American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Mucormycosis is a rare opportunistic infection caused by ubiquitous fungi typically found in soil, spoiled foods, bread, and dust. The acute infection most commonly is rhinocerebral and is associated with metabolic acidosis. ⋯ Even after aggressive and appropriate treatment with surgical debridement and IV administration of amphotericin B, the fungus invaded the central nervous system. This article discusses current methods of treating mucormycosis and important critical care nursing considerations for patients who have the infection.
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In 55% of progressive care units, someone is assigned to watch the cardiac monitors at all times, but the effect of this practice on patients' outcomes has not been examined. ⋯ The presence of a monitor watcher was not associated with lower rates of most adverse outcomes evaluated; however, fewer episodes of sustained ventricular tachycardia occurred when a monitor watcher was present. Sustained ventricular tachycardia is life-threatening, disturbing to the patient, and may result in a longer hospital stay while medical therapy is being adjusted. The results of this study support the use of a monitor watcher to prevent sustained ventricular tachycardia.
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Comparative Study
Comparison of methods of measuring pulmonary artery pressure.
Pulmonary artery waveforms fluctuate because of changes in intrathoracic pressure caused by respirations. Monitoring system algorithms determine digital displays of pressure measurements on the basis of recognition, analysis, and comparison of consecutive waveforms. ⋯ Because of physiological and technical influences, measurements of systolic and diastolic pressures in the pulmonary artery made with the digital and cursor methods were not as reliable as measurements made with the graphic method. The findings support continued use of the graphic method for accurate measurements of pulmonary artery pressure.
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Although nurses are accountable for pain management, it cannot be assumed that they are well informed about pain. Nurses' knowledge base underlies their pain management; therefore, it is important to measure their knowledge. ⋯ Testing nurses' knowledge of pain indicated gaps that can be addressed through educational interventions. Research is needed in which the test developed for this study is used as both pretest and posttest in an intervention study with pediatric critical care nurses or is modified for use with nurses in other clinical areas.