Articles: critical-care.
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Capnography, the science of CO2 waveforms analysis, can play a role in the management of mechanically ventilated patients. Mass spectrometers are the devices most commonly used to collect sequentially and examine CO2 waveforms from multiple patients in the ICU or operating rooms. ⋯ The patient's progress during weaning and the consequences of changes in mechanical assistance can be virtually and noninvasively determined. An expanded role of capnography in mechanically ventilated patients can increase the use of mass spectrometers in the ICU.
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Pain is a multidimensional, complex experience. Critically ill patients are particularly vulnerable to pain. Patients in a critical care environment often have difficulty communicating their pain, and their pain may be aggravated by fear and anxiety. ⋯ Finally, methods of pain measurement and treatment are outlined, and their appropriateness to critical care is evaluated. Although knowledge about pain mechanisms, measurement, and therapies has expanded, many issues remain unexplained. This article poses questions regarding pain in critically ill patients and presents specific areas for future nursing research.
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The delirium that is commonly associated with admission to an intensive care setting (intensive care unit [ICU] psychosis) may be terrifying to the patient, but may go undetected by the nurse. Our current understanding of this delirium is discussed according to incidence, defining characteristics, and etiologic or contributing factors such as predisposing patient factors, pharmacologic agents, and environmental factors. ⋯ These episodes of delirium are examined with reference to sensory-perceptual, perceptual or sensory alterations. We discuss nursing interventions that help to prevent or lessen the impact of delirium before an ICU admission, during the ICU course, and after discharge from the ICU.