Critical care nursing clinics of North America
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The number of patients with heart failure is growing; the associated morbidity and mortality remains dismal. Advance care planning, end-of-life conversations, and palliative care referrals are appropriate, but do not occur regularly. ⋯ Nurses are well-positioned to provide basic. Nurses are also instrumental in initiating referrals to the specialized palliative care team as the patient's needs become too complex or the disease progresses and the patient approaches the end of life.
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Crit Care Nurs Clin North Am · Dec 2015
ReviewCardiac Transplantation: Considerations for the Intensive Care Unit Nurse.
Heart transplantation is a recommended and curative treatment option for patients with advanced heart failure symptoms despite receiving optimal medical and device therapy. The availability of donor organs limits the number of patients able to receive a heart transplant. ⋯ Understanding the specific interventions and therapies unique to this patient population is critical to their care. This article reviews considerations for the intensive care unit clinician in the management of heart transplant patients in this setting.
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Crit Care Nurs Clin North Am · Dec 2015
ReviewHigh-Output Heart Failure Caused by Thyrotoxicosis and Beriberi.
High-output heart failure is not seen as commonly as low-output heart failure and some of the typical guideline recommendations may not benefit patients with high-output failure. High-output failure is caused by several diseases, including thyrotoxicosis and beriberi, highlighted in this article. ⋯ Prompt recognition of these infrequently seen syndromes is essential. This article outlines the medical treatment and nursing care needed to return these patients to a normal state.
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Crit Care Nurs Clin North Am · Sep 2015
ReviewImplementing Palliative Care Interdisciplinary Teams: Consultative Versus Integrative Models.
Interdisciplinary teams are at the core of intensive care unit palliative care consultation. They allow health professionals of different disciplines to collaborate in a synergistic fashion to achieve the goals of patients and their families. ⋯ There are multiple benefits to highly functioning teams, as well as challenges that may be faced when trying to provide patient care in a team-based setting. Interdisciplinary teams of different structures may provide the ideal support for complex cases in critical care settings.
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Aggressively managing the symptoms of patients with critical life-limiting illness or terminal disease can improve the quality of life for patients and loved ones, regardless of how much time they have remaining. Palliative symptom management approaches disease in a holistic manner, addressing not only the physical aspect of symptoms but also the psychological, social, and spiritual dimensions of suffering for total symptom relief. Pain is the most common reason for critical care palliative consultation, and using the World Health Organization Pain Ladder to systematically quantify, treat, and titrate pain is effective. Options include both pharmacologic and nonpharmacologic treatment.