Critical Care Nursing - E-Book , livre ebook

Critical Care Nursing
Diagnosis and Management
SEVENTH EDITION
Linda D. Urden, DNSc, RN, CNS, NE-BC, FAAN
Professor and Director, Master's and International Nursing Programs, University of San
Diego, San Diego, California
Kathleen M. Stacy, PhD, RN, CNS, CCRN, PCCN,
CCNS
Clinical Nurse Specialist–Pulmonary/Medicine PCU, Palomar Medical Center, Escondido,
California
Clinical Associate Professor, Hahn School of Nursing and Health Science, University of San
Diego, San Diego, California
Mary E. Lough, PhD, RN, CNS, CCRN, CNRN, CCNS
Clinical Nurse Specialist–Critical Care, Stanford Hospital and Clinics, Stanford, California
Clinical Professor, Department of Physiological Nursing, University of California, San
Francisco (UCSF), San Francisco, CaliforniaD i s c l a i m e r
This title includes additional digital media when purchased in print format. For this
digital book edition, media content may not be included.Table of Contents
Cover image
Title page
Copyright
Dedication
About the Authors
Contributors
Reviewers
Preface
Acknowledgments
Unit 1: Foundations of Critical Care Nursing
Chapter 1: Critical Care Nursing Practice
Overview
History of Critical Care
Critical Care Nursing
Contemporary Critical Care
Critical Care Nursing Roles
Critical Care Professional Accountability
Critical Care Nursing Standards
Evidence-Based Nursing PracticeHolistic Critical Care Nursing
Complementary and Alternative Therapies
Nursing's Unique Role in Health Care
Critical Care Nursing Practice
Technology in Critical Care
Interprofessional Collaborative Practice
Interdisciplinary Care Management Models and Tools
Quality, Safety, and Regulatory Issues in Critical Care
Privacy and Confidentiality
Healthy Work Environment
Summary
Chapter 2: Ethical Issues
Differences between Morals and Ethics
Ethical Principles
Scarce Resources in Critical Care
Withholding and Withdrawing Treatment
Medical Futility
Ethics as a Foundation for Nursing Practice
Ethical Decision Making in Critical Care
Strategies for Promotion of Ethical Decision Making
Summary
Chapter 3: Legal Issues
Overview
Administrative Law: Professional Regulation
Tort Law: Negligence and Professional Malpractice, Intentional Torts
Constitutional Law: Patient Decision Making
Legal Issues Looking Forward
SummaryChapter 4: Genetics and Genomics in Critical Care
Genetics and Genomics
Genetic and Genomic Structure and Function
Genetic Inheritance
How Information about Genetics is Obtained
Genetics in Critical Care
Genetics, Genomics, and Nursing
Human Genetics Key Terms
Summary
Chapter 5: Patient and Family Education
Challenges of Patient and Family Education
Education
Step 1: Assessment
Step 2: Education Plan Development
Step 3: Implementation
Step 4: Evaluation
Step 5: Documentation
Factors that Affect the Teaching-Learning Process
Informational Needs of Families in Critical Care
Preparation of the Patient and Family for Transfer from Critical Care
Summary
Chapter 6: Psychosocial and Spiritual Alterations and Management
Stress and Psychoneuroimmunology
Post-Traumatic Stress Reactions
Anxiety
Alterations in Self-Concept
Risk for Compromised Human Dignity
Spiritual Challenges in Critical CareCoping with Stress and Illness
Holistic Psychosocial-Spiritual Care
Communicate with Compassion and Care
Practice Dignity-Enhancing Care
Support Patient Coping
Provide Family-Centered Care
Engage Spiritual Resources
Patients with Mental Health Co-Morbidities
Nurse Self-Care
Summary
Chapter 7: Sleep Alterations and Management
Normal Human Sleep
Pharmacology
Sleep Pattern Disturbance
Sleep Apnea Syndrome
Summary
Pharmacology
Sleep Pattern Disturbance
Sleep Apnea Syndrome
Chapter 8: Nutrition Alterations and Management
Nutrient Metabolism
Assessing Nutritional Status
Implications of Undernutrition for the Sick or Stressed Patient
Nutrition Support
Nutrition and Cardiovascular Alterations
Nutrition and Pulmonary Alterations
Nutrition and Neurologic Alterations
Nutrition and Renal AlterationsNutrition and Gastrointestinal Alterations
Nutrition and Endocrine Alterations
Summary
Chapter 9: Pain and Pain Management
Importance of Pain Assessment
Definition and Description of Pain
Pain Assessment
Pain Management
Summary
Chapter 10: Sedation, Agitation, Delirium: Assessment and Management
Sedation
Agitation
Delirium
Alcohol Withdrawal Syndrome and Delirium Tremens
Collaborative Management
Summary
Chapter 11: End-of-Life Issues
End-of-Life Experience in Critical Care
Ethical and Legal Issues
Comfort Care
Communication and Decision Making
Withdrawal or Withholding of Treatment
Palliative Care
Withdrawal of Mechanical Ventilation
Professional Issues
Organ Donation
Family Care
Collaborative CareSummary
Unit 2: Cardiovascular Alterations
Chapter 12: Cardiovascular Anatomy and Physiology
Anatomy
Physiology
Summary
Chapter 13: Cardiovascular Clinical Assessment
History
Physical Examination
Summary
Chapter 14: Cardiovascular Diagnostic Procedures
Cardiovascular Assessment and Monitoring
Laboratory Assessment
Diagnostic Procedures
Summary
Chapter 15: Cardiovascular Disorders
Coronary Artery Disease
Myocardial Infarction
Sudden Cardiac Death
Heart Failure
Cardiomyopathy
Pulmonary Hypertension
Endocarditis
Valvular Heart Disease
Atherosclerotic Diseases of the Aorta
Peripheral Arterial Disease
Carotid Artery DiseaseVenous Thromboembolism
Hypertensive Emergency
Summary
Chapter 16: Cardiovascular Therapeutic Management
Pacemakers
Implantable Cardioverter Defibrillators
Fibrinolytic Therapy
Catheter Interventions for Coronary Artery Disease
Cardiac Surgery
Mechanical Circulatory Assist Devices
Vascular Surgery
Effects of Cardiovascular Medications
Summary
Unit 3: Pulmonary Alterations
Chapter 17: Pulmonary Anatomy and Physiology
Thorax
Conducting Airways
Respiratory Airways
Pulmonary Blood and Lymph Supply
Ventilation
Respiration
Ventilation/Perfusion Relationships
Gas Transport
Summary
Chapter 18: Pulmonary Clinical Assessment
History
Physical ExaminationAssessment Findings of Common Disorders
Summary
Chapter 19: Pulmonary Diagnostic Procedures
Laboratory Studies
Diagnostic Procedures
Bedside Monitoring
Summary
Chapter 20: Pulmonary Disorders
Acute Lung Failure
Acute Respiratory Distress Syndrome
Pneumonia
Aspiration Pneumonitis
Pulmonary Embolism
Status Asthmaticus
Air Leak Disorders
Long-Term Mechanical Ventilator Dependence
Summary
Chapter 21: Pulmonary Therapeutic Management
Oxygen Therapy
Artificial Airways
Invasive Mechanical Ventilation
Noninvasive Ventilation
Positioning Therapy
Thoracic Surgery
Pharmacology
Summary
Unit 4: Neurologic AlterationsChapter 22: Neurologic Anatomy and Physiology
Divisions of the Nervous System
Microstructure of the Nervous System
Central Nervous System
Summary
Chapter 23: Neurologic Clinical Assessment and Diagnostic Procedures
Clinical Assessment
History
Physical Examination
Diagnostic Procedures
Laboratory Studies
Multimodal Bedside Monitoring
Summary
Chapter 24: Neurologic Disorders and Therapeutic Management
Coma
Stroke
Guillain-BARRé Syndrome
Craniotomy
Intracranial Hypertension
Pharmacologic Agents
Summary
Unit V: Kidney Alterations
Chapter 25: Kidney Anatomy and Physiology
Macroscopic Anatomy
Vascular Anatomy
Microscopic Structure and Function
Nervous System InnervationUrine Formation
Functions of the Kidneys
Fluid Balance
Electrolyte Balance
Summary
Chapter 26: Kidney Clinical Assessment and Diagnostic Procedures
History
Physical Examination
Additional Assessments
Laboratory Assessment
Urine Toxicology Screen
Imaging Studies
Kidney Biopsy
Summary
Chapter 27: Kidney Disorders and Therapeutic Management
Acute Kidney Injury
Assessment and Diagnosis
At-Risk Disease States and Acute Kidney Injury
Renal Replacement Therapy: Dialysis
Summary
Unit VI: Gastrointestinal Alterations
Chapter 28: Gastrointestinal Anatomy and Physiology
Mouth
Esophagus
Stomach
Small Intestine
Large IntestineAccessory Organs
Summary
Chapter 29: Gastrointestinal Clinical Assessment and Diagnostic Procedures
Clinical Assessment
History
Physical Examination
Laboratory Studies
Diagnostic Procedures
Summary
Chapter 30: Gastrointestinal Disorders and Therapeutic Management
Acute Gastrointestinal Hemorrhage
Acute Pancreatitis
Acute Liver Failure
Gastrointestinal Surgery
Therapeutic Management
Summary
Unit VII: Endocrine Alterations
Chapter 31: Endocrine Anatomy and Physiology
Pancreas
Pituitary Gland and Hypothalamus
Thyroid Gland
Adrenal Gland
Summary
Chapter 32: Endocrine Clinical Assessment and Diagnostic Procedures
History
Pancreas
Pituitary GlandThyroid Gland
Adrenal Gland
Summary
Chapter 33: Endocrine Disorders and Therapeutic Management
Neuroendocrinology of Stress and Critical Illness
Diabetes Mellitus
Diabetic Ketoacidosis
Hyperglycemic Hyperosmolar State
Diabetes Insipidus
Syndrome of Inappropriate Secretion of Antidiuretic Hormone
Thyroid Storm
Myxedema Coma
Summary
Unit VIII: Multisystem Alterations
Chapter 34: Trauma
Mechanisms of Injury
Phases of Trauma Care
Specific Trauma Injuries
Complications of Trauma
Special Considerations
Summary
Chapter 35: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome
Shock Syndrome
Hypovolemic Shock
Cardiogenic Shock
Anaphylactic Shock
Neurogenic ShockSevere Sepsis and Septic Shock
Multiple Organ Dysfunction Syndrome
Summary
Chapter 36: Burns
Anatomy and Functions of the Skin
Pathophysiology and Etiology of Burn Injury
Classification of Burn Injury
Initial Emergency Burn Management
Special Management Considerations
Burn Nursing Diagnoses and Management
Stressors of Burn Nursing
Summary
Chapter 37: Organ Donation and Transplantation
Organ Donation
Immunology of Transplant Rejection
Heart Transplantation
Heart–Lung Transplantation
Single-Lung and Double-Lung Transplantation
Liver Transplantation
Kidney Transplantation
Pancreas Transplantation
Summary
Chapter 38: Hematologic Disorders and Oncologic Emergencies
Overview of Coagulation and Fibrinolysis
Disseminated Intravascular Coagulation
Thrombocytopenia
Heparin-Induced Thrombocytopenia
Sickle Cell AnemiaTumor Lysis Syndrome
Ane