Critical care nursing clinics of North America
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Acute renal failure in the critically ill patient may have a wide range of clinical presentations and necessitate numerous nursing interventions. This article reviews the etiologies, pathophysiology, and diagnoses related to acute kidney dysfunction with a particular emphasis on sequelae related to sepsis. Additionally, the nursing care for managing patients with acute renal failure with the available renal replacement modalities is discussed.
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Sepsis is noted for producing disruptions in hemostasis. The patient-related risk factors, clinical presentation, and management strategies are dependent upon the presiding disorder. ⋯ Nursing care focuses on prevention, early recognition, and supportive care for the thrombotic or bleeding patient. An overview of the disorders of hemostasis in sepsis and nursing care of these patients are described in this article.
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Crit Care Nurs Clin North Am · Jun 1994
ReviewThe inflammatory/immune response in critical illness: role of the systemic inflammatory response syndrome.
The inflammatory/immune response is designed to protect the body and limit the extent of injury. In the setting of critical illness, however, regulation of this exquisite response is often lost for reasons that remain to be elucidated. Loss of regulation combined with shock, infection, inflammation, and/or ischemia often leads to the development of the systemic inflammatory response syndrome (SIRS), which frequently is associated with the development of septic shock, disseminated intravascular coagulation (DIC), multiple organ dysfunction (MODS), and other complications of critical illness.
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Crit Care Nurs Clin North Am · Mar 1994
Case ReportsAdvanced case studies in hemodynamic monitoring: postoperative cardiovascular patients.
Pediatric patients with complex congenital cardiac defects present unique challenges in hemodynamic monitoring to the critical care nurse. An understanding of the hemodynamic alterations caused by both the underlying lesions and the surgical repairs is necessary to establish acceptable parameters in caring for these patients. In these complex patients, understanding expected deviations from normal ranges and integrating this information with clinical presentations is critical for individualizing effective interventions. An overview of hemodynamic monitoring and two advanced case studies are presented.
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Crit Care Nurs Clin North Am · Mar 1994
Mechanical support for congestive heart failure in infants and children.
Pharmacologic therapy is the primary intervention for congestive heart failure in children. When pharmacologic support is unsuccessful, however, the use of mechanical support is becoming more common. The use of intraaortic balloon counterpulsation, extracorporeal membrane oxygenation, ventricular assist devices, and abdominal compression devices in infants and children is increasingly becoming a viable option in pediatrics. Despite these advances, development of mechanical support for refractory CHF must continue for the development of ventricular assist devices and artificial hearts for infant and children as a bridge to transplant.