AACN clinical issues in critical care nursing
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AACN Clin Issues Crit Care Nurs · Nov 1991
ReviewUse of patient-controlled analgesia with critically ill patients: a risk/benefit analysis.
Patient-controlled analgesia (PCA), a system by which patients self-administer intravenous doses of narcotics using specially programmed infusion pumps, has been used for pain management in acute care settings for nearly two decades. The safety and effectiveness of PCA has been documented in many acutely ill patient populations. ⋯ However, intravenous narcotics of any type can provoke hemodynamic or respiratory complications in these compromised patients. Nursing expertise is a key factor in the successful implementation of PCA in critically ill patients.
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AACN Clin Issues Crit Care Nurs · Nov 1991
ReviewIssues regarding the use of analgesia and sedation in critically ill neonates.
Attitudes and beliefs of physicians and nurses have shifted during the past decade, resulting in more frequent administration of analgesics and sedatives to neonates. However, nurses caring for critically ill newborns have difficulty in determining appropriate interventions because of the lack of clear and complete knowledge related to the use of analgesia and sedation in this patient population. This chapter presents current information on six key issues related to the use of analgesia and sedation in neonates. An algorithm for determining appropriate intervention for neonates with pain, distress, or agitation is proposed to provide a more systematic approach to the use of analgesics and sedatives.
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AACN Clin Issues Crit Care Nurs · Nov 1991
ReviewAneurysmal subarachnoid hemorrhage: neurosurgical frontiers and nursing challenges.
Despite increases in survival beyond the initial hemorrhage, the devastating consequences of subarachnoid hemorrhage persist. Ruptured intracranial aneurysms are the most likely cause of subarachnoid hemorrhage, with morbidity and mortality rates approaching 75%. ⋯ In order to positively influence outcome after subarachnoid hemorrhage, preservation of an adequate cerebral blood flow and prevention of secondary aneurysmal rupture is essential. This article reviews aneurysmal subarachnoid hemorrhage, relating the management of complications to currently accepted treatment strategies.
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AACN Clin Issues Crit Care Nurs · Nov 1991
Case ReportsBenzodiazepine sedation in critically ill patients.
Agitation is a common phenomenon in critically ill patients. This multidimensional challenge can prolong illness, interfere with treatment, and harm the patient. The nurse must assess the cause of the agitation and provide effective, timely intervention. ⋯ With astute assessment and intervention, agitation can be prevented and treated to enhance recovery from critical illness. Benzodiazepines are an effective treatment intervention for agitation. With thorough knowledge of the actions and potential effects of these drugs, the nurse can provide the best pharmacologic intervention to treat agitation in the critically ill patient.
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AACN Clin Issues Crit Care Nurs · Nov 1991
Case ReportsPain and analgesia: considerations for the elderly in critical care.
A large percentage of patients in critical care are older than 65 years old. Pain is a problem common to the elderly receiving critical care. ⋯ Understanding physiologic changes experienced with aging and anticipated changes in functional abilities is necessary to the development of a pain-management plan and to providing comprehensive nursing care. Pharmacologic analgesia will be a part of the pain-management plan, with consideration given to the effects on the elderly.