Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Mar 2014
Nursing practice of palliative care with critically ill older adults.
Palliative care is emerging as an alternative care paradigm for critically ill older patients in the critical care setting. Critical care nurses are well positioned to take on a leadership role in reconceptualizing care in the critical care unit, and creating the space and opportunity for palliative care. This article provides information on the practice of palliative care with critically ill older adults along with evidence-based content and resources, allowing critical care nurses to advocate for palliative care in their own work environments accompanied by the necessary resources that will support efficient implementation.
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Crit Care Nurs Clin North Am · Mar 2014
The epidemiology of acute and critical illness in older adults.
The world and US population continues to increase with an extended lifespan. Disability rates in older adults have not changed, however; they are living longer with disabilities that affect quality of life and complicate acute and critical illness. Because increasing numbers of older adults will live with disabilities and chronic disease, new strategies are needed to improve both quality of life and end-of-life decision making.
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Thrombocytopenia is defined as a platelet count less than 150,000/μL. It can be the result of decreased platelet production, sequestration of the platelets, or increased destruction of the platelets. ⋯ Treatment is determined by the underlying cause of the thrombocytopenia. This article discusses the evaluation and management of common causes of thrombocytopenia.
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Crit Care Nurs Clin North Am · Dec 2013
ReviewHemostasis, coagulation abnormalities, and liver disease.
Coagulopathy-related bleeding events are a major concern in the management of acute and chronic liver disease. The liver attempts to maintain a balance between procoagulant and anticoagulant factors, and providers struggle with poor prognostic indicators to manage bleeding and critical complications. Subtle changes in patient presentation that may require extensive provider-directed interventions, such as blood transfusions, intravenous fluid management, mitigating possible sepsis, and evaluating appropriate pharmacologic treatment, are discussed.
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An infection of the ventricular system of the brain is referred to as ventriculitis. The signs and symptoms of ventriculitis include the triad of altered mental status, fever, and headache, as seen in the patient with meningitis. Identifying the organism responsible is important in determining the cause and in planning a treatment strategy. Nurses have a pivotal role in the early identification and management of the patient with ventriculitis.