American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial Clinical Trial
The effect of earplugs on sleep measures during exposure to simulated intensive care unit noise.
Sleep deprivation may contribute to impaired immune function, ventilatory compromise, disrupted thermoregulation, and delirium. Noise levels in intensive care units may be related to disturbed sleep patterns, but noise reduction has not been tested in this setting. ⋯ The results provide a reasonable basis for testing the effects of earplugs on the sleep of critically ill subjects.
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Randomized Controlled Trial Clinical Trial
Effects of relaxing music on cardiac autonomic balance and anxiety after acute myocardial infarction.
Acute myocardial infarction places additional demands on an already compromised myocardium. Relaxing music can induce a relaxation response, thereby reversing the deleterious effects of the stress response. ⋯ Patients recovering from acute myocardial infarction may benefit from music therapy in a quiet, restful environment.
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Clinical Trial Controlled Clinical Trial
Obtaining blood samples for coagulation studies from a normal saline lock.
To determine the amount of blood that should be discarded from a peripheral normal saline lock, a capped-off intravenous port, before a blood sample is obtained for determination of activated partial thromboplastin time from patients being treated with heparin. ⋯ Nurses can obtain accurate measurements of activated partial thromboplastin time with blood samples obtained from normal saline locks by first discarding a volume of blood equal to 2 times the dead space of the catheter and extension set. Obtaining blood samples in this manner reduces patients' discomfort due to repeated venipuncture and diminishes blood loss.
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Critically ill patients are at high risk for pressure ulcers. ⋯ Patients in intensive care units have an increased risk for pressure ulcers. Although waiting until 12 hours after a patient's admission to the intensive care unit to obtain the initial Braden rating may be reasonable (with the second rating obtained 36 hours after admission), additional research is needed before this practice can be recommended.
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Clinical Trial Controlled Clinical Trial
Instillation of normal saline during endotracheal suctioning: effects on mixed venous oxygen saturation.
Instillation of normal saline before endotracheal suctioning is thought to facilitate removal of secretions and ultimately to improve the patient's oxygenation status. To date, no studies have used an in vivo measure of oxygenation such as mixed venous oxygen saturation to characterize the effects of instillation of normal saline. ⋯ Instillation of normal saline before endotracheal suctioning has an adverse effect on oxygenation as indicated by mixed venous oxygen saturation. This finding contradicts the assumption that instillation of normal saline improves oxygenation status.