Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Dec 2005
Review Case ReportsPediatric fluid and electrolyte balance: critical care case studies.
The care of the critically ill infant or child often is complicated further by disruptions in fluid or electrolyte balance. Prompt recognition of these disruptions is essential to the care of these patients. This article provides an overview of the principles of fluid and electrolyte balance in the critically ill infant and child. Imbalances in fluid homeostasis and imbalances in sodium, potassium, and calcium homeostasis are presented in a case study format.
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Critical illness of a child affects all members of the family, including well brothers and sisters. Stress in their lives results from changes in parental behaviors, caregiving arrangements, and family relationships. ⋯ Educating pediatric ICU nurses about the needs and reactions of well siblings enables them to optimize support to siblings and educate parents. A sibling policy guarantees that choice and support are offered in a consistent and thorough manner to each critically ill child's family; this helps to ensure that the family unit has the abilities to nurture the ill child and other well children.
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Diabetic ketoacidosis (DKA), a pathophysiologic, life-threatening process that results from uncontrolled diabetes mellitus-induced hyperglycemia, is seen frequently in the pediatric ICU. This article reviews the pathophysiology, management, goals of treatment, and nursing implications of the child who is diagnosed with DKA. Facets particular to the pediatric population are reviewed.
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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.