American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Comparative Study
Job stress and burnout in acute and nonacute pediatric nurses.
To identify predictors of burnout in pediatric nurses and to compare the incidence of burnout, job stress, anxiety and perceived social support in acute and nonacute care pediatric nurses. ⋯ Even though high burnout levels are more frequent in acute care pediatric nurses, burnout is a problem in both acute and nonacute care pediatric nurses. The pattern of results suggests that efforts directed toward reducing anxiety and job stress and increasing coworker support, particularly for less experienced nurses, might reduce burnout.
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Comparative Study Clinical Trial
Pulmonary artery pressure measurement in patients with elevated pressures: effect of backrest elevation and method of measurement.
To determine whether pulmonary artery pressure measurement is accurate if the head of the bed is elevated; to compare the end-expiratory graphic recording and digital monitor methods for pulmonary artery pressure measurement; to determine whether either mean arterial pressure or mixed venous oxygen saturation changes during backrest elevation. ⋯ These results show that pulmonary artery pressures can be measured accurately with the head of the bed in an elevated position. The data indicate that obtaining pulmonary artery pressure measurements from the digital display of the bedside monitor is accurate when respiratory wave form fluctuations are minimal but may lead to inaccurate values with prominent respiratory fluctuations. Further research is needed to validate this finding in different patient populations and with other models of monitoring equipment.
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Comparative Study
Urinary bladder/pulmonary artery temperature ratio of less than 1 and shivering in cardiac surgical patients.
Temperature gradients that normally exist between body areas may be altered as a result of heat generated by shivering. ⋯ Pulmonary artery and urinary bladder temperatures are readily available clinically. The combination of a ratio of less than 1 and an increase in rate pressure product should be considered suggestive of shivering in coronary artery bypass graft patients.
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This is a case study of a patient 32 weeks pregnant who presented with multiple endocrine neoplasia type IIa, with severe pheochromocytoma complicated by adult respiratory distress syndrome. The patient's blood pressure was labile, with systolic variations from 50 to 230 mm Hg and tachycardia ranging from 150 to 180 beats per minute. ⋯ Hemodynamic measures are compared with the clinical presentation. The importance of fluid replacement is discussed.