North Am · Sep 2005
ReviewSleep and sedation in the pediatric intensive care unit.
Sleep is an important and necessary function of the human body. Somatic growth and cellular repair occur during sleep. ⋯ Medications administered in the pediatric intensive care unit can also disrupt sleep. This article reviews what is known about sleep in the pediatric intensive care unit and the effects of common sedation medications on sleep.