AACN clinical issues in critical care nursing
-
Elderly patients who enter the critical care setting have special nursing care needs based on the physiologic changes of aging. An overview of the changes of aging associated with the immunologic, cardiovascular, integumentary, musculoskeletal, and renal systems provides the basis for care planning to meet the needs of older adults in the intensive care unit.
-
AACN Clin Issues Crit Care Nurs · Feb 1992
Adverse psychologic responses of the elderly to critical illness.
Afflicting as many as 80% of critically ill elderly (older than 65 years) patients, adverse psychologic reactions (e.g., acute confusional states) to critical illness and its treatment present a unique challenge to medical and nursing intensive care practitioners. Additionally, the consequences of these adverse psychologic reactions financially strain health-care organizations, placing additional constraints on the delivery of health-care services. This article presents information regarding the origins of these adverse psychologic reactions and nursing strategies for the prevention, identification, and management of these clinical states. With such information, nurses who work in critical care units may be better equipped to identify and care for patients at risk of or experiencing an adverse psychologic reaction to critical illness.
-
Dysrhythmias in infants and children are, in many ways, similar to those in adults, yet several important differences exist in their presentation and management. Complex dysrhythmias most frequently encountered in pediatrics include sinus node dysfunction, chaotic atrial rhythm, atrial flutter, supraventricular tachycardia (including Wolff-Parkinson-White syndrome and junctional ectopic tachycardia), complete atrioventricular block (congenital and acquired), and ventricular dysrhythmias (premature ventricular contractions and ventricular tachycardia). Newer approaches to the diagnosis and management of these dysrhythmias are addressed in this paper.
-
Emergency department nursing care of the older individual requires a specific knowledge base to ensure optimal outcomes. Health-care resource utilization specific to elderly patients in the emergency department and selected common health problems that bring older people to the emergency department are described. Distinctions between normal age-related changes and disease signs and symptoms are explained to provide emergency department nurses with the requisite information to care for the elderly appropriately.
-
Traumatic brain injury affects approximately 500,000 persons each year. For those patients who survive until they reach the hospital, the major goal of the health care team is to prevent secondary injuries or insults that may follow the initial event and worsen the brain injury. ⋯ Early recognition of these factors and prompt intervention can improve the neurologic outcome of the patient with severe head injury. An understanding of the causes and effects of these secondary insults is critical to the appropriate medical and nursing management of these patients.