AACN clinical issues
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A child's emergent admission to the pediatric intensive care unit (PICU) can strike fear and feelings of helplessness into the hearts of parents who only hours earlier had been in control of their lives. Acute critical illness seriously threatens the parents' ability to fulfill their familiar and important roles of protecting and providing for their child. ⋯ In planning interventions, these issues should be considered as well as the specific needs that parents have emphasized: accurate information, ready access to their children, and meaningful participation in their children's care. Advanced practice nurses are in an excellent position to improve delivery of psychosocial services to parents of critically ill children through direct care, acting as models of care practices and mentoring staff, staff education, policy development, and clinical research.
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AACN clinical issues · Feb 1998
ReviewNursing strategies to prevent ventilator-associated pneumonia.
Critically ill patients who require mechanical ventilation are at high risk for development of pneumonia during the course of treatment. Ventilator-associated pneumonia leads to higher rates of mortality and morbidity, increased length of hospital stay, and higher hospital costs. ⋯ Colonization and subsequent pneumonia commonly occurs from microaspiration of secretions from the oropharynx and gastrointestinal tract. In this article, the mechanism of microaspiration, diagnosis of ventilator-associated pneumonia, and nursing strategies to reduce the incidence of pneumonia are described.
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AACN clinical issues · Feb 1998
ReviewAdverse responses to analgesia, sedation, and neuromuscular blocking agents in infants and children.
Analgesics, sedation, and neuromuscular blocking agents are commonly used in treating critically ill infants and children. Although these medications are beneficial and imperative to the care of the child, their use is not risk free. Adverse responses occur in these children. With improved methods for use and monitoring, adverse responses can be minimized.