Dynamics (Pembroke, Ont.)
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Dynamics (Pembroke, Ont.) · Jan 2004
Comparative Study Clinical Trial Controlled Clinical TrialA comparison between single and double-pump syringe changes of intravenous inotropic medications in children.
The purpose of this study was to examine the consistency of dosage delivery of inotropic medications when changing syringes in syringe pumps. Two nursing practices of syringe changes were compared: single-pump (SP) versus double-pump (DP). The SP syringe change involved using one and the same pump, and changing only the syringe. ⋯ The findings suggest that the DP practice for syringe changes provides better consistency in the dosage delivery of inotropic medications. However, the SP practice can also be highly suitable when considering the overall benefits and risks of both practices of syringe changes. Implications for nursing are discussed.
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Caring for the patient in the post-anesthetic period requires an understanding of the intubation and extubation process. The nurse must be knowledgeable of the numerous tracheal extubation-related complications that can occur. ⋯ After reviewing extubation criteria and the safe extubation process, the nurse can apply this knowledge to patient care. Although nurses are excellent initiators of tracheal extubation, the procedure is ideally performed by an anesthetist or internist who can treat complications that arise, or re-intubate the patient, if required.
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Dynamics (Pembroke, Ont.) · Jan 2004
ReviewAnalgesic and sedative pharmacology in the intensive care unit.
Sedation and analgesia are central elements in the care of critically ill, mechanically-ventilated patients. The goal of analgesic therapy is to provide relief from pain and physical discomfort which may lead to poor sleep, agitation, or a stress response. Opioids, such as morphine, fentanyl, and hydromorphone, are considered first-line agents for treating pain. ⋯ The benzodiazepines and propofol are the primary sedative agents used in the intensive care unit (ICU). Agents such as clonidine and haloperidol may have a role in the ICU when used concomitantly with sedatives and analgesics. An understanding of the pharmacotherapy of sedation and analgesia in the ICU will help support appropriate usage of these agents and improve patient care.
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Dynamics (Pembroke, Ont.) · Jan 2004
ReviewManaging diabetic ketoacidosis: the role of the ICU nurse in an endocrine emergency.
Diabetic ketoacidosis is an endocrine emergency that requires intensive management and monitoring. Eight per cent of diabetic-related admissions are for the management of diabetic ketoacidosis and, prior to the discovery of insulin, all of these patients died (Delaney, Zisman & Kettyle, 2000). In this article, the author reviews the pathophysiology of the classic presentation of diabetic ketoacidosis: hyperglycemia and ketoacidosis. The management of the acute situation is described in order to enable the critical care nurse to provide and advocate for best patient care practices.
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Evidence-based clinical practice is a goal of professional nursing. Linking research to the clinical realm appears logical and sounds simplistic, yet frequently our preconceived thoughts and ideas of ease of change do not equate with the reality of the situation. ⋯ Maintaining artificial airways was a frequent topic of discussion in this PICU. The questions surrounding this practice were reviewed using an evidence-based practice framework in order to provide a clinical practice guideline that would assist in the delivery of care.