Professional nurse (London, England)
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Patients who are critically ill can become malnourished very quickly, which has an impact on their recovery and length of hospital stay. In the first part of this paper on producing nutritional guidelines, the author presents her rationale for the guidelines and examines the effects of malnutrition, risk assessment, interventions available and the ethical considerations.
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Nurses need to be aware of the physiological aspects of fluid homeostasis and the nursing care and management required to manage patients with fluid balance problems effectively. This paper examines fluid management for patients with hypovolaemia, and provides reflective study points to encourage nurses to investigate the issues further.
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Despite continued investment in training and equipment, the chance of a good outcome following the invasive technique of cardiopulmonary resuscitation in hospital remains low. Given these facts, early and full discussion of do-not-resuscitate orders with certain patients and their relatives and the use of advance directives will help to clarify this issue.
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Nurses may suffer physiological and psychological stress following a cardiopulmonary resuscitation attempt. Implementation of debriefing sessions following the care of a patient experiencing a cardiac arrest can reduce staff stress. Using a debriefing process enables learning opportunities to be identified and acted on by resuscitation teams.