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AACN Essentials of Critical Care Nursing

by: Chulay, Marianne; Burns, Suzanne M.

AACN Essentials of Critical Care Nursing

by: Chulay, Marianne; Burns, Suzanne M.

ISBN 13:
9780071447713
ISBN 10:
0071447717
Edition: 1st
Format: Paperback
Copyright: 07/29/2005
Publisher: McGraw-Hill Professional
Newer Edition

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Summary

Covering basic to advanced critical care concepts, this easy-to-use, evidence-based resource provides essential foundation for the nursing care of critically-ill patients. It is the ideal reference for nurses beginning their critical care experience as well as experienced nurses who may use the book as a user-friendly resource for both essential and advanced concepts. ECG rhythm interpretation and treatment and pharmacology also make it an excellent resource for progressive care nurses.

Contributors

Reviewers

xvii

Preface

xix

Section I. The Essentials

(212)

Assessment of Critically Ill Patients and Families

(14)

Mary Fran Tracy

Assessment Framework

(1)

Prearrival Assessment

(1)

Admission Quick Check

(1)

Comprehensive Admission Assessment

(1)

Ongoing Assessment

(1)

Prearrival Assessment: Before the Action Begins

(1)

Admission Quick Check Assessment: The First Few Minutes

(2)

Airway and Breathing

(1)

Circulation and Cerebral Perfusion

(1)

Chief Complaint

(1)

Drugs and Diagnostic Tests

(1)

Equipment

(1)

Comprehensive Admission Assessment

(7)

Past Medical History

(1)

Social History

(1)

Physical Assessment by Body System

(3)

Psychosocial Assessment

(2)

Ongoing Assessment

(3)

Planning Care for Critically Ill Patients and Families

(20)

Mary Fran Tracy

Multidisciplinary Plan of Care and Critical Pathways

(1)

Prevention of Common Complications

(8)

Physiologic Instability

(1)

Deep Venous Thrombosis

(5)

Hospital-Acquired Infections

(1)

Skin Breakdown

(1)

Sleep Pattern Disturbances

(1)

Psychosocial Impact

(1)

Patient and Family Education

(2)

Assessment of Learning Readiness

(1)

Strategies to Address Patient and Family Education

(1)

Outcome Measurement

(1)

Family-Focused Care

(1)

Transporting the Critically Ill Patient

(3)

Assessment of Risk for Complications

(1)

Level of Care Required During Transport

(1)

Preparation

(1)

Transport

(1)

Interfacility Transfers

(1)

Transitioning to the Next Stage of Care

(1)

Supporting Patients and Families During the Dying Process

(4)

Interpretation and Management of Basic Cardiac Rhythms

(28)

Carol Jacobson

Basic Electrophysiology

(1)

ECG Waveforms, Complexes, and Intervals

(1)

P Wave

(1)

QRS Complex

(1)

T and U Waves

(1)

ST Segment

(1)

PR Interval

(1)

QT Interval

(1)

Cardiac Monitoring

(3)

Determination of the Heart Rate

(1)

Determination of the Cardiac Rhythm

(1)

Common Arrhythmias

(1)

Rhythms Originating in the Sinus Node

(2)

Sinus Bradycardia

(1)

Sinus Tachycardia

(1)

Sinus Arrhythmia

(1)

Sinus Arrest

(1)

Arrhythmias Originating in the Atria

(4)

Premature Atrial Complexes

(1)

Wandering Atrial Pacemaker

(1)

Atrial Tachycardia

(1)

Atrial Flutter

(1)

Atrial Fibrillation

(1)

Arrhythmias Originating in the Atrioventricular Junction

(1)

Premature Junctional Complexes

(1)

Junctional Rhythm, Accelerated Junctional Rhythm and Junctional Tachycardia

(1)

Arrhythmias Originating in the Ventricles

(4)

Premature Ventricular Complexes

(1)

Ventricular Rhythm and Accelerated Ventricular Rhythm

(1)

Ventricular Tachycardia

(1)

Ventricular Fibrillation

(1)

Ventricular Asystole

(1)

Atrioventricular Blocks

(3)

First-Degree Atrioventricular Block

(1)

Second-Degree Atrioventricular Block

(2)

High-Grade Atrioventricular Block

(1)

Third-Degree Atrioventricular Block (Complete Block)

(1)

Temporary Pacing

(3)

Indications

(1)

Transvenous Pacing

(1)

Epicardial Pacing

(1)

Components of a Pacing System

(1)

Basics of Pacemaker Operation

(2)

ECG Characteristics of Paced Rhythms

(1)

Initiating Transvenous Ventricular Pacing

(1)

Initiating Epicardial Pacing

(1)

External (Transcutaneous) Pacemakers

(1)

Defibrillation and Cardioversion

(5)

Defibrillation

(1)

Automatic External Defibrillators

(1)

Cardioversion

(3)

Hemodynamic Monitoring

(46)

Leanna R. Miller

Hemodynamic Parameters

(7)

Cardiac Output

(2)

Components of Cardiac Output/Cardiac Index

(1)

Stroke Volume and Stroke Volume Index

(1)

Factors Affecting Stroke Volume/Stroke Volume Index

(4)

Basic Components of Hemodynamic Monitoring Systems

(2)

Pulmonary Artery Catheter

(1)

Arterial Catheter

(1)

Pressure Tubing

(1)

Pressure Transducer

(1)

Pressure Amplifier

(1)

Pressure Bag and Flush Device

(1)

Alarms

(1)

Obtaining Accurate Hemodynamic Values

(3)

Zeroing the Transducer

(1)

Leveling the Transducer to the Catheter Tip

(2)

Calibration of the Transducer/Amplifier System

(1)

Ensuring Accurate Waveform Transmission

(1)

Insertion and Removal of Catheters

(7)

Pulmonary Artery Catheters

(3)

Arterial Catheters

(4)

Obtaining and Interpreting Hemodynamic Waveforms

(13)

Patient Positioning

(1)

Interpretation

(7)

Artifacts in Hemodynamic Waveforms: Respiratory Influence

(1)

Cardiac Output

(5)

Continuous Mixed Venous Oxygen Monitoring

(2)

Svo2 Monitoring Principles

(1)

Selected Examples of Clinical Applications

(1)

Right Ventricular Ejection Fraction Catheters

(1)

Monitoring Principles

(1)

Troubleshooting

(1)

Minimally Invasive Hemodynamic Monitoring

100

(2)

Thoracic Bioimpedance

100

(1)

Esophageal Doppler Cardiac Output

100

(1)

Carbon Dioxide Rebreathing

100

(1)

Gastric Tonometry

100

(1)

Sublingual Capnometry

101

(1)

Application of Hemodynamic Parameters

102

(9)

Low Cardiac Output States

102

(4)

High Cardiac Output States

106

(5)

Airway and Ventilatory Management

111

(34)

Robert E. St. John

Respiratory Assessment Techniques, Diagnostic Tests, and Monitoring Systems

111

(7)

Arterial Blood Gas Monitoring

111

(1)

Analysis

112

(4)

Venous Blood Gas Monitoring

116

(1)

Pulse Oximetry

116

(2)

Assessing Pulmonary Function

118

(1)

Airway Management

118

(7)

Oropharyngeal Airway

118

(2)

Nasopharyngeal Airway

120

(1)

Artificial Airways

120

(5)

Oxygen Therapy

125

(4)

Complications

125

(2)

Oxygen Delivery

127

(2)

Basic Ventilatory Management

129

(16)

Indications

129

(1)

General Principles

129

(3)

Modes

132

(3)

Complications

135

(1)

Weaning From Short-Term Mechanical Ventilation

136

(2)

Troubleshooting Ventilators

138

(1)

Communication

139

(2)

Principles of Management

141

(4)

Pain, Sedation, and Neuromuscular Blockade Management

145

(20)

Joan Michiko Ching

Suzanne M. Burns

Physiologic Mechanisms of Pain

145

(2)

Peripheral Mechanisms

145

(2)

Spinal Cord Integration

147

(1)

Central Processing

147

(1)

Responses to Pain

147

(1)

Pain Assessment

148

(1)

A Multilevel Approach to Pain Management

148

(1)

Nonsteroidal Anti-Inflammatory Drugs

149

(1)

Side Effects

150

(1)

Opioids

150

(3)

Side Effects

150

(1)

Intravenous Opioids

151

(1)

Patient-Controlled Analgesia

151

(1)

Switching From IV to Oral Opioid Analgesia

152

(1)

Epidural Analgesia

153

(2)

Epidural Opioids

153

(1)

Epidural Local Anesthetics

154

(1)

Cutaneous Stimulation

155

(1)

Distraction

155

(1)

Imagery

155

(1)

Relaxation and Sedation Techniques

155

(1)

Deep Breathing and Progressive Relaxation

156

(1)

Presence

156

(1)

Special Considerations for Pain Management in the Elderly

156

(1)

Assessment

157

(1)

Interventions

157

(1)

Sedation

157

(2)

Reasons for Sedation

157

(1)

Drugs for Sedation

158

(1)

Goals of Sedation, Monitoring, and Management

159

(1)

Sedation Scales: Goals and Monitoring

159

(1)

Sedation Management

159

(1)

Neuromuscular Blockade

159

(6)

Neuromuscular Blocking Agents

160

(1)

Monitoring and Management

161

(4)

Pharmacology

165

(34)

Earnest Alexander

Medication Administration Methods

165

(2)

Intravenous

165

(1)

Intramuscular or Subcutaneous

165

(1)

Sublingual

166

(1)

Intranasal

166

(1)

Transdermal

166

(1)

Central Nervous System Pharmacology

167

(9)

Sedatives

167

(3)

Analgesics

170

(1)

Neuromuscular Blocking Agents

171

(2)

Anticonvulsants

173

(3)

Cardiovascular System Pharmacology

176

(9)

Miscellaneous Agents

176

(1)

Parenteral Vasodilators

177

(3)

Antiarrhythmics

180

(2)

Thrombolytic Agents

182

(1)

Vasoconstricting Agents

183

(1)

Inotropic Agents

184

(1)

Activated Protein C

185

(1)

Anti-Infective Pharmacology

185

(2)

Aminoglycosides

185

(1)

Vancomycin

186

(1)

Other Antibiotics

186

(1)

Pulmonary Pharmacology

187

(1)

Theophylline

187

(1)

Albuterol

187

(1)

Gastrointestinal Pharmacology

188

(2)

Stress Ulcer Prophylaxis

188

(1)

Acute Peptic Ulcer Bleeding

189

(1)

Variceal Hemorrhage

189

(1)

Renal Pharmacology

190

(1)

Diuretics

190

(1)

Hematologic Pharmacology

191

(2)

Anticoagulants

191

(2)

Direct Thrombin Inhibitors

193

(1)

Glycoprotein IIb/IIa Inhibitor

193

(1)

Immunosuppressive Agents

193

(2)

Cyclosporine

193

(1)

Tacrolimus (FK506)

194

(1)

Sirolimus (Rapamycin)

194

(1)

Special Dosing Considerations

195

(4)

Continuous Renal Replacement Therapy

195

(1)

Drug Disposition in the Elderly

195

(1)

Therapeutic Drug Monitoring

195

(4)

Ethical and Legal Considerations

199

(14)

Juanita Reigle

The Foundation for Ethical Decision Making

199

(5)

Professional Codes and Standards

199

(1)

Position Statement and Guidelines

200

(1)

Institutional Policies

200

(1)

Legal Standards

200

(1)

Principles of Ethics

201

(2)

Care

203

(1)

Patient Advocacy

204

(1)

The Process of Ethical Analysis

204

(1)

Assessment

204

(1)

Plan

204

(1)

Implementation

205

(1)

Evaluation

205

(1)

Contemporary Ethical Issues

205

(4)

Informed Consent

205

(1)

Determining Capacity

205

(1)

Advance Directives

206

(1)

End-of-Life Issues

207

(2)

Resuscitation Decisions

209

(1)

Building an Ethical Environment

209

(4)

Values Clarification

209

(1)

Provide Information and Clarify Issues

209

(1)

Recognize Moral Distress

210

(1)

Engage in Collaborative Decision Making

210

(3)

Section II. Pathologic Conditions

213

(176)

Cardiovascular System

215

(32)

Barbara Leeper

Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems

215

(3)

Assessment of Chest Pain

215

(1)

Coronary Angiography

215

(1)

Percutaneous Coronary Interventions

216

(1)

Other Percutaneous Coronary Interventions

217

(1)

Pathologic Conditions

218

(29)

Acute Ischemic Heart Disease

218

(12)

Congestive Heart Failure

230

(8)

Shock

238

(5)

Hypertension

243

(4)

Respiratory System

247

(20)

Marianne Chulay

Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems

247

(5)

Chest X-Rays

247

(4)

Computed Tomography and Magnetic Resonance Imaging

251

(1)

Chest Tubes

252

(1)

Pathologic Conditions

252

(15)

Acute Respiratory Failure

252

(4)

Acute Respiratory Distress Syndrome

256

(2)

Acute Respiratory Failure in the Patient With Chronic Obstructive Pulmonary Disease

258

(2)

Pneumonia

260

(3)

Pulmonary Embolism

263

(4)

Multisystem Problems

267

(12)

Ruth M. Kleinpell

Pathologic Conditions

267

(7)

Sepsis and Multiple Organ Dysfunction Syndrome

267

(7)

Overdoses

274

(5)

Etiology, Risk Factors, and Pathophysiology

274

(5)

Neurologic System

279

(26)

Dea Mahanes

Assessment Techniques

279

(8)

Level of Consciousness

279

(1)

Glasgow Coma Scale

280

(1)

Mental Status

281

(2)

Motor Assessment

283

(1)

Sensation

283

(2)

Cranial Nerve Assessment and Assessment of Brainstem Function

285

(1)

Vital Sign Alterations in Neurologic Dysfunction

286

(1)

Death by Neurologic Criteria

287

(1)

Diagnostic Testing

287

(3)

Lumbar Puncture

287

(1)

Computed Tomography

288

(1)

Magnetic Resonance Imaging

288

(1)

Cerebral Angiography

289

(1)

Transcranial Doppler Ultrasound

290

(1)

Electroencephalography

290

(1)

Electromyography

290

(1)

Intracranial Pressure: Concepts and Monitoring

290

(6)

Cerebral Blood Flow

291

(1)

Causes of Increased Intracranial Pressure

291

(5)

Acute Ischemic Stroke

296

(3)

Etiology, Risk Factors, and Pathophysiology

296

(1)

Diagnostic Tests

297

(2)

Hemorrhagic Stroke

299

(1)

Etiology, Risk Factors, and Pathophysiology

299

(1)

Clinical Presentation

300

(1)

Diagnostic Tests

300

(1)

Principles of Management of Intracerebral Hemorrhage

300

(1)

Seizures

300

(2)

Etiology, Risk Factors, and Pathophysiology

300

(1)

Clinical Presentation

300

(1)

Principles of Management of Seizures

301

(1)

Infections of the Central Nervous System

302

(1)

Meningitis

302

(1)

Encephalitis

302

(1)

Intracranial Abscess

302

(1)

Neuromuscular Diseases

303

(2)

Myasthenia Gravis

303

(1)

Guillain-Barre Syndrome

303

(2)

Hematology and Immunology Systems

305

(12)

Diane K. Dressler

Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems

305

(3)

Complete Blood Count

305

(1)

Red Blood Cell Count

305

(1)

Hemoglobin

306

(1)

Hematocrit

306

(1)

Red Blood Cell Indices

306

(1)

Total White Blood Cell Count

306

(1)

White Blood Cell Differential

306

(1)

Platelet Count

307

(1)

Erythrocyte Sedimentation Rate

307

(1)

Coagulation Studies

307

(1)

Additional Tests and Procedures

308

(1)

Pathologic Conditions

308

(9)

Anemia

308

(2)

Immunocompromise

310

(2)

Coagulopathies

312

(5)

Gastrointestinal System

317

(24)

Joanne Krumberger

Carol Reese Parrish

Joe Krenitsky

Pathologic Conditions

317

(15)

Acute Upper Gastrointestinal Bleeding

317

(8)

Liver Failure

325

(5)

Acute Pancreatitis

330

(1)

Bowel Infarction/Obstruction

331

(1)

Nutritional Support for Critically Ill Patients

332

(9)

Nutrition Needs

332

(1)

Residual Volume

333

(1)

Aspiration

334

(1)

Bowel Sounds

335

(1)

Nausea and Vomiting

336

(1)

Osmolality or Hypertonicity of Formula

336

(1)

Diarrhea

337

(1)

Flow Rates and Hours of Infusion

337

(1)

Formula Selection

337

(4)

Renal System

341

(16)

Carol Hinkle

Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems

341

(1)

Pathologic Conditions

341

(9)

Acute Renal Failure

341

(5)

Life-Threatening Electrolyte Imbalances

346

(4)

Renal Replacement Therapy

350

(7)

Access

351

(1)

Dialyzer/Hemofilters/Dialysate

352

(1)

Procedures

352

(1)

Indications for and Efficacy of Renal Replacement Therapy Modes

352

(3)

General Renal Replacement Therapy Interventions

355

(2)

Endocrine System

357

(14)

Joanne Krumberger

Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems

357

(2)

Blood Glucose Monitoring

357

(2)

Pathologic Conditions

359

(12)

Hyperglycemic Emergencies

359

(5)

Acute Hypoglycemia

364

(1)

Syndrome of Inappropriate Antidiuretic Hormone Secretion

365

(2)

Diabetes Insipidus

367

(4)

Trauma

371

(18)

Carol A. Rauen

Jamie B. Sinks

Specialized Assessment Techniques, Diagnostic Tests, and Monitoring Systems

371

(7)

Primary and Secondary Trauma Survey Assessment

371

(3)

Diagnostic Studies

374

(2)

Mechanism of Injury

376

(1)

Physiologic Consequences of Trauma

377

(1)

Common Injuries in the Critically Ill Trauma Patient

378

(4)

Thoracic Trauma

378

(2)

Abdominal Trauma

380

(1)

Musculoskeletal Trauma

381

(1)

Complications of Traumatic Injury in Severe Multisystem Trauma

382

(3)

Acute Respiratory Distress Syndrome

384

(1)

Infection/Sepsis

385

(1)

Systemic Inflammatory Response Syndrome

385

(1)

Psychological Consequences of Trauma

385

(4)

Section III. Advanced Concepts in Caring for the Critically Ill Patient

389

(112)

Advanced ECG Concepts

391

(40)

Carol Jacobson

The 12-Lead Electrocardiogram

391

(20)

Axis Determination

396

(3)

Bundle Branch Block

399

(2)

Myocardial Ischemia, Injury, and Infarction

401

(6)

Preexcitation Syndromes

407

(4)

Advanced Arrhythmia Interpretation

411

(8)

Supraventricular Tachycardias

412

(3)

Differentiating Wide QRS Beats and Rhythms

415

(4)

ST-Segment Monitoring

419

Measuring the ST Segment

420

(1)

Choosing the Best Leads for ST-Segment Monitoring

421

Cardiac Pacemakers

418

(13)

Evaluating Pacemaker Function

423

(1)

VVI Pacemaker Evaluation

423

(4)

DDD Pacemaker Evaluation

427

(4)

Advanced Cardiovascular Concepts

431

(32)

Barbara Leeper

Pathologic Conditions

431

(32)

Cardiomyopathy

431

(5)

Valvular Disease

436

(5)

Pericarditis

441

(2)

Aortic Aneurysm

443

(3)

Cardiac Transplantation

446

(6)

Intra-Aortic Balloon Pump Therapy

452

(3)

Ventricular Assist Devices

455

(8)

Advanced Respiratory Concepts

463

(14)

Suzanne M. Burns

Advanced Modes of Mechanical Ventilation

463

(7)

New Concepts: Mechanical Ventilation

463

(1)

Volume Versus Pressure Ventilator

464

(5)

Alternative Ventilator Options

469

(1)

Weaning Patients From Long-Term Mechanical Ventilation

470

(7)

Wean Assessment

470

(1)

Wean Planning

471

(1)

Weaning Trials, Modes, and Methods

471

(1)

Respiratory Fatigue, Rest, and Conditioning

471

(1)

Wean Trial Protocols

472

(1)

Other Protocols for Use

473

(1)

Critical Pathways

473

(1)

Systematic Institutional Initiatives for the Management of the LTMV Patient Population

473

(4)

Advanced Neurologic Concepts

477

(24)

Dea Mahanes

Subarachnoid Hemorrhage

477

(4)

Etiology, Risk Factors, and Pathophysiology

477

(1)

Clinical Presentation

477

(2)

Diagnostic Tests

479

(2)

Traumatic Brain Injury

481

(6)

Etiology, Risk Factors, and Pathophysiology

481

(4)

Clinical Presentation

485

(1)

Diagnostic Tests

485

(2)

Traumatic Spinal Cord Injury

487

(7)

Etiology, Risk Factors, and Pathophysiology

487

(2)

Clinical Presentation

489

(1)

Diagnostic Tests

490

(1)

Future Spinal Cord Injury Treatment

490

(4)

Brain Tumors

494

(7)

Etiology, Risk Factors, and Pathophysiology

494

(1)

Diagnostic Tests

495

(2)

Advanced Technology: Brain Tissue Oxygen Monitoring

497

(4)

Section IV. Key Reference Information

501

(60)

Normal Values Table

503

(2)

Marianne Chulay

Pharmacology Tables

505

(14)

Earnest Alexander

Advanced Cardiac Life Support Algorithms

519

(10)

Marianne Chulay

Guidelines for the Transfer of Critically Ill Patients

529

(4)

Marianne Chulay

Transfers Within the Hospital

529

(1)

Transport Personnel

529

(1)

Transport Equipment Requirements

529

(1)

Monitoring During Transfer

529

(1)

Pretransfer Coordination and Communication

529

(1)

Transfers Between Hospitals

530

(3)

Transport Personnel

530

(1)

Transport Medication Requirements

530

(1)

Transfer Equipment

530

(1)

Monitoring During Transfer

531

(1)

Transfer Algorithm

532

(1)

Hemodynamic Monitoring Troubleshooting Guide

533

(6)

Leanna R. Miller

Ventilatory Troubleshooting Guide

539

(12)

Robert E. St. John

Suzanne M. Burns

Cardiac Rhythms, ECG Characteristics, and Treatment Guide

551

(10)

Carol Jacobson

Index

561

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AACN Essentials of Critical Care Nursing

AACN Essentials of Critical Care Nursing

9780071447713

0071447717

Summary

Author Biography

Table of Contents

Supplemental Materials

Write a Review

Amazon no longer offers textbook rentals. We do!

AACN Essentials of Critical Care Nursing

AACN Essentials of Critical Care Nursing

9780071447713

0071447717

Summary

Author Biography

Table of Contents

Supplemental Materials

Write a Review

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