Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Jun 2014
ReviewNutrition in the pediatric population in the intensive care unit.
Nutrition is an essential component of patient management in the pediatric intensive care unit (PICU). Poor nutrition status accompanies many childhood chronic illnesses. A thorough assessment of the critically ill child is required to inform the plan for nutrition support. ⋯ To prevent inappropriate caloric intake, reassessment of the child's nutrition status is imperative. Enteral nutrition is the recommended route of intake. Human milk is preferred for infants.
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Crit Care Nurs Clin North Am · Jun 2014
ReviewNutrition in the chronically ill critical care patient.
Chronic critical illness is a problem in the critical care environment. The ultimate goal in managing care for the chronically critically ill is liberation from mechanical ventilation, leading to improved survival and enhanced quality of life. Clinical practice guidelines are presented as a framework in providing care for this distinct patient population. Research studies supplement the recommendations to ensure best care guides critical care decisions using the best evidence in the context of patient values and clinical expertise.
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Malnutrition has been identified as a cause for disease as well as a condition resulting from inflammation associated with acute or chronic disease. Malnutrition is common in acute-care settings, occurring in 30% to 50% of hospitalized patients. Inflammation has been associated with malnutrition and malnutrition has been associated with compromised immune status, infection, and increased intensive care unit (ICU) and hospital length of stay. The ICU nurse is in the best position to advocate for appropriate nutritional therapies and facilitate the safe delivery of nutrition.
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Crit Care Nurs Clin North Am · Jun 2014
ReviewBedside caregivers as change agents: implementation of early enteral nutrition in critical care.
Enteral nutrition is an important aspect of caring for critically ill patients, yet delays in implementation of guidelines and recommendations occur. Bedside caregivers are in a key position to evaluate current practice and lead change to implement evidence-based practice guidelines. Interdisciplinary teams can use change models, such as Larrabee's, to provide guidance and support success of practice change projects.