Critical Care Nursing
Diagnosis and Management
- 10th Edition - January 17, 2025
- Imprint: Elsevier
- Editors: Linda D. Urden, Kathleen M. Stacy, Mary E. Lough, Kimberly Sanchez
- Language: English
- Paperback ISBN:9 7 8 - 0 - 4 4 3 - 1 1 5 8 1 - 3
- LooseLeaf ISBN:9 7 8 - 0 - 4 4 3 - 1 1 8 5 3 - 1
- Paperback ISBN:9 7 8 - 0 - 4 4 3 - 1 1 8 5 2 - 4
- eBook ISBN:9 7 8 - 0 - 4 4 3 - 1 1 8 5 4 - 8
**Selected for 2025 Doody’s Core Titles® in Critical Care**Winner of a Silver American Journal of Nursing Book of the Year award for its 9th edition!Prepare for the cha… Read more
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Request a sales quote**Selected for 2025 Doody’s Core Titles® in Critical Care**
Winner of a Silver American Journal of Nursing Book of the Year award for its 9th edition!
Prepare for the challenges of today’s progressive and critical care nursing environments! Critical Care Nursing: Diagnosis and Management, 10th Edition is a comprehensive guide to critical care nursing concepts as they apply to clinical assessment, diagnostic procedures, and therapeutic management. Using a logical, body systems organization, this award-winning text uses an evidence-based approach to address the care of patients with critical physiological alterations. This new edition features an emphasis on diversity, equity, and inclusion to reflect the 2021 AACN Essentials and the 2020-2030 Future of Nursing Report. It also features new disorder summary figures, Social Determinants of Health boxes, Supporting the Well-Being of Nurses boxes, Informatics boxes, and expanded resources for the Next-Generation NCLEX® Examination. Ideal for CCRN® and PCCN® exam preparation, Urden’s Critical Care Nursing helps you develop the critical thinking and clinical judgment skills required for success in progressive and critical care nursing settings.
Winner of a Silver American Journal of Nursing Book of the Year award for its 9th edition!
Prepare for the challenges of today’s progressive and critical care nursing environments! Critical Care Nursing: Diagnosis and Management, 10th Edition is a comprehensive guide to critical care nursing concepts as they apply to clinical assessment, diagnostic procedures, and therapeutic management. Using a logical, body systems organization, this award-winning text uses an evidence-based approach to address the care of patients with critical physiological alterations. This new edition features an emphasis on diversity, equity, and inclusion to reflect the 2021 AACN Essentials and the 2020-2030 Future of Nursing Report. It also features new disorder summary figures, Social Determinants of Health boxes, Supporting the Well-Being of Nurses boxes, Informatics boxes, and expanded resources for the Next-Generation NCLEX® Examination. Ideal for CCRN® and PCCN® exam preparation, Urden’s Critical Care Nursing helps you develop the critical thinking and clinical judgment skills required for success in progressive and critical care nursing settings.
- NEW! Updated content reflects the latest concepts, techniques, and technology of progressive and critical care nursing, and includes an emphasis on diversity, equity, inclusion, and overcoming health disparities, as specified in the 2021 AACN Essentials and the 2020-2030 Future of Nursing Report
- NEW! Social Determinants of Health (SDOH) boxes address specific determinants of health and offer insights into future research and policy recommendations, summarizing the impact of SDOH on critically ill patients
- NEW! Supporting the Well-Being of Nurses boxes use vignettes to introduce and illustrate a model of nursing well-being
- NEW! Informatics boxes explore the use of information and technology to communicate, manage knowledge, mitigate error, and support decision-making in nursing practice
- NEW! Disorder Summary figures in the disorders chapters make it easier to understand complex medical conditions
- Comprehensive, evidence-based content addresses all aspects of today’s progressive and critical care nursing practice, and includes references and online resources for further research and study
- Consistent organization within each body-system unit provides an efficient framework for classroom learning, for CCRN® and PCCN® certification preparation, and for reference in clinical practice
- Case studies promote critical thinking by asking you to consider a patient’s history, clinical assessment, diagnostic procedures, and diagnoses in order to solve clinical problems
- Patient care management plans incorporate the diagnosis, signs and symptoms, outcomes, and nursing interventions with rationales
- UNIQUE! Facilitating Care Transitions chapter explains how critical care nurses can ensure patient safety and provide family education through all phases and locations of care, during transitions to other units and departments within the facility, and during patient discharge to various sites (e.g., home, hospice, long-term care)
- UNIQUE! Illustrated Patient-Centered Critical Care boxes highlight the trend to patient and family involvement, with discussions of topics such as family meetings, debriefing after a code, patient diaries, creating a calm environment, pet visitation, music therapy, the transition of care, and 24/7 ICU visitation
- Pharmacologic Management tables summarize common medications used for the treatment of various disorders, along with any special considerations
- Patient and Family Education Plan boxes introduce the home care topics to teach the patient and family prior to discharge
- Expanded Building Clinical Judgment case studies are provided on the Evolve website to help you prepare for the latest nursing licensure exam
Students in undergraduate critical care nursing courses (primarily BSN and RN-to-BSN); Students in master's-level critical care nursing courses; Nurses in clinical practice being oriented to progressive and critical care units
- Title of Book
- Cover image
- Title page
- Table of Contents
- Copyright
- Dedication
- About the Authors
- Contributors
- Preface
- Organization
- Special Features
- New to This Edition
- Acknowledgments
- Unit I. Foundations of Critical Care Nursing
- 1. Critical Care Nursing Practice
- History of Critical Care
- Contemporary Critical Care
- Critical Care Nursing Roles
- Expanded-Role Nursing Positions
- Advanced Practice Nurses
- Social Determinants of Health (SDOH)
- SDOH Domains
- Disparities Among People
- Inequities Among People5,6
- SDOH Goal
- Economic Stability
- Education Access and Quality
- Health Care Access and Quality
- Neighborhood and Built Environment
- Social and Community Context
- Critical Care Professional Accountability
- Critical Care Professional Organizations
- Society of Critical Care Medicine (SCCM)
- American Association of Critical Care Nurses (AACN)
- Evidence-Based Nursing Practice
- Factors Driving EBP
- Tools to Assist Nurses With Adoption of Scientific Evidence
- Diagnosis and Patient Care Management
- Holistic Critical Care Nursing
- Caring
- Patient-Centered Care
- Cultural Care
- Complementary and Alternative Therapies
- Mindfulness
- Massage
- Animal-Assisted Intervention
- Music Therapy
- Technology in Critical Care
- New Technologies and Products
- Tele-ICU
- Interprofessional Collaborative Practice
- Interprofessional Collaborative Practice
- Rapid Response Teams (RRTs)
- Interdisciplinary Care Management Models and Tools
- Care Management
- Case Management
- Care Management Tools
- Algorithm
- Practice Guideline
- Order Set
- Managing and Tracking Outcome Variances
- Quality, Safety, and Regulatory Issues in Critical Care
- Quality and Safety Issues
- Quality and Safety Regulations
- Quality and Safety Resources
- Challenges Facing Nurses
- Compassion Fatigue
- Monitor Alert and Alarm Fatigue
- Incivility
- Bullying
- Physical
- Mental of Emotional
- Workplace Performance
- Workplace Violence (WPV)
- Risk Factors for Client-on-Worker Violence
- Supporting Health and Equity of the Nation
- Supporting the Well-Being of Nurses
- Recommendations for Registered Nurses (RNs): Incivility and Bullying
- Recommendations for Nurses: Workplace Violence
- Healthy Work Environment (HWE)
- Key Points
- 2. Ethical and Legal Issues
- Ethical Issues
- Morals Versus Ethics
- Morals, Ethics, and Ethical Problems
- Nurses, Moral Distress, and Moral Courage
- Moral Distress in Times of Crisis
- Individual Nurse’s Actions
- Virtues
- Principles of Health Care Ethics
- Ethical Principles
- Conflicting Principles, Paternalism, and Medical Futility
- Professional Nursing Ethics and the Nursing Code of Ethics
- Situational and Organizational Ethical Decision Making in Critical Care
- The Nurse’s Role in Addressing Discrimination: Protecting and Promoting Inclusive Strategies
- Frameworks for Resolving Ethical Problems
- Strategies for the Promotion of Ethical Decision Making
- Institutional Ethicists, Ethics Committees, and Ethics Consultation Services
- Ethics Rounds and Conferences
- Legal Issues
- Administrative Law: Professional Regulation
- Boards of Nursing and Nurse Practice Acts
- Functions of Boards of Nursing
- Scope of Practice
- Standards of Practice
- Nursing Practice Act
- Nursing Standards of Care
- Tort Law: Negligence and Professional Malpractice, Intentional Torts
- Tort Law
- Ordinary Negligence
- Standard 1: Assessment
- Competencies
- Standard 2: Diagnosis
- Competencies
- Standard 3: Outcomes Identification
- Competencies
- Standard 4: Planning
- Competencies
- Standard 5: Implementation
- Competencies
- Standard 6: Evaluation
- Competencies
- Professional Malpractice
- Duty
- Breach
- Harm Caused by the Breach
- Damages
- Professional Malpractice and the Nursing Process
- Assessment Failure: Failure to Assess and Analyze the Level of Care Needed by the Patient
- Assessment Failure: Failure to Assess and Clarify the Patient’s Condition
- Planning Failure: Failure to Appropriately Diagnose
- Implementation Failure: Failure to Communicate Patient Findings in a Timely Manner
- Implementation Failure: Failure to Take Appropriate Action
- Implementation Failure: Failure to Document
- Implementation Failure: Failure to Preserve Patient Privacy
- Evaluation Failure: Failure to Act as a Patient Advocate
- Wrongful Death
- Negligent Informed Consent
- Assault and Battery
- Constitutional Law: Patient Decision Making
- U.S. Constitutional Right for Self-Determination (14th Amendment)
- Patients with Decision-Making Capacity
- Patients Without Decision-Making Capacity
- Never and Not Yet Competent Patients
- Previously Competent Patients
- Advance Directives
- Futile (or Nonbeneficial) Treatment and Orders Not to Resuscitate
- Brain Death
- Legal Issues Looking Forward
- Brief Patient History
- Focused Clinical Assessment
- Diagnostic Procedures
- Questions
- Brief Patient History
- Focused Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- 3. Genetic Issues
- Genetics and Genomics
- Genetic and Genomic Structure and Function
- Chromosomes
- DNA and the Double Helix
- DNA Replication
- DNA Alphabet
- Transcription
- Translation
- Telomeres
- Genetic Variation
- Mutation
- Single Nucleotide Polymorphisms
- Alleles
- Genetic Inheritance
- Chromosome Disorders
- Single-Gene Disorders
- Complex Gene and Gene-Environment Disorders
- Mitochondrial Disorders
- Genotype and Phenotype
- Copy Number Variation
- Genetic History and Family Pedigree
- Clinical Presentation
- Genetic Evidence
- Gene-Environment Interactions
- Inheritance
- Who Should Undergo Genetic Testing?
- Direct-to-Consumer Testing?
- Homozygous Versus Heterozygous
- Modes of Inheritance
- Autosomal Dominant Inheritance
- Autosomal Recessive Inheritance
- Sex-Linked Inheritance
- Obtaining Genetics and Genomics Information
- Genetic Epidemiology and Phenotypes
- Family-Based Genetic Studies
- Genetic Association Studies
- Case-Control Studies
- Candidate Gene Studies
- Genome-Wide Association Studies
- Genome Mapping Projects
- Human Genome Project
- ENCODE Project
- Exome Sequencing Project
- Human Proteome Project
- Human Microbiome Project
- Genetic Diversity
- Diversity, Haplotype Blocks, and Linkage Disequilibrium
- Genetics in Critical Care
- Thrombosis Genetics
- Factor V Leiden and Thrombosis
- Prothrombin Gene Mutation and Thrombosis
- Cancer Genetics
- The Cancer Genome Atlas
- Cardiovascular Genetics
- Long QT Syndrome
- Familial Inherited Cardiomyopathies
- Hypertrophic Cardiomyopathy
- Dilated Cardiomyopathy
- Arrhythmogenic Right Ventricular Cardiomyopathy
- Clinical Presentation
- Genetic Evidence
- Gene-Environment Interactions
- Inheritance
- Who Should Undergo Genetic Testing?
- Pharmacogenetics
- Cytochrome P450 and Medication Metabolism
- Warfarin
- Malignant Hyperthermia
- Gene Editing—Crispr-Cas9 Technology
- Clinical Presentation
- Genetic Evidence
- Gene-Environment Interactions
- Inheritance
- Who Should Undergo Genetic Testing?
- Sickle Cell Disease CRISPR Gene Editing
- Genetics, Genomics, and Nursing
- Ethical and Legal Issues in Genetics and Genomics
- Malignant Hyperthermia
- Sickle Cell Disease
- Organizations
- Tutorials and Education
- Direct-to-Consumer Tests
- Genetic Information Nondiscrimination Act
- Human Genetics Key Terms
- Key Points
- 4. Facilitating Care Transitions
- Care Transitions
- Core Components to Any Care Transition
- Management of Complex Health Issues and Medications
- Medication Reconciliation
- Patient and Family Education
- Timing of Education
- Education Strategies and Evaluation
- Patient- and Family-Centered Education
- Health Care Team Member Accountability
- Handoff
- Continuity of Care
- Coordination of Physical Transport
- Airway
- Breathing
- Circulation
- Special Considerations During Care Transitions
- Changes in Baseline Physical and Cognitive Function
- Contact Precautions
- Droplet Precautions
- Airborne Precautions
- Older Adults
- Racial and Ethnic Disparities
- Rural Communities
- End of Life
- Models or Programs for Care Transitions
- Additional Resources
- Key Points
- Orders
- Medications
- Questions
- 5. Psychosocial and Spiritual Considerations
- Stressors in Critical Care
- Coping With Stress and Illness
- Coping Mechanisms
- Promoting Optimal Coping
- Individual Response to Stressors Depends on:
- Anxiety
- Alterations in Self-Concept
- Body Image Disturbance
- Low Self-Esteem
- Disturbed Personal Identity
- Compromised Dignity
- Enhancing Dignity
- Powerlessness
- Supporting Self-Control in Powerlessness in Critically Ill Patients
- Spiritual Responses
- Spiritual Distress
- Hopelessness
- Providing Support
- Providing Holistic Care
- Psychosocial Support
- Caring Communication
- Promoting Trust
- Communicating With Compassion
- Complementary and Alternative Therapies
- Environmental Support
- Family-Centered Care
- Visitation Policies
- Comorbid Psychiatric Disorders
- Major Depressive Disorder
- Posttraumatic Stress Disorder
- Post–Intensive Care Syndrome
- Prevention and Management of PICS
- Brief Patient History
- Focused Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- 6. Nutrition Alterations and Management
- Nutrient Metabolism
- Focused Assessment of Nutrition Status
- Diet and Pertinent Health History
- Adults Who Experience Any of the Following
- Nutritional History
- Inadequate Intake of Nutrients
- Inadequate Digestion or Absorption of Nutrients
- Increased Nutrient Losses
- Increased Nutrient Requirements
- Clinical Signs and Physical Manifestations
- Manifestations That May Indicate Protein-Calorie Malnutrition
- Manifestations Often Present in Vitamin and Mineral Deficiencies
- Manifestations Often Observed With Excessive Vitamin Intake
- Anthropometric Measurements
- Laboratory Studies
- Evaluating Nutrition Assessment Findings
- Determining Nutrition Needs
- Malnutrition
- Etiology-Based Approach in Defining Malnutrition
- Phenotypic and Etiologic Based Approach in Defining Malnutrition
- Protein-Calorie Malnutrition
- Metabolic Response to Starvation and Stress
- Gluconeogenesis
- Hypermetabolism
- Oral Intake
- Swallow Evaluation for Oral Intake
- Screening Protocols
- Instrumental Assessments
- Social Wellness—Personal
- Oral Supplementation
- Enteral and Parenteral Nutrition Support
- Enteral Nutrition
- Enteral Feeding Access
- Location and Type of Feeding Tube
- Assessment and Prevention of Feeding Tube Complications
- Formula Delivery
- Evaluating Enteral Nutritional Intake
- Preventing Tubing and Catheter Misconnections
- Parenteral Nutrition
- Types of Parenteral Nutrition
- Nursing Management of Potential Complications
- Monitoring and Evaluation of Nutrition Support
- Refeeding Syndrome
- Nutritional Considerations for Alterations in Body Systems
- Nutrition and Cardiovascular Alterations
- Myocardial Infarction
- Heart Failure
- Cardiac Cachexia
- Nutrition and Pulmonary Alterations
- Prevent or Correct Undernutrition and Underweight
- Avoid Overfeeding
- Prevent Fluid Volume Excess
- Nutrition and Neurologic Alterations
- Oral Feedings
- Tube Feedings
- Prevention of Overweight and Obesity
- Nutrition and Kidney Alterations
- Protein
- Fluid
- Energy (Calories)
- Other Nutrients
- Reducing Household Food Insecurity and Hunger
- Nutrition and Gastrointestinal Alterations
- Hepatic Failure
- Pancreatitis
- Nutrition and Endocrine Alterations
- Nutrition Support and Blood Glucose Control
- Severe Vomiting or Diarrhea in Patients With Type 1 Diabetes Mellitus
- Nutrition Education in Diabetes
- Nutrition and Surgery
- Preoperative Nutrition Optimization
- Preoperative Nutrition Preparation
- Postoperative Nutrition Interventions
- Evolution of Nutrition Science
- Additional Resources
- Brief Patient History
- Diagnostic Procedures
- Clinical Assessment
- Questions
- Key Points
- Nutrient Metabolism
- Focused Assessment of Nutrition Status
- Malnutrition
- Oral Intake
- Enteral and Nutritional Nutrition Support
- Refeeding Syndrome
- Nutritional Considerations for Alterations in Body Systems
- 7. Pain and Pain Management
- Pain
- Definition and Description of Pain
- Components of Pain
- Types of Pain
- Acute Pain
- Chronic Pain
- Nociceptive Pain
- Neuropathic Pain
- Nociplastic Pain
- Physiology of Pain
- Nociception
- Transduction
- Transmission
- Perception
- Modulation
- Biologic Stress Response
- Short-Term Direct Response
- Midterm Indirect Response
- Long-Term Indirect Response
- Communication Framework for Pain Assessment
- Pain Assessment
- Personal Component of Pain Assessment
- P: Provocative and Palliative or Aggravating Factors
- Q: Quality
- R: Region or Location, Radiation
- S: Severity and Other Symptoms
- T: Timing
- U: Understanding
- V: Values
- Observable or Objective Component of Pain Assessment
- Behavioral Pain Scale
- Critical-Care Pain Observation Tool
- Use of Cut-off Scores
- Limitations Related to the Use of Behavioral Pain Scales
- Physiologic Indicators
- Challenges to Pain Assessment and Management
- Communication
- Altered Level of Consciousness and Unconsciousness
- Older Adult Patients
- Delirious Patients
- Cultural Influences
- Opioid-Related Tolerance and Physical Dependence
- Opioid-Related Iatrogenic Withdrawal Syndrome
- Opioid Use Disorder and Opioid Misuse
- Health Organization Responsibilities in Pain Management
- Pain Management
- Pharmacologic Management of Pain
- Opioid Analgesics
- Morphine
- Fentanyl
- Hydromorphone
- Meperidine
- Codeine
- Methadone
- Remifentanil
- Sufentanil
- Preventing and Treating Opioid-Induced Respiratory Depression
- Monitoring Opioid Analgesia
- Opioid Reversal
- Nonopioid Analgesics
- Sedative With Analgesic Properties: Dexmedetomidine
- Acetaminophen
- Nonsteroidal Antiinflammatory Drugs
- Ketorolac
- Ketamine
- Lidocaine
- Anticonvulsants
- Antidepressants
- Delivery Methods
- Patient-Controlled Analgesia
- Intraspinal Pain Control
- Intrathecal Analgesia
- Epidural Analgesia
- Equianalgesia
- Nonpharmacologic Pain Management
- Physical Techniques
- Massage
- Ice Therapy
- Cognitive-Behavioral Techniques
- Deep Breathing and Relaxation
- Music
- Bundle Interventions
- Additional Resources
- Key Points
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- 8. Sedation, Agitation, and Delirium Management
- Sedation
- Sedation and Agitation Assessment Scales
- Pain Assessment Scales
- Levels of Sedation
- Pharmacologic Management of Sedation
- Benzodiazepines
- Sedative-Hypnotic Agents—Propofol
- Central Alpha Agonists—Dexmedetomidine
- Light Sedation (Minimal Sedation, Anxiolysis)
- Moderate Sedation With Analgesia (Conscious Sedation, Procedural Sedation)
- Deep Sedation and Analgesia
- General Anesthesia
- Daily Sedation Interruption
- Agitation
- Delirium
- Pharmacologic Management of Delirium
- Interventions to Prevent Delirium
- Post–Intensive Care Unit Syndrome
- Patient Diaries
- Alcohol Withdrawal Syndrome and Delirium Tremens
- Alcohol Use Screening Tools
- Pharmacologic Management of Alcohol Withdrawal
- Collaborative Management
- Additional Resources
- Brief Patient History
- Focused Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- Agitation
- Delirium
- 9. Palliative and End-of-Life Care
- End-of-Life Challenges
- Language
- Barriers
- Values
- Information
- Evidence
- End-of-Life Experience in Critical Care
- Advance Directives
- Physician Orders for Life-Sustaining Treatment
- Advance Care Planning
- Ethical and Legal Issues
- Comfort Care
- Goals
- Cardiopulmonary Resuscitation
- Effect of Do-Not-Resuscitate Orders
- Prognostication and Prognostic Tools
- Decision Making
- Communication
- Simple and Realistic Terms
- Education for Professionals
- Patients
- Families
- Strategies to Support Shared Decision Making
- Daily Rounds
- Family Meetings
- Cultural and Spiritual Influences
- Hospice Information
- Withdrawal or Withholding of Treatment
- Proactive Approach
- Futility/Nonbeneficial Care Discussions
- Steps Toward Comfort Care
- Palliative Care
- Symptom Management
- Pain
- Dyspnea
- Nausea and Vomiting
- Fever and Infection
- Edema
- Anxiety
- Delirium
- Metabolic Derangement
- Near-Death Awareness
- Withdrawal of Mechanical Ventilation
- Creation of a Support Environment
- Process of Withdrawing Life Support
- Signs of Impending Death
- Sedation During Withdrawal of Life Support
- Ventilator Settings
- Terminal Weaning Versus Extubation
- Professional Issues
- Health Care Settings
- Emotional Support for the Nurse
- Organ Donation
- Legal Issues
- Brain Death
- Family Care
- Waiting for Good News
- Families in Crisis
- Family Presence During Cardiopulmonary Resuscitation
- Visiting Hours
- After Death
- Collaborative Care
- Patient-Centered and Family-Centered Care and Decision Making: Comprehensive Ideal for End-of-Life Care
- Ethical Principles Related to Withdrawal of Life-Sustaining Treatment
- Practical Aspects of Withdrawing Life-Sustaining Treatments in Critical Care Unit
- Symptom Management in End-of-Life Care
- Considerations at Time of Death
- Research, Quality Improvement, and Education
- Additional Resources
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- Unit II. Cardiovascular Alterations
- 10. Cardiovascular Anatomy and Physiology
- Anatomy
- Major Structures of the Heart
- Size, Weight, and Layers of the Heart
- Pericardium
- Pericardial Cavity and Fluid
- Epicardium
- Myocardium
- Endocardium
- Cardiac Chambers
- Right Atrium
- Left Atrium
- Left Ventricle
- Right Ventricle
- Cardiac Valves
- Mitral and Tricuspid Atrioventricular Valves
- Papillary Muscles and Chordae Tendineae
- Aortic and Pulmonic Valves
- Conduction System
- Sinoatrial Node
- Atrioventricular Node
- Bundle of His, Bundle Branches, and Purkinje Fibers
- Coronary Blood Supply
- Right Coronary Artery
- Left Coronary Artery
- Collateral Circulation
- Coronary Veins
- Thebesian Vessels
- Major Blood Vessels
- Aorta
- Pulmonary Artery
- Pulmonary Veins
- Systemic Circulation
- Arteries
- Blood Flow and Blood Pressure
- Microcirculation
- Veins
- Microscopic Cellular Structures
- Cardiac Muscle Fibers
- Cardiac Cells
- Physiology
- Electrical Activity of the Heart
- Transmembrane Potentials
- Resting Membrane Potential
- Phases of the Action Potential
- Phase 0
- Phase 1
- Phase 2
- Phase 3
- Phase 4
- Cardiac Myocyte Conduction and Excitability
- Absolute and Relative Refractory Periods
- Mechanical Myocardial Action
- Excitation-Contraction Coupling
- Cardiac Cycle
- Atrial Systole
- Isovolumic Contraction
- Ventricular Systole
- Isovolumic Relaxation
- Ventricular Diastole
- Interplay of Heart and Blood Vessels: Cardiac Output
- Preload
- Afterload
- Contractility
- Heart Rate
- Autonomic Nervous System Control
- Baroreceptors
- Chemoreceptors
- Right Atrial Receptors
- Natriuretic Peptides
- Renin-Angiotensin-Aldosterone System
- Respiratory Influences on Heart Rate
- Control of Peripheral Systemic Circulation
- Intrinsic Control of the Systemic Circulation
- Extrinsic Control of the Systemic Circulation
- Key Points
- 11. Cardiovascular Clinical Assessment
- History
- Evaluating Chest Pain
- Physical examination
- Inspection
- Face
- Common Cardiovascular Symptoms
- Patient Lifestyle
- Cardiovascular Risk Factors
- Medical History
- Child
- Adult
- Nail Beds and Cyanosis
- Thorax
- Abdomen
- Lower Extremities
- Posture
- Weight
- Mentation
- Jugular Veins
- Abdominojugular Reflux
- Family History
- Current Medication Use
- Cardiac Studies or Interventions Completed in the Past
- Thoracic Reference Points
- Apical Impulse
- Palpation
- Arterial Pulses
- Carotid Pulses
- Brachial, Ulnar, and Radial Pulses
- Femoral Pulses
- Popliteal Pulses
- Dorsalis Pedis and Posterior Tibial Pulses
- Descending Aorta Pulse
- Capillary Refill
- Edema
- Auscultation
- Allen Test by Visual Inspection
- Allen Test with Pulse Oximetry
- Blood Pressure Measurement
- Noninvasive Blood Pressure Monitoring
- Guidelines
- Technique
- Results
- Positive Orthostasis
- Orthostatic Hypotension
- Blood Pressure Cuff Size
- Korotkoff Sounds
- Auscultatory Gap
- Pulse Pressure
- Pulsus Paradoxus
- Pulsus Alternans
- Vascular Bruits
- Normal Heart Sounds
- First and Second Heart Sounds
- Physiologic Splitting of S1 and S2
- Pathologic Splitting of S1 and S2
- Measurement With Sphygmomanometer
- Measurement by Waveform Analysis
- Abnormal Heart Sounds
- Third and Fourth Heart Sounds
- Heart Murmurs
- Mitral Stenosis Murmur
- Mitral Regurgitation Murmur
- Aortic Stenosis Murmur
- Aortic Insufficiency Murmur
- Innocent Murmurs
- Aortic Area
- Tricuspid Area
- Pulmonic Area
- Mitral Area
- Erb’s Point
- Murmurs Associated With Myocardial Infarction
- Papillary Muscle Rupture Murmur
- Ventricular Septal Rupture Murmur
- Pericardial Friction Rub
- Key Points
- 12. Cardiovascular Diagnostic Procedures
- Hemodynamic Monitoring
- Hemodynamic Monitoring Equipment
- Heparin
- Calibration of Hemodynamic Monitoring Equipment
- Zeroing the Transducer
- Midaxillary Line
- Levelling the Transducer
- Patient Position During Hemodynamic Monitoring
- Head of Bed Backrest Position
- Lateral Position
- Intraarterial Blood Pressure Monitoring
- Indications
- Catheters
- Insertion and Allen Test
- Nursing Management
- Infection
- Perfusion Pressure
- Pulse Pressure
- Noninvasive Cuff Blood Pressure
- Arterial Pressure Waveform Interpretation
- Decreased Arterial Perfusion
- Pulse Deficit
- Pulsus Paradoxus
- Pulsus Alternans
- Overdamped Waveform
- Underdamped Waveform
- Fast-Flush Square Waveform Test
- Hemodynamic Monitoring Alarms
- Invasive Hemodynamic Monitoring
- Central Venous Pressure Monitoring
- Central Venous Catheter Lumen Options
- Specialized Central Venous Catheters
- Site Selection
- Internal Jugular Vein
- Clinical Alarm Systems
- Clinical Alarm System Effectiveness
- Clinical Alarm Safety Alarm Identification
- Disabling and Silencing Alarms
- Power
- Subclavian Vein
- Femoral Vein
- Insertion of a Central Venous Catheter
- Complications
- Air Embolus
- Thrombus Formation
- Infection
- Nursing Management
- Central Venous Pressure—Volume Assessment
- Passive Leg Raise
- Removal of a CVC
- Patient Position
- Central Venous Pressure Waveform
- Cannon Waves
- Pulmonary Artery Pressure Monitoring
- Cardiac Output Determinants
- Oxygen Supply and Demand
- Preload
- Clinical Estimation of Preload
- Frank-Starling Law of the Heart
- Ejection Fraction
- Preload and Ventricular Dysfunction
- Pulmonary Artery Diastolic Pressure and Pulmonary Artery Occlusion Pressure Relationship
- Pulmonary Hypertension and PAD-PAOP
- Valvular Heart Disease and PAD-PAOP
- Mitral Regurgitation and PAD-PAOP
- Afterload
- Systemic Vascular Resistance
- Systemic Vascular Resistance and Afterload Reduction
- Pulmonary Vascular Resistance
- Contractility
- Optimizing Contractility
- Pulmonary Artery Catheters
- Right Atrial Lumen
- Pulmonary Artery Lumen
- Balloon Lumen
- Thermistor Lumen
- Additional PA Catheter Features
- Insertion of the Pulmonary Artery Catheter
- Pulmonary Artery Waveform Interpretation
- Right Atrial Waveform
- Right Ventricular Waveform
- Pulmonary Artery Waveform
- Pulmonary Artery Occlusion Waveform (Wedge)
- Medical Management
- Nursing Management
- Patient Position
- Respiratory Variation
- Positive End-Expiratory Pressure and PAOP (Wedge)
- Avoiding Complications With PA Catheters
- Pulmonary Artery Catheter Removal
- Cardiac Output Measurement With a Pulmonary Artery Catheter
- Thermodilution Cardiac Output Bolus Measurement
- Cardiac Output Curve
- Injectate Temperature
- Patient Position and Cardiac Output
- Clinical Conditions That Alter Cardiac Output
- Continuous Thermodilution Cardiac Output Measurement
- Calculated Hemodynamic Profiles Using a Pulmonary Artery Catheter
- Continuous Monitoring of Mixed Venous Oxygen Saturation and Central Venous Oxygen Saturation
- SvO2 Catheter
- ScvO2 Catheter
- SvO2 or ScvO2 Calibration
- Admission
- Analysis of Hemodynamic ProfileaaFormulas and normal values. The hemodynamic values are given in Table 12.1 and in Appendix B.ABP, Arterial blood pressure; BSA, body surface area; CI, cardiac index; CO, cardiac output; CVP, central venous pressure; HR, heart rate; LCWI, left cardiac work index; LVSW, left ventricular stroke work; LVSWI, left ventricular stroke work index; MAP, mean arterial pressure; PAD, pulmonary artery diastolic pressure; PAOP, pulmonary artery occlusion pressure; PAPM, pulmonary artery mean pressure; RCW, right cardiac work; RCWI, right cardiac work index; RVSW, right ventricular stroke work; RVSWI, right ventricular stroke work index; SI, stroke volume index; SV, stroke volume; SVR, systemic vascular resistance; SVRI, systemic vascular resistance index.
- Admission
- Analysis of the Hemodynamic Profile on AdmissionaaFormulas and normal values for the hemodynamic values are given in Table 12.1 and in Appendix B.ABP, Arterial blood pressure; BSA, body surface area; CI, cardiac index; CO, cardiac output; CVP, central venous pressure; HR, heart rate; LCWI, left cardiac work index; LVSWI, left ventricular stroke work index; MAP, mean arterial pressure; PAD, pulmonary artery diastolic pressure; PAOP, pulmonary artery occlusion pressure; PAPM, pulmonary artery mean pressure; PAS, pulmonary artery systolic pressure; RCW, right cardiac work; RCWI, right cardiac work index; SI, stroke volume index; SV, stroke volume; SVRI, systemic vascular resistance index.
- Three Hours Later
- Analysis of Hemodynamic Profile After 3 Hours
- The Next Day
- Analysis of Hemodynamic Profile the Next Day
- Nursing Management
- Normal SvO2 Values
- Normal ScvO2 Values
- SvO2 or ScvO2 and Arterial Oxygen Saturation
- SvO2 or ScvO2 and Cardiac Output
- SvO2 or ScvO2 and Hemoglobin
- SvO2 or ScvO2 and Oxygen Consumption
- Normal SvO2 or ScvO2
- Low SvO2 or ScvO2
- High SvO2
- Less-Invasive Hemodynamic Monitoring
- Arterial Waveform–Based Hemodynamic Monitoring Systems
- Noninvasive—Finger Cuff Hemodynamic Monitoring Systems
- Minimally Invasive—Pulse Wave Analysis Hemodynamic Monitoring Systems
- Invasive—Transpulmonary Thermodilution Monitoring Systems
- Visual Hemodynamic Monitoring Systens
- Transesophageal Echocardiography
- Ultrasound-Based Hemodynamic Monitoring
- Doppler-Based Hemodynamic Monitoring Methods
- Electrocardiography
- Basic Principles of Electrocardiography
- Phase 0
- Phases 1 and 2
- Phase 3
- Phase 4
- Electrocardiogram Leads
- 12-Lead Electrocardiogram Leads
- Standard Limb Leads
- Augmented Vector Leads
- Precordial Leads
- Right Ventricular Precordial Leads
- Posterior Wall Leads
- Baseline Distortion
- Electrocardiogram Analysis
- Specialized Electrocardiogram Paper
- Calibration
- ECG Waveforms
- P Wave
- QRS Complex
- T Wave
- Intervals Between Waveforms
- PR Interval
- QRS Duration
- ST Segment
- QT Interval
- QRS Axis
- Calculating the QRS Axis
- Cardiac Monitor Lead Analysis
- Lead II
- Lead V1
- Electrocardiogram Lead Selection for Optimal Bedside Monitoring
- Continuous Dysrhythmia Monitoring
- Continuous ST Segment Monitoring
- Atrial Enlargement
- Ventricular Hypertrophy
- Myocardial Ischemia and Infarction
- Electrocardiogram Changes Indicating Ischemia and Infarction
- Infarct Location by 12-Lead Electrocardiogram
- Infarction Progression on Electrocardiogram
- Intraventricular Conduction Defects
- Right and Left Bundle Branch Blocks
- Right Bundle Branch Block
- Left Bundle Branch Block
- Hemiblocks
- Bifascicular Block
- Dysrhythmia Interpretation
- Heart Rate Determination
- Rhythm Determination
- P Wave Evaluation
- PR Interval Evaluation
- QRS Complex Evaluation
- QT Interval Evaluation
- Sinus Rhythms
- Normal Sinus Rhythm
- Sinus Bradycardia
- Sinus Tachycardia
- Sinus Dysrhythmia
- Atrial Dysrhythmias
- Premature Atrial Contractions
- Supraventricular Tachycardia
- Supraventricular Tachycardia With Aberrant Conduction
- Paroxysmal Supraventricular Tachycardia
- Focal Atrial Tachycardia
- Multifocal Atrial Tachycardia
- Atrial Flutter
- Pathogenesis of Atrial Flutter
- Atrial and Ventricular Rates in Atrial Flutter
- Atrial Flutter Management
- Atrial Fibrillation
- Pathogenesis of Atrial Fibrillation
- Atrial Fibrillation Risk Factors
- Atrial Fibrillation Management
- Atrial Fibrillation Rhythm Control
- Surgical Procedures to Manage Atrial Fibrillation
- Catheter Procedures to Manage Atrial Fibrillation
- Atrial Fibrillation Rate Control
- Stroke Risk Assessment and Antithrombotic Therapy in Atrial Fibrillation
- CHADS2
- CHA2DS2-VASc
- Junctional Dysrhythmias
- Premature Junctional Contraction
- Junctional Escape Rhythm
- Junctional Tachycardia and Accelerated Junctional Rhythm
- Ventricular Dysrhythmias
- Premature Ventricular Contraction
- Compensatory Pause
- Describing Ventricular Ectopy
- Premature Ventricular Complex Timing
- Causes of Premature Ventricular Contractions
- Premature Ventricular Complex Management
- Idioventricular Rhythms
- Ventricular Tachycardia
- Ventricular Fibrillation
- Differential Diagnosis of Wide QRS Complex Tachycardia
- Significance of Wide QRS Complex Tachycardia
- Clinical Differentiation of VT from SVT
- Atrioventricular Blocks
- First-Degree Atrioventricular Block
- Second-Degree Atrioventricular Block
- Mobitz Type I
- Mobitz Type II
- 2:1 Conduction
- Third-Degree Atrioventricular Block
- Management of Atrioventricular Block
- Laboratory Tests
- Electrolytes
- Potassium
- Hyperkalemia
- Hypokalemia
- Calcium
- Hypercalcemia
- Hypocalcemia
- Magnesium
- Hypermagnesemia
- Hypomagnesemia
- High-Alert Medication Safety
- Infusion Pump Safety
- Hospital Safety
- Cardiac Biomarker Studies
- Cardiac Biomarkers in Acute Coronary Syndrome
- Troponin T and Troponin I
- Natriuretic Peptide Biomarkers in Heart Failure
- B-Type Natriuretic Peptide
- N-Terminal Fragment of Pro-B-Type Natriuretic Peptide
- Hematologic Studies
- Red Blood Cells
- White Blood Cells
- Platelets
- Blood Coagulation Studies
- Prothrombin Time
- International Normalized Ratio
- Activated Partial Thromboplastin Time
- Activated Clotting Time
- Anti-Factor Xa Assay
- Serum Lipid Studies
- Total Cholesterol
- Low-Density Lipoproteins
- Very-Low-Density Lipoproteins and Triglycerides
- High-Density Lipoproteins
- Triglycerides
- Cardiac Diagnostic Procedures
- Cardiac Catheterization and Coronary Arteriography
- Left-Heart Catheterization
- Right-Heart Catheterization
- Cardiac Catheterization Procedure
- Nursing Management
- Access Site Care
- Peripheral Pulses
- Rehydration
- Angina
- Dysrhythmias
- Patient and Family Education
- Electrophysiology Study
- EPS Procedure
- Atrial Measurements
- Ventricular Measurements
- Implantable Cardioverter Defibrillator
- Chest Radiography for the Cardiovascular System
- Tissue Densities on Radiography
- Standard Views
- Portable Chest Radiography
- Nursing Interventions to Produce an Optimal Chest Radiograph
- Chest Radiograph Indications
- Chest Radiograph Analysis: Cardiac Factors
- Heart Size
- Pulmonary Edema
- Chest Radiograph Analysis: Cardiac Lines and Tubes
- Digital Radiography
- Ambulatory Electrocardiography
- Continuous Electrocardiogram Recording Systems
- Intermittent Electrocardiogram Recording Systems
- Remote Temporary ECG Monitoring Patches
- Implantable Loop Recorder
- Smart Watch Heart Rate and Rhythm Monitors
- Stress Tests: Exercise With Electrocardiogram Monitoring
- Physiology of Exercise on the Cardiovascular System
- Stress Test Protocols
- Heart Rate Criteria in Treadmill Stress Test
- Clinical Reasons to Stop a Treadmill Test
- Signal-Averaged Electrocardiogram
- Echocardiography
- Transthoracic Echocardiography
- Transesophageal Echocardiography
- Intravascular Ultrasound
- Intracardiac Ultrasound
- Two-Dimensional and Three-Dimensional Echocardiograms
- Two-Dimensional Motion-Mode Echocardiography
- Phonocardiogram
- Color-Flow Doppler Echocardiography
- Stress Echocardiography
- Pharmacologic Stress Test
- Magnetic Resonance Imaging
- Magnetic Resonance Imaging Physics
- Metal Objects
- MRI Limitations
- Cardiac MRI
- Cardiac Computed Tomography Angiogram
- Coronary Artery Calcium Score
- Cardiac Radionuclide Imaging Studies
- Purpose of Radionuclide Scans
- Radionuclide Isotopes
- Stress Myocardial Perfusion Imaging
- Exercise Stress Myocardial Perfusion Imaging Procedure
- Pharmacologic Stress Myocardial Perfusion Imaging Procedure
- Radionuclide Test Results
- Additional Resources
- Key Points
- Hemodynamic Monitoring
- Electrocardiography
- Laboratory Tests
- Diagnostic Procedures
- 13. Cardiovascular Disorders
- Population Level Heart-Health Promotion
- Coronary Artery Disease
- Description and Etiology
- Risk Factors
- Women and Heart Disease Risk
- Heart Disease and Pregnancy
- Heart Disease and Menopause
- Prevention of Heart Disease in Women
- Mortality From Heart Disease for Women
- Nonmodifiable Risk Factors
- Modifiable Risk Factors
- Age
- Family History
- Diabetes Mellitus
- Physical Activity/Sedentary Lifestyle
- Obesity
- Fat Pattern Distribution
- High-Fat Diet
- Hyperlipidemia
- HDL (Goal >40 mg/dL for Men; >50 mg/dL for Women)
- LDL (Goal <100 mg/dL)
- Triglycerides (Ideal Goal <100 mg/dL)
- Lipoprotein(a) (Goal <30 mg/dL)
- Metabolic Syndrome
- Tobacco/Cigarette Smoking
- Hypertension
- Risk Equivalents for CAD
- Location
- Duration
- Quality
- Radiation
- Precipitating Factors
- Medication Relief
- Major Adverse Cardiac Event—Multifactorial Risk
- Chronic Coronary Disease
- Primary Versus Secondary Prevention of Coronary Artery Disease
- Pathophysiology of Coronary Artery Disease
- Vascular Inflammation
- Development of Atherosclerosis
- Atherosclerotic Plaque Rupture
- Plaque Regression
- C-Reactive Protein
- Acute Coronary Syndrome
- Description and Etiology
- Angina
- Angina Symptom Equivalents
- Women and Angina
- Stable Angina
- Unstable Angina
- Call 911
- Variant Angina
- Silent Ischemia
- Initial Pharmacologic and Lifestyle Treatment Recommendations
- Interventional and Surgical Recommendations for Stable High-Risk Patients
- Medical Management
- Nursing Management
- Recognizing Myocardial Ischemia
- Relieving Chest Pain
- Maintaining a Calm Environment
- Educating the Patient and Family
- Myocardial Infarction
- Description and Etiology
- Pathophysiology of Acute Myocardial Infarction
- Ischemia
- Injury
- Infarction
- Q Wave Myocardial Infarction
- Twelve-Lead Electrocardiogram Changes
- Myocardial Infarction Location
- Anterior Wall Infarction
- Left Lateral Wall Infarction
- Inferior Wall Infarction
- Right Ventricular Infarction
- Posterior Wall Infarction
- Non–ST Segment Elevation Myocardial Infarction
- Cardiac Biomarkers During Myocardial Infarction
- Complications of Acute Myocardial Infarction
- Sinus Bradycardia
- Sinus Tachycardia
- Atrial Dysrhythmias
- Ventricular Dysrhythmias
- Atrioventricular Heart Block During Myocardial Infarction
- Ventricular Aneurysm After Myocardial Infarction
- Ventricular Septal Rupture After Myocardial Infarction
- Papillary Muscle Rupture After Myocardial Infarction
- Cardiac Wall Rupture After Myocardial Infarction
- Pericarditis After Myocardial Infarction
- Heart Failure and Acute Myocardial Infarction
- Medical Management
- Recanalization of Coronary Arteries
- Anticoagulation
- Antiplatelet Therapy
- Dysrhythmia Prevention
- Prevention of Ventricular Remodeling
- Nursing Management
- Balance of Myocardial Oxygen Supply and Demand
- Prevention of Complications
- Depression After Myocardial Infarction
- Educating the Patient and Family
- Sudden Cardiac Death
- Description
- Prevention of Acute Coronary Syndrome
- Recommendations That Decrease Risk of Developing Non-STEMI and STEMI
- Recommendations About Emergency ACS Symptoms
- Recommendations for Prehospital EMS Paramedic First Responders
- Recommendations for Initial Emergency Clinical Management
- STEMI
- Non-STEMI
- Recommendations for Initial Emergency Physical Assessment
- Vital Signs
- Physical Assessment
- Recommendations for Emergency Diagnostics
- 12-Lead ECG
- Laboratory Studies
- Cardiac Biomarkers
- Imaging Studies
- Recommendations for Care
- Prevent Hypoxia
- Coronary Vasodilation
- Pain Control
- Anti-Platelet Therapy
- Beta-Blockers
- Angiotensin-Converting Enzyme Inhibitors
- Recommendations for Emergency Interventions for STEMI
- Fibrinolytic Medications
- PCI
- Cardiac Surgery
- Emergency CABG Surgery is Undertaken for Specific Indications in STEMI:
- Recommendations for Secondary Prevention of Complications
- Medications
- Recommendations for Management of Complications After STEMI
- Cardiogenic Shock
- Ventricular Arrhythmias
- AV Block
- Provide Relevant Education
- Medications
- Emergency Information
- Risk Factors
- Cardiac Rehabilitation
- Systems of Care
- Etiology
- Genetic SCD Risk
- Genetic cardiovascular disease accounts for 40% of SCD in young adults.
- Medical Management
- Heart Failure
- Description and Etiology
- Pathophysiology
- Assessment and Diagnosis
- Left Ventricular Failure—Signs and Symptoms
- Right Ventricular Failure—Signs and Symptoms
- Heart Failure Stages
- Left Ventricular Dysfunction—Stage C Heart Failure
- Heart Failure With a Reduced Ejection Fraction
- Heart Failure With a Mildly Reduced Ejection Fraction
- Heart Failure With Improved Ejection Fraction
- Heart Failure With a Preserved Ejection Fraction
- Left Ventricular Dysfunction—Stage D Heart Failure
- Neurohormonal Compensatory Mechanisms in Heart Failure
- Heart Failure and Sympathetic Nervous System Activation
- Heart Failure and Renin Angiotensin Aldosterone System Activation
- Heart Failure and Ventricular Hypertrophy
- Heart Failure and Prevention of Ventricular Remodeling
- Heart Failure and Atrial Dysrhythmias
- Heart Failure and Ventricular Dysrhythmias
- Heart Failure and Natriuretic Peptide Biomarkers
- Heart Failure and Pulmonary Complications
- Heart Failure and Breathlessness
- Heart Failure and Pulmonary Edema
- Pharmacologic Management in Heart Failure
- RAAS Inhibitor Medications
- Mineralocorticoid Receptor Antagonists
- Beta-Blockers
- Sodium Glucose Cotransporter-2 Inhibitors
- Diuretics
- Medical Management
- Symptom Relief
- Enhancement of Cardiac Output
- Heart Failure and Nonpharmacologic Interventions
- Heart Failure and Palliative Care
- Nursing Management
- Optimizing Cardiopulmonary Function
- Promoting Comfort and Emotional Support
- Monitoring Effects of Pharmacologic Therapy
- Nutritional Intake
- Educate the Patient and Family
- Cardiomyopathy
- Description and Etiology
- Hypertrophic Cardiomyopathy
- HCM Imaging
- HCM Genotype and Phenotype
- HCM Symptoms
- HCM Management
- Dilated Cardiomyopathy
- Ischemic Dilated Cardiomyopathy
- Familial Genetic Dilated Cardiomyopathy
- Acquired or Nonischemic Dilated Cardiomyopathy
- Idiopathic Dilated Cardiomyopathy
- Restrictive Cardiomyopathy
- Medical Management of Cardiomyopathy
- Nursing Management
- Educate the Patient and Family
- Pulmonary Hypertension
- Pulmonary Arterial Hypertension
- PAH Definition
- World Health Organization Classification of Pulmonary Hypertension
- WHO Functional Classification of Pulmonary Hypertension
- WHO Group I—Idiopathic Pulmonary Arterial Hypertension
- WHO Group I—Heritable Pulmonary Arterial Hypertension—Genetics
- WHO Group I—Pulmonary Arterial Hypertension
- WHO Group I—Pulmonary Venoocclusive Disease and Pulmonary Capillary Hemangiomatosis
- WHO Group II—Pulmonary Hypertension Caused by Left Heart Disease
- WHO Group III—Pulmonary Hypertension Due to Lung Disease and/or Hypoxia
- WHO Group IV—Pulmonary Hypertension Due to Pulmonary Artery Obstructions
- WHO Group V—Pulmonary Hypertension With Unclear and/or Multifactorial Mechanisms
- Pathophysiology of Pulmonary Hypertension
- Assessment and Diagnosis
- Physical Assessment
- Diagnostic Tests for PAH
- Vasoreactivity Test
- Exercise Tolerance Assessment
- Medical Management
- Pharmacologic Management of Pulmonary Hypertension
- Calcium Channel Blockers
- Endothelin Receptor Antagonists
- Phosphodiesterase Inhibitors and Soluble Guanylate Cyclase Stimulators
- Nitric Oxide
- Prostacyclin Analogs and Prostacyclin Receptor Agonists
- Activin Signaling Inhibitors
- Diuretics
- Supplemental Oxygen
- Acute Decompensated Right Ventricular Failure
- Nursing Management
- Educate the Patient and Family
- Endocarditis
- Description and Etiology
- Recommendations for Early Detection and Screening for Pulmonary Artery Hypertension
- Recommendations for Diagnostic Tests to Further Evaluate Pulmonary Artery Hypertension
- Recommendations for General Management of Pulmonary Artery Hypertension
- Recommendations for Medications to Treat Pulmonary Artery Hypertension
- Pathophysiology
- Assessment and Diagnosis
- Modified Duke Criteria
- Blood Cultures
- Chest Radiograph
- Echocardiogram
- Complications
- Medical Management
- Nursing Management
- Resolving the Infection
- Preventing Complications
- Educate the Patient and Family
- Valvular Heart Disease
- Description and Etiology
- Pathophysiology
- Mitral Valve Stenosis
- Mitral Valve Regurgitation
- Aortic Valve Stenosis
- Aortic Valve Regurgitation
- Tricuspid Valve Stenosis
- Tricuspid Valve Regurgitation
- Pulmonary Valve Disease
- Mixed Valvular Lesions
- Diagnosis of IE
- Endocarditis Prophylaxis is Recommended for:
- Antimicrobial Therapy
- Complications From IE
- Complications From Antibiotics
- Indications for Surgery
- Medical Management
- Nursing Management
- Cardiac Output
- Fluid Balance
- Educate the Patient and Family
- Acute Aortic Syndromes
- Description and Etiology
- Recommendations for Detection and Surveillance of Valvular Disease by Echocardiography
- Recommendations for Aortic Stenosis
- Recommendations for Aortic Regurgitation
- Recommendations for Mitral Stenosis
- Recommendations for Mitral Regurgitation
- Aortic Aneurysm
- Aortic Aneurysm Size
- Aortic Dissection
- Assessment and Diagnosis
- Medical Management
- Nursing Management
- Hypertension Management
- Pain Control
- Educate the Patient and Family
- Peripheral Artery Disease
- Description and Etiology
- Pathophysiology
- Recommendations for Prevention of Atherosclerotic Aortic Aneurysm and Dissection
- Recommendations for Treatment of Aortic Dissection
- Recommendations for Treatment of Elective Abdominal Aortic Aneurysm
- Assessment and Diagnosis
- Ankle-Brachial Index
- Intermittent Claudication
- Rest Pain
- Acute Occlusion
- Atrophic Tissue Changes
- Medical Management
- Nursing Management
- Arterial Pulses
- Skin Integrity
- Pain Control
- Educate the Patient and Family
- Carotid Artery Disease
- Description and Etiology
- Recommendations to Increase Awareness of PAD and Its Consequences
- Recommendations to Improve Identification of Patients With Symptomatic PAD
- Recommendations to Treat Risk Factors Associated With PAD
- Pathophysiology
- Medical Management
- Nursing Management
- Neurologic Assessment
- Educate the Patient and Family
- Venous Thromboembolism
- Description and Etiology
- Etiology
- Recommendations for Prevention of Carotid Artery Disease
- Recommended Medications for Carotid Artery Disease
- Recommended Interventions for Carotid Artery Disease
- Asymptomatic Patients
- Symptomatic Patients
- Assessment and Diagnosis
- Venous Ultrasound and d-Dimer
- Diagnosis of Pulmonary Embolism
- Medical Management
- Prevention of Venous Thromboembolism
- Management of Diagnosed Venous Thromboembolism
- Anticoagulation
- Nursing Management
- Activity With Deep Vein Thrombosis
- Risk of Pulmonary Embolism
- Anticoagulation
- Educate the Patient and Family
- Hypertensive Emergencies
- Description
- Etiology
- Pathophysiology
- Summary of Evidence-Based Recommendations for VTE Prevention
- Assessment and Diagnosis
- Medical Management
- Hypertensive Emergencies
- Hypertensive Urgencies
- Nursing Management
- Educate the Patient and Family
- Definition
- Recommendations
- Special Situations: Hypertension and Acute Ischemic Stroke
- Ultimate Blood Pressure Target Goal
- Additional Resources
- Key Points
- Coronary Artery Disease
- Acute Coronary Syndrome
- Myocardial Infarction
- Cardiomyopathy
- Sudden Cardiac Death
- Heart Failure
- Pulmonary Hypertension
- Endocarditis
- Valvular Heart Disease
- Atherosclerosis of the Aorta
- Peripheral Artery Disease
- Carotid Artery Disease
- Venous Thromboembolism
- Hypertensive Emergency
- 14. Cardiovascular Therapeutic Management
- Pacemakers
- Therapeutic Indications for Temporary Pacing
- Prevent Conduction Disturbances
- Overdrive Pacing
- Diagnostic Indications for Temporary Pacing
- Atrial Electrograms
- Pacemaker System
- Pacing Pulse Generator
- Pacing Lead Systems
- Pacing Routes
- Transcutaneous Cardiac Pacing
- Epicardial Pacing
- Transvenous Endocardial Pacing
- Transcutaneous
- Epicardial
- Transvenous (Endocardial)
- Five-Letter Pacemaker Codes
- Three-Letter Pacemaker Code
- Physiologic Pacing Modes
- Fixed-Rate (Asynchronous)
- Demand (Synchronous)
- Atrioventricular Sequential (Dual-Chamber)
- Pacemaker Settings
- Pacemaker Rate Control
- Pacemaker Output Control
- Pacemaker Sensitivity Control
- Pacemaker AV Interval Control
- Pacemaker Upper and Lower Rate Controls
- Pacemaker Emergency Pacing
- Pacemaker Safety Features
- Pacing Artifacts
- Pacemaker Malfunction
- Pacing Malfunction—Failure to Pace
- Pacing Malfunction—Loss of Capture
- Sensing Malfunction—Undersensing
- Sensing Malfunction—Oversensing
- Medical Management
- Nursing Management
- Prevention of Pacemaker Malfunction
- Microshock Protection
- Infection Risk
- Educate the Patient and Family
- Permanent Pacemakers
- Cardiac Implantable Electronic Devices
- Leadless Pacemakers
- Cardiac Resynchronization Therapy
- Medical Management
- Nursing Management
- Implantable Cardioverter Defibrillators
- Indications for ICD
- Prevention of Sudden Cardiac Death
- Implantable Cardioverter Defibrillator System
- Implantable Cardioverter Defibrillator Leads
- Transvenous Implantable Cardioverter Defibrillator Implant
- Subcutaneous Implantable Cardioverter Defibrillator Implant
- Medical Management
- Comprehensive Diagnostic Evaluation
- Programming the ICD
- Avoiding Inappropriate Shocks
- Nursing Management
- Educate the Patient and Family
- Fibrinolytic Therapy
- Fibrinolytic Actions
- Eligibility Criteria
- Exclusion Criteria for Fibrinolytic Therapy
- Fibrinolytic Agents
- Streptokinase
- Tissue Plasminogen Activator
- Recombinant Plasminogen Activator
- Tenecteplase
- Outcomes of Fibrinolytic Therapy
- Evidence of Reperfusion
- Pain and Reperfusion Dysrhythmias
- ST Segment Monitoring Leads
- Cardiac Biomarkers After Fibrinolytic Therapy
- Residual Coronary Artery Stenosis
- Nursing Management
- Monitoring for Bleeding
- Prevention of Bleeding
- Educate the Patient and Family
- Percutaneous Coronary Interventions
- Indications for Percutaneous Coronary Interventions
- Percutaneous Transluminal Coronary Angioplasty
- Intravascular Ultrasound
- Atherectomy
- Rotational Atherectomy
- Orbital Atherectomy
- Thrombectomy
- Embolic Protection Devices
- Coronary Stents
- Drug-Eluting Stents
- Bioresorbable Stents
- Stent Thrombosis
- Antiplatelet Therapy After Stent Deployment
- In-Stent Restenosis
- PCI Procedure
- Acute Complications After PCI
- Patient Factors
- Anatomic Factors
- Procedural Factors
- Nursing Management
- Monitoring for Angina
- Prevention of Contrast-Induced Acute Kidney Injury
- Vascular Site Care—Radial Artery
- Vascular Site Care—Femoral Artery
- Vascular Closure Devices—Femoral Artery
- Peripheral Ischemia
- Educate the Patient and Family
- Percutaneous Valve Repair
- Mitral Regurgitation—Transcatheter Repair
- Mitral Stenosis—Balloon Valvuloplasty
- Aortic Stenosis—Transcatheter Aortic Valve Implantation
- Cardiac Surgery
- Coronary Artery Bypass Graft Surgery
- Valvular Heart Surgery
- Mechanical Valves
- Biologic or Tissue Valves (Bioprostheses)
- Percutaneous
- Cardiopulmonary Bypass
- Off-Pump Coronary Artery Bypass Graft Surgery
- Nursing Postoperative Management After Coronary Artery Bypass Graft Surgery
- Cardiovascular Support
- Heart Rate Optimization
- Preload Optimization
- Afterload Optimization
- Vasodilation.
- Contractility Optimization
- Mechanical Complications
- Temperature Regulation
- Control of Bleeding
- Chest Tube Patency
- Cardiac Tamponade
- Pulmonary Care
- Neurologic Complications
- Infection
- Blood Glucose Control
- Acute Kidney Injury
- Resuscitation of Patients Who Arrest After Cardiac Surgery
- Guidelines for Coronary Artery Bypass Graft Surgery
- Educate the Patient and Family
- Minimally Invasive Cardiac Surgery
- Totally Endoscopic Coronary Artery Bypass—Robotic Assisted
- Strong Evidence to Support the Following
- Coronary Artery Bypass Graft Surgery for Patients
- Anesthetic Considerations
- Bypass Graft Conduits
- Antiplatelet Therapy
- Management of Hyperlipidemia
- Blood Glucose Management
- Dysrhythmia Management
- Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blockers
- Smoking Cessation
- Cardiac Rehabilitation
- Reduction in Risk of Infection
- Bleeding and Transfusions
- Moderate Evidence to Support the Following
- Coronary Artery Bypass Graft Surgery for Patients
- Hybrid Coronary Revascularization
- Antiplatelet Therapy
- Beta-Blockers
- Emotional Dysfunction and Psychosocial Considerations
- Carotid Artery Disease
- Infection Prevention
- Adjuncts to Myocardial Protection
- Dysrhythmia Management
- Surgical Treatment of Atrial Fibrillation
- Left Atrial Appendage Surgical Occlusion
- Percutaneous Treatment of Atrial Fibrillation
- Mechanical Circulatory Support
- Intra-Aortic Balloon Pump
- Counterpulsation Physiology in IABP
- Intra-Aortic Balloon Insertion
- Nursing Management
- Timing the IABP
- Complications With IABP
- Increased
- Decreased
- Weaning From the Intra-Aortic Balloon Pump
- Educate the Patient and Family
- Short-Term Mechanical Circulatory Support Devices
- TandemHeart—Left Atria to Aorta Assist Device
- Impella—Left Ventricle to Aorta Mechanical Assist Device
- Right Ventricular Assist Devices
- Extracorporeal Membrane Oxygenation System
- ECMO Hemodynamic Support
- ECMO Pulmonary Support
- ECMO Safety
- Long-Term Ventricular Assist Devices
- Nursing Management of a Patient With a Left Ventricular Assist Device
- Assist Device Failure
- Anticoagulation
- Infection
- Educate the Patient and Family
- Vascular Surgery
- Carotid Endarterectomy
- Symptomatic Carotid Stenosis
- Asymptomatic Carotid Stenosis
- Carotid Endarterectomy Indications
- Carotid Endarterectomy Procedure
- Postoperative Management After Carotid Endarterectomy
- Neurologic Assessment
- Bleeding
- Cardiovascular Monitoring
- Arterial Pressure Monitoring
- Carotid Stents
- Aortic Aneurysm and Dissection Repair
- Aortic Aneurysm Assessment
- Aortic Dissection Assessment
- Endovascular Stents for Abdominal Aneurysm or Dissection
- Surgical Procedure for Abdominal Aneurysm or Dissection
- Postoperative Nursing Management After Aortic Repair
- Peripheral Vascular Procedures
- Peripheral Arterial Disease Symptoms
- Lifestyle and Pharmacologic Management
- Revascularization for Peripheral Arterial Disease
- Percutaneous Interventions for Peripheral Arterial Disease
- Surgical Revascularization for Peripheral Arterial Disease
- Nursing Management Following Peripheral Vascular Procedures
- Cardiovascular Medications
- Antidysrhythmic Medications
- Class I—Sodium Channel Blockers
- Class II—Beta-Blockers
- Class III—Potassium Channel Blockers
- Class IV—Calcium Channel Blockers
- Unclassified Antidysrhythmics
- Antidysrhythmic Medication Side Effects
- Antidysrhythmic Medications and Atrial Fibrillation
- Antithrombotic Medications for Atrial Fibrillation
- Inotropic Medications
- Sympathomimetic Agents
- Dopamine
- Dobutamine
- Epinephrine
- Norepinephrine
- Isoproterenol
- Phosphodiesterase Inhibitors
- Vasopressor Medications
- Hormone Vasoactive Agents—Vasopressin and Angiotensin II
- Vasopressin
- Angiotensin II
- Vasodilator Medications
- Direct Smooth Muscle Relaxants
- Sodium Nitroprusside
- Nitroglycerin
- Hydralazine
- Calcium Channel Blockers to Manage Hypertension
- Nicardipine
- Clevidipine
- Alpha-Adrenergic Blockers
- Phentolamine
- Labetalol
- Nursing Management of Vasoactive Medications
- Vasopressor Titration Strategies
- Titration Parameters
- Vasopressor Infusions in Peripheral Catheters
- Pharmacologic Treatment of Heart Failure
- Angiotensin-Converting Enzyme Inhibitors
- Angiotensin-Receptor Blockers
- Digoxin
- Additional Resources
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical
- Questions
- Key Points
- Pacemakers
- Implantable Cardioverter Defibrillators
- Fibrinolytic Therapy
- Catheter-Based Interventions for Coronary Artery Disease
- Catheter-Based Interventions for Cardiac Valvular Disease
- Cardiac Surgery
- Mechanical Circulatory Assist Devices
- Vascular Surgery
- Effects of Cardiovascular Medications
- Unit III. Pulmonary Alterations
- 15. Pulmonary Anatomy and Physiology
- Anatomy
- Thorax
- Thoracic Cage
- Lungs
- Pleura
- Muscles of Ventilation
- Conducting Airways
- Upper Airways
- Trachea
- Bronchial Tree
- Respiratory Airways
- Respiratory Bronchioles
- Alveoli
- Pulmonary Blood and Lymph Supply
- Pulmonary Circulation
- Alveolar-Capillary Membrane
- Bronchial Circulation
- Physiologic Shunting
- Lymphatic Circulation
- Physiology
- Ventilation
- Work of Breathing
- Pulmonary Volumes and Capacities
- Regulation of Ventilation
- Respiration
- Diffusion
- Ventilation/Perfusion Relationships
- Distribution of Ventilation
- Distribution of Perfusion
- Ventilation/Perfusion Mismatch
- Gas Transport
- Oxygen Content
- Carbon Dioxide Content
- Key Points
- Anatomy
- Physiology
- 16. Pulmonary Clinical Assessment
- History
- Initial Presentation
- Common Symptoms
- Focused Physical Assessment
- Inspection
- Tongue and Sublingual Area
- Chest Wall Configuration
- Cough
- Shortness of Breath or Dyspnea on Exertion
- Chest Pain
- Medical History
- Child
- Adult
- Respiratory Effort
- Additional Assessment Areas
- Surgical
- Family History
- Current Medication Use
- Palpation
- Position of the Trachea
- Thoracic Expansion
- Tactile Fremitus
- Percussion
- Underlying Lung Structure
- Diaphragmatic Excursion
- Auscultation
- Normal Breath Sounds
- Abnormal Breath Sounds
- Voice Sounds
- Assessment Findings of Common Disorders
- Key Points
- History
- Focused Physical Assessment
- 17. Pulmonary Diagnostic Procedures
- Laboratory Studies
- Arterial Blood Gases
- Steps for Interpretation of Blood Gas Levels
- Oxygen Saturation
- Oxygen Content
- Base Excess and Base Deficit
- Classic Shunt Equation and Oxygen Tension Indices
- PaO2/FiO2 Ratio
- PaO2/PAO2 Ratio
- Alveolar–Arterial Gradient
- Dead Space Equation
- Sputum Studies
- Diagnostic Procedures
- Bronchoscopy
- Indications
- Procedural Considerations
- Complications
- Thoracentesis
- Indications
- Procedural Considerations
- Complications
- Bedside Pulmonary Function Tests
- Indications
- Static and Dynamic Compliance
- Inspiratory Muscle Strength
- Spirometry
- Ventilation/Perfusion Scanning
- Indications
- Procedure
- Results
- Chest Radiography
- Bones
- Mediastinum
- Diaphragm
- Pleural Space
- Lung Tissue
- Tubes, Wires, and Lines
- Other Diagnostic Procedures
- Nursing Management
- Bedside Monitoring
- Capnography
- Basic Principles
- Use in Critical Care
- Types
- Caution
- Inadequate Airway
- Inadequate Ventilation
- Inadequate Gas Exchange
- Pulse Oximetry
- Basic Principles
- Limitations
- Caution
- Additional Resources
- Key Points
- Laboratory Studies
- Diagnostic Procedures
- Bedside Monitoring
- 18. Pulmonary Disorders
- Acute Respiratory Failure
- Description and Etiology
- Etiology
- Pathophysiology
- Alveolar Hypoventilation
- Ventilation/Perfusion Mismatching
- Intrapulmonary Shunting
- Tissue Hypoxia
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Oxygenation
- Ventilation
- Pharmacology
- Acidosis
- Nutrition Support
- Complications
- Nursing Management
- Optimize Oxygenation and Ventilation
- Educate the Patient and Family
- Acute Respiratory Distress Syndrome
- Description and Etiology
- Etiology
- Pathophysiology
- Exudative Phase
- Proliferative Phase
- Fibrotic Phase
- Coronaviruses
- COVID-19 Clinical Features
- COVID-19 Clinical Management
- COVID-19 Environmental Management
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Ventilation
- Oxygen Therapy
- Tissue Perfusion
- Nursing Management
- Optimize Oxygenation and Ventilation
- Pneumonia
- Description and Etiology
- Severe Community-Acquired Pneumonia
- Hospital-Acquired Pneumonia
- Ventilator-Associated Pneumonia
- Pathophysiology
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Host Related
- Infection Control Related
- Treatment Related
- Medical Management
- Antibiotic Therapy
- Independent Lung Ventilation
- Nursing Management
- Optimize Oxygenation and Ventilation
- Prevent Spread of Infection
- Aspiration Pneumonitis
- Description and Etiology
- Etiology
- Hand Hygiene Guidelines
- Pathophysiology
- Acid Liquid Gastric Contents
- Nonacid Liquid Gastric Contents
- Outcome
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Nursing Management
- Optimize Oxygenation and Ventilation
- Prevent Aspiration
- Acute Pulmonary Embolism
- Description and Etiology
- Etiology
- Pathophysiology
- Increased Dead Space
- Bronchoconstriction
- Compensatory Shunting
- Hemodynamic Consequences
- Predisposing Factors
- Precipitating Conditions
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Prevention of Recurrence or Extension of the Thrombus
- Clot Dissolution
- Reversal of Pulmonary Hypertension
- Nursing Management
- Optimize Oxygenation and Ventilation
- Monitor for Bleeding
- Educate the Patient and Family
- Critical Asthma Syndrome
- Description and Etiology
- Etiology
- Pathophysiology
- Pulmonary Effects
- Cardiovascular Effects
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Bronchodilators
- Systemic Corticosteroids
- Oxygen Therapy
- Ventilation
- Nursing Management
- Optimize Oxygenation and Ventilation
- Educate the Patient and Family
- Pneumothorax
- Description and Etiology
- Etiology
- Pathophysiology
- Assessment and Diagnosis
- Assessment
- Diagnostic Procedures
- Medical Management
- Chest Tube Placement
- Chest Drainage Systems
- Nursing Management
- Optimize Oxygenation and Ventilation
- Maintain Chest Drainage System
- Long-Term Mechanical Ventilator Dependence
- Description
- Etiology and Pathophysiology
- Medical and Nursing Management
- Preweaning Stage
- Weaning Process Stage
- Weaning Outcome Stage
- Additional Resources
- Key Points
- Acute Respiratory Failure
- Acute Respiratory Distress Syndrome
- Pneumonia
- Aspiration Pneumonitis
- Pulmonary Embolism
- Critical Asthma Syndrome
- Pneumothorax
- Long-Term Mechanical Ventilation Dependence
- 19. Pulmonary Therapeutic Management
- Oxygen Therapy
- Principles of Therapy
- Indications
- Monitoring
- Methods of Delivery
- Low-Flow Systems
- Reservoir Systems
- High-Flow Systems
- Complications of Oxygen Therapy
- Oxygen Toxicity
- Carbon Dioxide Retention
- Absorption Atelectasis
- Nursing Management
- Artificial Airways
- Pharyngeal Airways
- Oropharyngeal Airway
- Nasopharyngeal Airway
- Endotracheal Tubes
- Rapid Sequence Intubation
- Complications
- Tracheostomy Tubes
- Tracheostomy Procedure
- Complications
- Nursing Management
- Humidification
- Cuff Management
- Suctioning
- Communication
- Oral Hygiene
- Extubation and Decannulation
- Indications
- Use of Mechanical Ventilators
- Types of Ventilators
- Ventilator Mechanics
- Modes of Ventilation
- Ventilator Settings
- Complications
- Ventilator-Induced Lung Injury
- Cardiovascular Compromise
- Patient-Ventilator Dyssynchrony
- Ventilator-Associated Pneumonia
- Weaning
- Readiness to Wean
- Weaning Trial
- Nursing Management
- Patient Assessment
- Symptom Management
- ABCDEF Bundle
- Ventilator Assessment
- Patient Safety
- Noninvasive Ventilation
- Nursing Management
- Positioning Therapy
- Prone Positioning
- Rotation Therapy
- Thoracic Surgery
- Preoperative Care
- Prevention of Hospital-Acquired Pressure Injury in the Prone Patient
- Surgical Considerations
- Complications and Medical Management
- Acute Respiratory Failure
- Bronchopleural Fistula
- Hemorrhage
- Cardiovascular Disturbances
- Postoperative Nursing Management
- Optimizing Oxygenation and Ventilation
- Preventing Atelectasis
- Maintaining the Chest Tube System
- Assisting the Patient to Return to Adequate Activity Level
- Pharmacology
- Bronchodilators and Adjuncts
- Neuromuscular Blocking Agents
- Peripheral Nerve Stimulator
- Additional Resources
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- Oxygen Therapy
- Artificial Airways
- Invasive Mechanical Ventilation
- Noninvasive Mechanical Ventilation
- Positioning Therapy
- Thoracic Surgery
- Pharmacology
- Unit IV. Neurologic Alterations
- 20. Neurologic Anatomy and Physiology
- Divisions of the Nervous System
- Anatomic Divisions
- Physiologic Divisions
- Microstructure of the Nervous System
- Neuroglia
- Neurons
- Cell Body
- Dendrites
- Saltatory Conduction
- Neuronal Function
- Neuronal Channels
- Action Potentials
- Neurotransmitters
- Channel Receptors
- Synaptic Termination
- Central Nervous System
- Cranial Protective Mechanisms
- Cranium
- Meninges
- Ventricular System
- Cerebrospinal Fluid
- Blood-Brain Barrier
- Cerebrum
- Function
- Frontal Lobe
- Parietal Lobe
- Temporal Lobe
- Occipital Lobe
- Limbic Lobe
- Internal Capsule
- Function
- Basal Ganglia
- Function
- Diencephalon
- Thalamus
- Hypothalamus
- Cerebellum
- Function
- Brainstem
- Midbrain
- Pons
- Medulla Oblongata
- Reticular Formation
- Arterial Circulation
- Anterior Circulation
- Posterior Circulation
- Circle of Willis
- Venous Circulation
- Spinal Cord
- Spinal Protective Mechanisms
- Vertebral Column
- Intervertebral Disks
- Meninges
- Vascular Supply
- Peripheral Nervous System
- Spinal Nerves
- Spinal Roots
- Gray and White Matter
- Cranial Nerves
- Autonomic Nervous System
- Key Points
- Anatomy
- Physiology
- 21. Neurologic Clinical Assessment and Diagnostic Procedures
- History
- Focused Physical Assessment
- Level of Consciousness
- Evaluation of Arousal
- Appraisal of Awareness
- Common Neurologic Symptoms
- Events Preceding Onset of Symptoms
- Progression of Symptoms
- Family History
- Medical History
- Child
- Adult
- Glasgow Coma Scale
- Full Outline of UnResponsiveness Score
- Surgical History
- Traumatic History
- Allergies
- Patient Profile
- Current Medication Use and Compliance
- Motor Function
- Evaluation of Muscle Size and Tone
- Estimation of Muscle Strength
- Peripheral Tactile Response
- Abnormal Motor Responses
- Evaluation of Reflexes
- Pupillary Function
- Estimation of Pupil Size and Shape
- Evaluation of Pupillary Reaction to Light
- Assessment of Eye Movement
- Respiratory Function
- Observation of Respiratory Pattern
- Evaluation of Airway Status
- Vital Signs
- Evaluation of Blood Pressure
- Observation of Heart Rate and Rhythm
- Conscious Patient
- Unconscious Patient
- Rapid Neurologic Assessment
- Neurologic Changes Associated With Intracranial Hypertension
- Laboratory Studies
- Cerebrospinal Fluid Analysis
- Contraindications
- Preprocedure Preparation
- Procedure
- Diagnostic Procedures
- Radiologic Procedures
- Skull and Spine Films
- Computed Tomography
- Magnetic Resonance Imaging
- Cerebral Angiography
- Myelography
- Cerebral Blood Flow and Metabolism Imaging
- Perfusion Computed Tomography
- Xenon Computed Tomography
- Perfusion Magnetic Resonance Imaging
- Carotid Ultrasonography
- Emission Tomography Studies
- Electrophysiology Studies
- Electroencephalography
- Evoked Potentials
- Bedside Monitoring
- Intracranial Pressure Monitoring
- Types of Intracranial Pressure Monitoring Devices
- Intracranial Pressure Waves
- Pupillometry
- Cerebral Perfusion Pressure Monitoring
- Cerebral Blood Flow Monitoring
- Transcranial Doppler
- Transcranial Color-Coded Duplex Sonography
- Thermal Diffusion Flowmetry
- Laser Doppler Flowmetry
- Cerebral Oxygenation and Metabolic Monitoring
- Partial Brain Tissue Oxygen Pressure
- Retrograde Jugular Bulb Oxygen Saturation
- Near-Infrared Spectroscopy
- Cerebral Microdialysis
- Continuous Electroencephalography Monitoring
- Additional Resources
- Key Points
- History
- Focused Physical Assessment
- Diagnostic Procedures
- Laboratory Studies
- Bedside Monitoring
- 22. Neurologic Disorders and Therapeutic Management
- Stroke
- Ischemic Stroke
- Description and Etiology
- Pathophysiology
- Assessment and Diagnosis
- Medical Management
- Subarachnoid Hemorrhage
- Description and Etiology
- Pathophysiology
- Assessment and Diagnosis
- Medical Management
- Intracerebral Hemorrhage
- Description and Etiology
- Pathophysiology
- Assessment and Diagnosis
- Medical Management
- Nursing Management
- Monitor for Changes in Neurologic and Hemodynamic Status
- Maintain Surveillance for Complications
- Educate the Patient and Family
- Coma
- Description and Etiology
- Etiology
- Pathophysiology
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Emergent Treatment
- Supportive Treatment
- Nursing Management
- Eye Care
- Coma
- Guillain-Barré Syndrome
- Description and Etiology
- Etiology
- Pathophysiology
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Plasmapheresis and Intravenous Immunoglobulin
- Nursing Management
- Maintain Surveillance for Complications
- Initiate Rehabilitation
- Facilitate Nutrition Support
- Provide Comfort and Emotional Support
- Educate the Patient and Family
- Neurosurgery
- Types of Surgery
- Preoperative Care
- Preoperative Teaching
- Psychosocial Preparation
- Surgical Considerations
- Transcranial Approach
- Transsphenoidal Approach
- Positioning
- Postoperative Medical Management
- Intracranial Hypertension
- Surgical Hemorrhage
- Fluid Imbalance
- Cerebrospinal Fluid Leak
- Deep Vein Thrombosis
- Postoperative Nursing Management
- Preserve Cerebral Perfusion
- Promote Arterial Oxygenation
- Provide Comfort and Emotional Support
- Maintain Surveillance for Complications
- Initiate Early Rehabilitation
- Educate the Patient and Family
- Before Surgery
- After Surgery
- Intracranial Hypertension
- Pathophysiology
- Volume-Pressure Curve
- Cerebral Blood Flow and Autoregulation
- Assessment and Diagnosis
- Monitoring Devices
- Medical and Nursing Management
- Positioning and Other Nursing Activities
- Hyperventilation
- Temperature Management
- Blood Pressure Management
- Seizure Management
- Cerebrospinal Fluid Drainage
- Hyperosmolar Therapy
- Management of Metabolic Demand
- Herniation Syndromes
- Supratentorial Herniation
- Infratentorial Herniation
- Pharmacologic Agents
- Additional Resources
- Key Points
- Stroke
- Ischemic Stroke
- Subarachnoid Hemorrhage
- Intracerebral Hemorrhage
- Coma
- Guillain-Barré Syndrome
- Neurosurgery
- Intracranial Hypertension
- Brief Patient History
- Presenting Complaint
- Clinical Assessment:
- Diagnostic Tests:
- Diagnosis:
- Questions:
- Unit V. Kidney Alterations
- 23. Kidney Anatomy and Physiology
- Anatomy
- Macroscopic Anatomy
- Microscopic Anatomy
- Vascular Anatomy
- Nervous System Innervation
- Physiology
- Urine Formation
- Glomerular Filtration
- Tubular Reabsorption
- Tubular Secretion
- Metabolic Waste Elimination
- Hemodynamic Regulation
- Renin-Angiotensin-Aldosterone System
- Prostaglandins
- Glomerulus
- Proximal Tubule
- Thin Descending Limb of Loop of Henle
- Thin Ascending Limb of Loop of Henle
- Thick Ascending Limb of Loop of Henle
- Distal Tubule
- Collecting Duct
- Fluid Balance
- Osmolality Gradients in the Kidney Cortex and Medulla
- Neural and Hormonal Signals Affecting Concentration and Dilution of Urine
- Electrolyte Balance
- Potassium
- Sodium
- Chloride
- Phosphate
- Calcium
- Magnesium
- Acid–Base Balance
- Other Kidney Functions
- Erythrocyte Production
- Vitamin D Activation
- Urinary Drainage
- Effects of Aging on the Anatomy and Physiology of the Kidney
- Key Points
- Anatomy
- Physiology
- 24. Kidney Clinical Assessment and Diagnostic Procedures
- History
- Focused Physical Assessment
- Fluid Volume Status
- Edema
- Skin Turgor
- Oral Mucosa
- Relevant Cardiac Assessments
- Additional Assessments
- Hemodynamic Monitoring
- Weight Monitoring
- Intake and Output Monitoring
- Laboratory Studies
- Biomarkers
- Blood Urea Nitrogen
- Creatinine
- Blood Urea Nitrogen-to-Creatinine Ratio
- Cystatin C
- Other Biomarkers
- Glomerular Filtration Rate
- Creatinine Clearance
- Additional Laboratory Studies
- Urine Studies
- Diagnostic Procedures
- Kidney Biopsy
- Key Points
- History
- Focused Physical Assessment
- Laboratory Studies
- Diagnostic Procedures
- 25. Kidney Disorders and Therapeutic Management
- Acute Kidney Injury
- Description and Etiology
- Pathophysiology
- Assessment and Diagnosis
- Medical Management
- Prevention
- Fluid Balance
- Electrolyte Balance
- Acid–Base Balance
- Causes of Hypoperfusion
- Causes of Intrinsic Kidney Damage
- Causes of Obstruction
- Nursing Management
- Hemodynamic Monitoring
- Avoid Unnecessary Use of Indwelling Urinary Catheters
- Critical Care Indications
- Perioperative Indications
- Other Indications
- Insert Urinary Catheters Using Aseptic Technique
- Hand Hygiene
- Aseptic Technique and Sterile Equipment
- Adopt Evidence-Based Standards for Maintenance of Urinary Catheters
- Maintenance of Closed Drainage System
- Catheter Securement and Hygiene
- Review Need for the Indwelling Urinary Catheter Daily and Remove Catheter Promptly
- Documentation and Monitoring
- Hospital Strategies to Ensure Early Removal of an Indwelling Urinary Catheter
- Weight Monitoring
- Intake and Output Monitoring
- Educate the Patient and Family
- Chronic Kidney Disease
- Description and Etiology
- Pathophysiology
- Assessment and Diagnosis
- Medical Management
- Blood Pressure Management
- Anemia Management
- Mineral and Bone Disorder Management
- Lipid Management
- Glycemic Management
- Nutrition Management
- Nursing Management
- Educate the Patient and Family
- Pharmacology
- Diuretics
- Electrolyte Management
- Phosphorus Management
- Sodium Management
- Renal Replacement Therapy
- Continuous Renal Replacement Therapy
- Access
- Mechanism
- Modes
- Anticoagulation
- Nursing Management
- Intermittent Hemodialysis
- Access
- Mechanism
- Medical Management
- Nursing Management
- Peritoneal Dialysis
- Nursing Management
- Additional Resources
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- Acute Kidney Injury
- Chronic Kidney Disease
- Pharmacology
- Renal Replacement Therapy
- Unit VI. Gastrointestinal Alterations
- 26. Gastrointestinal Anatomy and Physiology
- Anatomy
- Mouth
- Esophagus
- Stomach
- Small Intestine
- Large Intestine
- Accessory Organs
- Pancreas
- Gallbladder
- Liver
- Physiology
- Mechanical Digestion for Propulsion and Segmentation
- Mouth
- Esophagus
- Stomach
- Small Intestine
- Large Intestine
- Enzymatic Digestion for Absorption
- Mouth and Esophagus
- Stomach
- Small Intestine
- Large Intestine
- Effects of Aging on the Anatomy and Physiology of the Gastrointestinal System
- Key Points
- Anatomy
- Physiology
- 27. Gastrointestinal Clinical Assessment and Diagnostic Procedures
- History
- Focused Physical Assessment
- Inspection
- Observation of the Oral Cavity
- Assessment of the Skin Over the Abdomen
- Evaluation of the Shape of the Abdomen
- Auscultation
- Evaluation of Bowel Sounds
- Assessment of Bruits
- Common Gastrointestinal Symptoms
- History of Present Illness or Problem
- Past Medical and Surgical History
- Past Medication Use
- Past Gastrointestinal Studies
- Family History
- Personal and Social History
- Percussion
- Palpation
- Laboratory Studies
- Diagnostic Procedures
- Right Upper Quadrant
- Right Lower Quadrant
- Left Upper Quadrant
- Left Lower Quadrant
- Endoscopy
- Esophagogastroduodenoscopy
- Enteroscopy
- Colonoscopy and Sigmoidoscopy
- Endoscopic Retrograde Cholangiopancreatography
- Plain Abdominal Radiograph
- Abdominal Ultrasound
- Computed Tomography of the Abdomen and Pelvis
- Magnetic Resonance Imaging
- Radionuclide Imaging
- Angiography
- Liver Biopsy
- Key Points
- History
- Focused Physical Assessment
- Laboratory Studies
- Diagnostic Procedures
- 28. Gastrointestinal Disorders and Therapeutic Management
- Acute Gastrointestinal Hemorrhage
- Description and Etiology
- Nonvariceal Upper Gastrointestinal Hemorrhage
- Variceal Upper Gastrointestinal Hemorrhage
- Pathophysiology
- Assessment and Diagnosis
- Laboratory Studies
- Upper Gastrointestinal Tract
- Lower Gastrointestinal Tract
- Medical Management
- Prevention
- Hemodynamic Stability
- Bleeding Control (Nonvariceal)
- Bleeding Control (Variceal)
- Nursing Management
- Gastrointestinal Intubation
- Maintain Surveillance for Complications
- Educate the Patient and Family
- Acute Pancreatitis
- Description and Etiology
- Pathophysiology
- Assessment and Diagnosis
- Mild Severity
- Moderate Severity
- Severe Severity
- Pancreatic strictures
- Medical Management
- Fluid Resuscitation
- Nutrition Support
- Complications
- Nursing Management
- Provide Comfort and Emotional Support
- Maintain Surveillance for Complications
- Educate the Patient and Family
- Respiratory
- Cardiovascular
- Renal
- Hematologic
- Endocrine
- Neurologic
- Ophthalmic
- Dermatologic
- Gastrointestinal or Hepatic
- Acute Liver Failure
- Description and Etiology
- Pathophysiology
- Infections
- Medications or Toxins
- Hypoperfusion
- Metabolic Disorders
- Surgery
- Other Causes
- Assessment and Diagnosis
- Laboratory Studies
- Medical Management
- Complications
- Nursing Management
- Maintain Surveillance for Complications
- Educate the Patient and Family
- Other Gastrointestinal Disorders
- Pharmacology
- Additional Resources
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- Acute Gastrointestinal Hemorrhage
- Acute Pancreatitis
- Acute Liver Failure
- Other Gastrointestinal Disorders
- Pharmacology
- Prevention of Clostridioides difficile Transmission
- Unit VII. Endocrine Alterations
- 29. Endocrine Anatomy and Physiology
- Pancreas
- Anatomy
- Blood Supply
- Exocrine Cells
- Endocrine Cells
- Physiology
- Insulin
- Blood Glucose
- Glucagon
- Somatostatin
- Pancreatic Polypeptide
- Glucose Regulatory Pathways Outside of the Pancreas
- Glucose Transporters
- Incretins in the Gastrointestinal System
- Sodium Glucose Cotransporter 2 in the Kidneys
- Pituitary Gland and Hypothalamus
- Anatomy
- Hypothalamus
- Pituitary Stalk
- Pituitary Gland
- Physiology
- Antidiuretic Hormone
- Thyroid Gland
- Anatomy
- Surrounding Nerves
- Blood Supply
- Parathyroid Glands
- Physiology
- Thyroid-Stimulating Hormone
- Iodine and Iodide
- Thyroglobulin
- Triiodothyronine and Thyroxine
- Calcitonin
- Hypothalamic-Pituitary-Thyroid Axis Feedback Loop
- Adrenal Gland
- Anatomy
- Adrenal Cortex
- Adrenal Medulla
- Adrenal Blood Supply
- Physiology
- Hypothalamic-Pituitary-Adrenal Axis
- Adrenal Hormones
- Key Points
- Pancreas
- Pituitary
- Thyroid
- Adrenal
- 30. Endocrine Clinical Assessment and Diagnostic Procedures
- History
- Pancreas
- History
- Focused Physical Assessment
- Hyperglycemia
- Laboratory Studies
- Blood Glucose
- Urine Glucose
- Glycated Hemoglobin
- Blood Ketones
- Current Health Status
- Assessment of Current Illness: Onset, Characteristics, and Course
- Medical History: Questions
- Family History: Questions
- Pituitary Gland
- History
- Focused Physical Assessment
- Hydration Status
- Vital Signs
- Weight Changes and Intake and Output
- Laboratory Studies
- Serum Antidiuretic Hormone Level
- Serum and Urine Osmolality
- Antidiuretic Hormone Test
- Copeptin
- Diagnostic Procedures
- Computed Tomography
- Magnetic Resonance Imaging
- Thyroid Gland
- History
- Focused Physical Assessment
- Laboratory Studies
- Thyroid-Stimulating Hormone
- Thyroid Tests in Critically Ill Patients
- Diagnostic Procedures
- Adrenal Gland
- History
- Focused Physical Assessment
- Adrenal Cortex
- Primary Aldosteronism
- Adrenal Insufficiency
- Adrenal Crisis
- Critical Illness–Related Corticosteroid Insufficiency
- Adrenal Medulla
- Primary Cushing Syndrome
- ACTH-Dependent Cushing Syndrome
- ACTH-Independent Cushing Syndrome
- Secondary or Iatrogenic Cushing Syndrome
- Clinical Signs and Symptoms of Cushing Syndrome
- Diagnostic Procedures
- Key Points
- Pancreas
- Pituitary
- Thyroid
- Adrenal
- 31. Endocrine Disorders and Therapeutic Management
- Acute Neuroendocrine Response to Critical Illness
- Hypothalamic-Pituitary-Adrenal Axis in Critical Illness
- Hyperglycemia and Hypoglycemia in Critical Illness
- Physiologic Stress and Glucagon Release
- Physiologic Stress and GLUT Activation
- Hyperglycemia Management Challenges in Critical Illness
- Clinical Guidelines for Blood Glucose Management in Critical Illness
- Glucose Variability
- Insulin Management in Critically Ill Patients
- Frequency of Blood Glucose Monitoring
- Point-of-Care Testing for Blood Glucose in Critical Illness
- Continuous Insulin Infusion
- Glucose Closed Loop Systems
- Glycemic Instability Protocol Guidelines
- Transition From Continuous Insulin Infusion to Subcutaneous Insulin
- Corrective Insulin Coverage
- Supplemental Corrective Insulin
- Hypoglycemia Management
- Nursing Management
- Monitor Blood Glucose and Insulin Effectiveness
- Hypoglycemia Prevention
- Monitor Hyperglycemic Side Effects of Vasopressor Therapy
- Provide Nutrition
- Educate the Patient and Family
- Collaborative Management
- Strong Evidence to Support
- Diabetes Mellitus
- Diabetes Mellitus Diagnosis
- Fasting Plasma Glucose
- Glycated Hemoglobin A1c
- Type 1 Diabetes
- Management of Type 1 Diabetes
- Type 2 Diabetes
- Insulin Resistance
- Lifestyle Management for Type 2 Diabetes
- Pharmacologic Management of Type 2 Diabetes
- Metformin
- Sodium-Glucose Cotransporter-2 Inhibitors
- Glucagon-Like Peptide-1 Receptor Agonists
- Dipeptidyl Peptidase-4 Receptor Inhibitors
- Thiazolidinediones
- Sulfonylureas
- Alpha-Glucosidase Inhibitors
- Insulin in Type 2 Diabetes
- Polypharmacy in Diabetes
- Medications That Sensitize the Body to Insulin (Insulin Sensitizers)
- Medications That Stimulate the Pancreas to Make More Insulin (Insulin Secretagogues)
- Medications That Delay Carbohydrate Absorption From Small Intestine
- Medications That Augment Gut Incretin Hormone Effects
- Medications That Increase Excretion of Glucose in the Urine
- Hyperglycemic Emergencies
- Diabetic Ketoacidosis
- Insulin Deficiency
- Hyperglycemia
- Fluid Volume Deficit
- Ketoacidosis
- Acid–Base Balance
- Focused Physical Assessment in DKA
- Clinical Manifestations
- Laboratory Studies
- Medical Management
- Reversing Dehydration
- Insulin Administration
- Reversing Ketoacidosis
- Replenishing Electrolytes
- Nursing Management
- Administering Fluids, Insulin, and Electrolytes
- Monitoring Response to Therapy
- Transition to Subcutaneous Insulin
- Surveillance for Complications
- Fluid Volume Overload
- Hypoglycemia
- Hypokalemia and Hyperkalemia
- Hyponatremia
- Level of Consciousness
- Skin Care
- Oral Care
- Infection Prevention
- Educate the Patient and Family
- Collaborative Management
- Hypoglycemia Prevention and Management
- Hypoglycemia Prevention in the Hospital
- Hypoglycemia Prevention for Diabetes Type 1 and Type 2
- Clinical Signs and Symptoms of Acute Hypoglycemia
- Hypoglycemia Management
- Hyperglycemic Hyperosmolar State
- Differences Between Hyperglycemic Hyperosmolar State and Diabetic Ketoacidosis
- Acute Phase
- Predischarge
- Strong Evidence to Support
- Very Little Evidence to Support
- Pathophysiology of HHS
- Focused Physical Assessment in HHS
- Laboratory Studies in HHS
- Medical Management of HHS
- Rapid Rehydration
- Insulin Administration
- Insulin Resistance
- Electrolyte Replacement
- Nursing Management
- Administering Fluids, Insulin, and Electrolytes
- Monitoring Response to Therapy
- Surveillance for Complications
- Educate the Patient and Family
- Collaborative Management
- Hyperglycemia Definition: Blood glucose above 180 mg/dL
- Hyperglycemia Prevention
- Hyperglycemia: Clinical Signs and Symptoms
- Hyperglycemia Management
- Pituitary Gland Disorders
- Diabetes Insipidus
- Etiology
- Central Diabetes Insipidus—AVP Deficiency
- Acute Phase
- Predischarge
- Strong Evidence to Support
- Weak Evidence to Support
- Central Diabetes Insipidus
- Primary Diabetes Insipidus (Rare in Critical Care)
- Secondary Diabetes Insipidus (Most Common in Critical Care)
- Nephrogenic Diabetes Insipidus
- Dipsogenic Diabetes Insipidus
- Nephrogenic Diabetes Insipidus—AVP Resistance
- Pathophysiology of AVP Deficiency and Resistance
- Focused Physical Assessment in AVP Deficiency
- Laboratory Studies
- Serum Sodium
- Serum Osmolality
- Urine Osmolality
- Antidiuretic Hormone Measurement
- Copeptin
- Medical Management
- Volume Restoration
- Medications
- Medications Used for Central Diabetes Insipidus
- Medications Used for Nephrogenic Diabetes Insipidus
- Nursing Management
- Administration of Fluids
- Administration of Medications
- Surveillance for Complications
- Patient and Family Education
- Collaborative Management
- Acute Phase
- Predischarge
- Syndrome of Inappropriate Antidiuresis
- Etiology
- Pathophysiology
- Focused Physical Assessment of SIAD
- Laboratory Values
- Copeptin
- Medical Management
- Fluid Restriction
- Sodium Replacement
- Malignancy Associated With SIAD
- Neurological Diseases Associated With Increased Production/Release of Arginine Vasopressin (AVP)
- Neurogenic Stimuli Capable of Increasing Arginine Vasopressin (AVP)
- Pulmonary Diseases Associated With Increased Arginine Vasopressin (AVP)
- Endocrine Disturbances Associated With Increased Arginine Vasopressin (AVP)
- Medications That Mimic, Increase, Release or Potentiate Increased Arginine Vasopressin (AVP)
- Pharmacologic Management
- Vasopressin Receptor Antagonists—Vaptans
- Nursing Management
- Restriction of Fluids
- Educate the Patient and Family
- Collaborative Management
- Acute Phase
- Predischarge
- Thyroid Gland Disorders
- Thyroid Storm
- Etiology
- Pathophysiology
- Focused Physical Assessment and Diagnosis
- Laboratory Studies
- Cardiovascular Signs and Symptoms
- Activation of Beta-Adrenergic (B1) Receptors in Heart
- Central Nervous System Signs and Symptoms
- Resulting From Increased Catecholamine Response
- Gastrointestinal Signs and Symptoms
- Integumentary Signs and Symptoms
- Thermoregulatory Signs and Symptoms
- Serum and Urine Signs
- Medical Management
- Prevent Cardiovascular Collapse
- Reduce Hyperthermia
- Fluid Replacement
- Pharmacologic Management of Thyroid Storm
- Medications That Block Catecholamine Effect
- Medications That Block Thyroid Synthesis
- Medications That Block Release of Thyroid Hormone
- Adrenal Insufficiency and Thyroid Storm
- Nursing Management
- Medication Administration
- Normalize Body Temperature
- Rehydration and Correction of Metabolic Derangements
- Educate the Patient and Family
- Collaborative Management
- Acute Phase
- Predischarge
- Myxedema Coma
- Etiology
- Pathophysiology
- Skin
- Cardiopulmonary System
- Pulmonary System
- Kidneys and Fluid and Electrolyte Balance
- Nutrition and Elimination
- Thermoregulation
- Anemia
- Focused Physical Assessment and Diagnosis
- Clinical Presentation
- Laboratory Studies
- Medical Management
- Pharmacologic Management of Myxedema Coma
- Nursing Management
- Pulmonary Care
- Cardiac Concerns
- Thermoregulation
- Thyroid Replacement Therapy
- Skin Care
- Elimination
- Patient and Family Education
- Collaborative Management
- Acute Phase
- Predischarge
- Adrenal Gland Disorders
- Oversecretion of Adrenal Hormones
- Primary Cushing Syndrome
- Secondary Cushing Syndrome
- Primary Aldosteronism
- Pheochromocytoma
- Undersecretion of Adrenal Hormones
- Addison Disease
- Additional Resources
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- Stress of Critical Illness
- Pancreas: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State
- Pituitary: Diabetes Insipidus and Syndrome of Inappropriate Antidiuresis (SIAD)
- Thyroid: Thyroid Storm and Myxedema Coma
- Adrenal
- Unit VIII. Multisystem Alterations
- 32. Trauma
- Mechanism of Injury
- Blunt Trauma
- Penetrating Trauma
- Phases of Trauma Care
- Blunt Trauma
- Penetrating Trauma
- Prehospital Care
- Emergency Department
- Primary Survey
- Secondary Survey
- Critical Care Phase
- Transfer Report
- Repeat Primary and Secondary Survey
- Prevention of Hypoxemia
- Prevention of Acidosis, Hypothermia, and Coagulopathy
- Endpoints in Trauma Resuscitation
- Specific Trauma Injuries
- Traumatic Brain Injuries
- Degree of Traumatic Brain Injury
- Etiology
- Pathophysiology
- Assessment and Diagnosis
- Medical Management
- Nursing Management
- Spinal Cord Injuries
- Etiology
- Pathophysiology
- Primary Injury Mechanisms
- Secondary Injury Mechanisms
- Acute Phase
- Subacute Phase
- Chronic Phase
- Assessment and Diagnosis
- Medical Management
- Nursing Management
- Maxillofacial Injuries
- Etiology
- Pathophysiology
- Assessment and Diagnosis
- Medical Management
- Nursing Management
- Thoracic Injuries
- Etiology
- Chest Wall Injuries
- Lung Injuries
- Heart and Vascular Injuries
- Abdominal Injuries
- Pathophysiology
- Assessment and Diagnosis
- Management
- Genitourinary Injuries
- Pathophysiology
- Assessment and Diagnosis
- Diagnosis
- Management
- Musculoskeletal Injuries
- Pelvic Fractures
- Complications of Trauma
- Pain
- Venous Thromboembolism
- Acute Compartment Syndrome
- Acute Respiratory Distress Syndrome
- Hypermetabolism
- Nutritional Support
- Acute Kidney Injury
- Patient Specific
- Trauma Specific
- Rhabdomyolysis and Myoglobinuria
- Fat Embolism Syndrome
- Transfusion-Related Acute Lung Injury
- Infection
- Wound Management
- Sepsis
- Missed Injury
- Multiple Organ Dysfunction Syndrome
- Special Considerations in Trauma
- Intimate Partner Violence and Trauma
- Alcohol and Substance Abuse and Trauma
- Communication
- Assess the Patient
- Provide Information
- Follow-up
- Trauma in Pregnancy
- Modification of Standard Protocols
- Placental Abruption
- Trauma and the Older Adult
- Etiology
- Limited Physiologic Reserve
- Assessment and Diagnosis
- Modification of Standard Protocols
- Outcomes
- Discharge Planning
- Acute Illness
- Cognitive Impairment
- Neuromuscular Disorders
- Medications
- Mass Casualty Events
- Mass Shootings
- Triage
- Disaster Planning
- Meeting Needs of Family Members and Significant Others
- Family Presence During Trauma Resuscitation
- Family Participation in Care
- Trauma Support Groups
- Additional Resources
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Admission to Critical Care Unit (CCU)
- Questions
- Key Points
- Phases of Trauma Care
- Specific Trauma Injuries
- 33. Sepsis, Shock, and Multiple Organ Dysfunction Syndrome
- Sepsis
- Description and Etiology
- Pathophysiology
- Assessment and Diagnosis
- Medical Management
- Hour-1 Bundle: Initial Resuscitation
- Treatment of the Infection
- Hemodynamic Management
- Maintenance of Oxygenation and Ventilation
- Prevention of Complications
- Shock Syndrome
- Description and Etiology
- Pathophysiology
- Assessment and Diagnosis
- Medical Management
- Hemodynamic Stability
- Promote Oxygenation and Ventilation
- Identify and Treat Underlying Cause
- Prevent Complications
- Vasoconstrictors
- Vasodilators
- Inotropes
- Antidysrhythmics
- Multiple Organ Dysfunction Syndrome
- Description and Etiology
- Pathophysiology
- Assessment and Diagnosis
- Medical Management
- Nursing Management
- Patient Care Management Plans
- Cardiovascular
- Hyperdynamic
- Hypodynamic
- Pulmonary
- Neurologic
- Kidney
- Gastrointestinal
- Gallbladder
- Liver
- Endocrine and Nutrition
- Hematologic
- Prevent and Monitor for Complications
- Preventing Infection
- Monitoring Intake and Output
- Assessing Organ Perfusion
- Promote Nutrition
- Provide Comfort and Emotional Support
- Educate the Patient and Family
- Additional Resources
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Key Points
- Sepsis
- Shock Syndrome
- Multiple Organ Dysfunction Syndrome
- Nursing Management
- 34. Burns
- Anatomy and Functions of the Skin
- Epidermis
- Dermis
- Hypodermis
- Pathophysiology and Etiology of Burn Injury
- Zones of Injury
- Classification of Burn Injury
- Size of Injury
- Depth of Burn Injury
- Partial-Thickness Burns
- Full-Thickness Burns
- Types of Injury
- Thermal Burns
- Electrical Burns
- Chemical Burns
- Radiation Burns
- Location of Injury
- Patient Age and History
- Child Abuse
- Initial Emergency Burn Management
- Airway Management
- Respiratory Management
- Circulatory Management
- Pathophysiology of Burn Shock
- Kidney Management
- Gastrointestinal System Management
- Extremity Pulse Assessment
- Laboratory Assessment
- Wound Care
- Burn Center Referral
- Special Management Considerations
- Inhalation Injury
- Nonthermal Burns
- Burn Nursing Management
- Resuscitation Phase
- Oxygenation Alterations
- Fluid Resuscitation
- Tissue Perfusion
- Other Considerations in the Resuscitation Phase
- Acute Care Phase
- Physiologic Attempts to Restore Skin Integrity
- Impaired Tissue Integrity
- Definitive Burn Wound Closure
- Other Considerations in the Acute Phase
- Rehabilitation Phase
- Impaired Physical Mobility
- Scar Management
- Itching
- Age Considerations
- Interprofessional Collaborative Care
- Outpatient Burn Care
- Support of the Patient With Burns
- Stressors of Burn Nursing
- Additional Resources
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Key Points
- 35. Organ Donation and Transplantation
- Organ Donation
- Role of the Critical Care Nurse in Organ Donation
- Organ Procurement Organization as Part of the Health Care Team
- National Donation and Transplantation Laws
- Uniform Anatomical Gift Act
- Uniform Determination of Death Act
- National Organ Transplant Act
- Omnibus Budget Reconciliation Act
- Medical Examiner/Coroner State Laws
- Overview of the Donation Process
- Types of Referrals
- Death by Neurological Criteria
- Cardiac Death
- Donor Evaluation
- Brain Death
- Clinical Examination for Brain Death
- Cerebral Motor Responses
- Brainstem Reflexes
- Pupillary Reflexes
- Oculocephalic Reflex
- Oculovestibular Reflex
- Corneal and Jaw Reflexes
- Gag and Cough Reflexes
- Apnea Testing
- Confirmatory Tests
- Prerequisites
- Procedure
- Cerebral Angiography
- Electroencephalography
- Transcranial Doppler Ultrasonography
- Cerebral Scintigraphy (Technetium Tc-99m Exametazime)
- Donation After Circulatory Determination of Death
- Controlled Donation After Circulatory Determination of Death
- Uncontrolled Donation After Circulatory Determination of Death
- Outcomes in Donation After Circulatory Death
- Authorization for Donation
- Donor Management
- Donor Management Goals
- Organ Allocation
- Organ Recovery
- Tissue Donation
- Organ Donation Nursing Responsibility
- Immunology of Transplantation
- Immune System
- Cells of the Immune System
- Lymphocytes
- B Cells: Humoral Immunity
- T Cells: Cell-Mediated Immunity
- Helper T Cells
- Cytotoxic T Cells
- Graft Rejection
- Hyperacute Rejection
- Acute Rejection
- Chronic Rejection
- Immunosuppressive Medications
- Maintenance Therapy
- Corticosteroids
- Cyclosporine
- Tacrolimus
- Azathioprine
- Mycophenolate Mofetil
- Sirolimus
- Everolimus
- Belatacept
- Induction Therapy
- Antithymocyte Globulin
- Interleukin-2 Receptor Antagonists
- Alemtuzumab
- Rituximab
- Acute Rejection Treatment
- Transplant Candidate Evaluation
- Evaluation Decision
- Transplant Recipient Listing
- Waiting for Transplant
- Pretransplant Support Groups
- Financial Stress 3>
- Remaining on the Transplant List
- Vaccinations
- Available Organ
- Patient and Family Education
- Heart Transplantation
- Indications and Selection
- Heart Transplantation Surgical Procedure
- Biatrial Technique
- Bicaval Technique
- Postoperative Medical and Nursing Management
- Early Postoperative Complications
- Primary Graft Dysfunction
- Secondary Graft Dysfunction
- Signs and Symptoms of Rejection
- Rejection Surveillance
- Infection Surveillance
- Patient and Family Education
- Pulmonary Vascular Disease
- Restrictive Lung Disease
- Obstructive Lung Disease
- Long-Term Considerations
- Cardiac Graft Vasculopathy
- Pregnancy After Heart Transplant
- Long-Term Functional Status
- Heart-Lung Transplantation
- Indications and Selection
- Heart-Lung Transplant Surgical Procedure
- Donor Heart-Lung Procurement Surgery
- Recipient Heart-Lung Transplant Surgery
- Absolute Contraindications
- Relative Contraindications
- Postoperative Nursing and Medical Management after Heart-Lung Transplant
- Mechanical Ventilation
- Fluids
- Pleural Drainage
- Ischemia-Reperfusion Injury
- Rejection Surveillance
- Infection
- Immunosuppression
- Patient and Family Education
- Long-Term Considerations
- Bronchiolitis Obliterans Syndrome
- Comorbidities
- Single-Lung and Double-Lung Transplantation
- COVID-19 and Lung Transplant
- Lung Transplantation Surgical Procedures
- Single-Lung Transplant Surgical Procedure
- Double-Lung Transplantation Surgical Procedure
- Lung Volume Reduction Surgery
- Living Donor Lobar Lung Transplantation
- Postoperative Nursing and Medical Management After Lung Transplant
- Patient and Family Education
- Long-Term Considerations
- Liver Transplantation
- Indications and Selection
- Cholestatic Liver Diseases
- Chronic Hepatocellular Diseases
- Vascular Diseases
- Acute and Subacute Liver Failure
- Inborn Metabolic Disorders
- Primary Hepatic Malignancies
- Recipient Liver Transplant Evaluation
- Model for End-Stage Liver Disease
- Waitlist Placement and MELD Score
- Pediatric End-Stage Liver Disease
- Laboratory Tests
- Urine
- Stool
- Gastrointestinal Work-Up
- Pulmonary Profile
- Radiographic and Diagnostic Tests
- Optional Tests
- Pretransplantation Phase
- Hepatic Encephalopathy
- Nutritional Support
- Portal Hypertension
- Spontaneous Bacterial Peritonitis
- Determining Donor Liver Suitability
- Living Donor Lobe Liver Transplant
- Living Donor Liver Transplantation Complications
- Donor Advocate
- Postoperative Care of the Living Donor
- Liver Transplantation Surgical Procedure
- Recipient Hepatectomy
- Vascular Anastomoses With Donor Liver
- Biliary Anastomosis
- Bile Drains
- Postoperative Nursing and Medical Management
- Hemodynamic Stabilization
- Electrolyte Management
- Pulmonary Management
- Coagulopathy Management
- Neurologic Management
- Pain Management
- Blood Glucose Management
- Kidney Function
- Infection Prevention
- Nutrition Management
- Liver Function Tests
- Pulmonary Complications
- Biliary Complications
- Gastrointestinal Complications
- Vascular Complications
- Liver Graft Nonfunction
- Rejection Surveillance
- Transfer Out of Critical Care
- Patient and Family Education
- Long-Term Considerations After Liver Transplant
- Future Considerations for Liver Transplantation
- Kidney Transplantation
- Indications and Selection
- Kidney Donation
- Deceased Kidney Donation
- Living Kidney Donation
- Living Kidney Paired Donation
- Kidney Transplantation Surgical Procedure
- Living Donor Kidney Laparoscopic Nephrectomy
- Deceased Donor Kidney Transplantation
- Kidney Transplant Recipient Surgery
- Postoperative Nursing and Medical Management of the Kidney Transplant Recipient
- Fluid Status
- Electrolytes
- Postoperative Complications
- Immunosuppression
- Infection Risk
- Preparation for Discharge Home
- Patient and Family Education
- Long-Term Considerations
- Pancreas Transplantation
- Indications and Selection
- Pancreas Transplantation Surgical Procedure
- Arterial and Venous Revascularization
- Exocrine Drainage
- Enteric Exocrine Drainage
- Bladder Exocrine Drainage
- Postoperative Nursing and Medical Management
- Patient and Family Education
- Long-Term Considerations
- Additional Resources
- Donation
- Transplantation
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- Organ Donation
- The Immune System
- Immunosuppressive Medications
- Transplant Candidate Evaluation
- Heart Transplantation
- Lung Transplantation
- Liver Transplantation
- Kidney Transplantation
- Pancreas Transplantation
- 36. Hematologic and Oncologic Emergencies
- Overview of Coagulation and Fibrinolysis
- Coagulation Mechanism
- Clot Formation
- Regulatory Mechanisms
- Fibrinolysis
- Disseminated Intravascular Coagulation
- Description and Etiology
- Etiology
- Obstetric Complications
- Infections
- Neoplasms
- Massive Tissue Injury
- Miscellaneous
- Pathophysiology
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Nursing Management
- Support Vital Functions
- Initiate Bleeding Precautions
- Provide Comfort and Emotional Support
- Thrombocytopenia
- Description and Etiology
- Etiology
- Pathophysiology
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Nursing Management
- Heparin-Induced Thrombocytopenia
- Description and Etiology
- Etiology
- Pathophysiology
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Direct Thrombin Inhibitors
- Nursing Management
- Decrease Incidence of Heparin Exposure
- Maintain Surveillance for Complications
- Educate the Patient and Family
- Sickle Cell Anemia
- Description and Etiology
- Etiology
- Pathophysiology
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Prevent Infection
- Pain Management
- Transfusion Therapy
- Administration of Hydroxyurea
- Nursing Management
- Support Vital Functions
- Maintain Surveillance for Complications
- Educate the Patient and Family
- Tumor Lysis Syndrome
- Description and Etiology
- Etiology
- Pathophysiology
- Hyperuricemia
- Hyperkalemia
- Hyperphosphatemia and Hypocalcemia
- Assessment and Diagnosis
- Assessment
- Diagnosis
- Medical Management
- Adequate Hydration
- Metabolic Imbalances
- Life-Threatening Complications
- Nursing Management
- Monitor Fluid and Electrolytes
- Maintain Surveillance for Complications
- Educate the Patient and Family
- Environmental Wellness
- Hospital-Acquired Anemia
- Etiology
- Blood Conservation Strategies
- Minimizing Blood Loss
- Managing Oxygen Delivery and Consumption
- Encouraging Safer Transfusions and Alternative Agents
- Recommendation 1:
- Recommendation 2:
- Additional Resources
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- Coagulation and Fibrinolysis
- Disseminated Intravascular Coagulation
- Idiopathic Thrombocytopenia Purpura
- Heparin-Induced Thrombocytopenia
- Sickle Cell Anemia
- Tumor Lysis Syndrome
- Hospital-Acquired Anemia
- Unit IX. Special Populations
- 37. The Obstetric Patient
- Physiologic Alterations in Pregnancy
- Disorders Related to Pregnancy
- Preeclampsia and Eclampsia
- Description and Etiology
- Pathophysiology
- Medical Management
- Hemolysis, Elevated Liver Enzymes, and Low Platelet Syndrome
- Description and Etiology
- Pathophysiology
- Medical Management
- Hemorrhage
- Description and Etiology
- Pathophysiology
- Medical Management
- Amniotic Fluid Embolism
- Description and Etiology
- Pathophysiology
- Medical Management
- Venous Thromboembolism
- Description and Etiology
- Medical Management
- Disseminated Intravascular Coagulation
- Description and Etiology
- Pathophysiology
- Medical Management
- Peripartum Cardiomyopathy
- Description and Etiology
- Pathophysiology
- Medical Management
- Acute Myocardial Infarction
- Description and Etiology
- Medical Management
- Other Disorders While Pregnant
- Trauma
- Pneumonia
- Acute Respiratory Distress Syndrome
- Cardiac Arrest
- Pharmacology
- Nursing Management
- Maintain Surveillance for Complications
- Maternal Monitoring
- Fetal Monitoring
- Additional Resources
- Brief Patient History
- Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- 38. The Pediatric Patient
- Admission to the Critical Care Unit
- Cardiovascular System
- Anatomy and Physiology
- Congenital Heart Defects
- Dysrhythmias
- Bradydysrhythmias
- Tachydysrhythmias
- Shock
- Hypovolemic Shock
- Cardiogenic Shock
- Septic Shock
- Obstructive Shock
- Cardiopulmonary Arrest
- Intraosseous Access
- Cardiopulmonary Resuscitation
- Postresuscitation Management
- Pulmonary System
- Anatomy and Physiology
- Upper Airway
- Lower Airway
- Chest Mechanics
- Oxygenation and Ventilation Delivery Devices
- Airway Positioning
- Supplemental Oxygen Devices
- Manual Resuscitation Bag
- Endotracheal Intubation
- Mechanical Ventilation
- Tracheostomy
- Size
- Depth of Insertion
- Cuff Pressure
- Bronchiolitis
- Respiratory Syncytial Virus
- Pathophysiology
- Assessment
- Management
- Status Asthmaticus
- Pathophysiology
- Assessment and Diagnosis
- Management
- SARS-CoV-2
- Neurological System
- Anatomy and Physiology
- Assessment
- Responsiveness
- Motor Function
- Signs of Increased Intracranial Pressure
- Seizures
- Etiology
- Nursing Management
- Status Epilepticus
- Bacterial Meningitis
- Assessment
- Nursing Management
- Trauma
- Head Trauma
- Primary Phase
- Secondary Phase
- Classification of Head Injuries
- Management
- Gastrointestinal System
- Anatomy and Physiology
- Management
- Fluid Replacement
- Nutrition
- Pain Management
- Physiology
- Assessment
- Management of Pain
- Nonsteroidal Antiinflammatory Drugs
- Opioid Analgesics
- Topical Anesthetics
- Nonpharmacologic Management
- Opioid-Related Issues
- Psychosocial Issues of the Child and Family
- The Ill Child’s Experience of Critical Illness
- Parents’ Experience of a Child’s Critical Illness
- Additional Resources
- Brief Patient History
- Focused Physical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Key Points
- 39. The Older Adult Patient
- Critical Care and the Older Adult
- Future Trends in Older Adult Aging
- Implications for Health Care Delivery
- Older Adults in the Future Requiring Critical Care
- Older Adults With Greater Chronicity and Morbidity
- Transition to Future Models of Care to Address Changing Needs
- Established Evidence-Based Eldercare Models
- Immobility
- Frailty
- Family and Caregiver Discharge Assessment and Preparation
- Age-Related Changes of the Cardiovascular System
- Dysrhythmias
- Myocardial Infarction
- Heart Failure
- Polyvascular Disease
- Hypertension
- Medication Management
- Cardiac Medication Considerations in Older Adults
- Age-Related Changes of the Respiratory System
- Thorax Changes
- Chest Wall Compliance and Pulmonary Function Studies
- Acute Respiratory Failure
- Pneumonia
- Pulmonary Embolism
- Neurocognitive Age-Related Changes
- Delirium in the Older Adult
- Delirium Subtypes
- Pathology and Impact of Delirium
- Orthostatic Hypotension
- Cerebral Blood Flow
- Age-Related Changes of Renal System
- Aging Kidney
- Decrease in Functional Nephrons
- Dehydration and Hypertension
- Impact of Diabetes Mellitus and Heart Failure on the Older Adult
- Cardiorenal Syndrome
- Chronic Kidney Disease
- Acute Kidney Injury
- Renal Replacement Therapy
- Water Balance Syndromes
- Diabetes in Older Adults
- Diabetic Care Management
- Age-Related Changes of the Gastrointestinal System and Nutrition
- Aging Gastrointestinal Physiology Impact
- Nutritional Screening Tools
- Feeding Goals
- Age-Related Changes of the Liver
- Change in Liver Physiology and Liver Dysfunctions
- Treatment for Liver Conditions
- Hepatic Encephalopathy
- Complications of Liver Failure
- Age-Related Changes in the Immune System
- Risk of Sepsis and Sepsis Shock in the Older Adult
- Chronic Critical Illness Condition
- Age-Related Changes in the Skin and Integumentary System
- Age-Related Changes in the Musculoskeletal System
- Biological/Intrinsic
- Impaired Mobility
- Behavioral
- Social and Economic
- Environmental
- Key Points
- Brief Patient History
- Focused Clinical Assessment
- Diagnostic Procedures
- Medical Diagnosis
- Questions
- Appendixes
- Appendix A. Patient Care Management Plans
- Activity Intolerance Due to Cardiopulmonary Dysfunction
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- For Patient on Bed Rest
- For Patient on Mechanical Ventilation
- Acute Pain Due to Transmission and Perception of Cutaneous, Visceral, Muscular, or Ischemic Impulses
- Signs and Symptoms
- Subjective
- Objective
- Outcomes
- Interventions and Rationale
- Anxiety Due to Threat to Biologic, Psychological, or Social Integrity
- Signs and Symptoms
- Subjective
- Objective
- Outcomes
- Interventions and Rationale
- Autonomic Dysreflexia Due to Excessive Autonomic Response to Noxious Stimuli
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Decreased Intracranial Adaptive Capacity Due to Failure of Normal Intracranial Compensatory Mechanisms
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Delirium Due to Sensory Overload, Sensory Deprivation, and Sleep Pattern Disturbance
- Signs and Symptoms
- Early Symptoms
- Later Symptoms
- Outcomes
- Interventions and Rationale
- For Sensory Overload
- For Sensory Deprivation
- For Hallucinations
- For Delusions
- For Illusions
- Disturbed Body Image Due to Actual Change in Body Structure, Function, or Appearance
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Hyperthermia Due to Increased Metabolic Rate
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Hypervolemia Due to Increased Secretion of Antidiuretic Hormone (ADH)
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Hypothermia Due to Decreased Metabolic Rate
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Hypovolemia Due to Absolute Loss
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Adaptation Due to Situational Crisis and Personal Vulnerability
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Airway Clearance Due to Excessive Secretions or Abnormal Viscosity of Mucus
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Breathing Due to Decreased Lung Expansion
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Cardiac Output Due to Alterations in Preload
- Signs and Symptoms
- Reduced Preload
- Excessive Preload
- Outcomes
- Interventions and Rationale
- For Reduced Preload Resulting from Volume Loss
- For Reduced Preload Resulting From Venous Dilation
- For Excessive Preload Resulting From Volume Overload
- For Excessive Preload Resulting From Venous Constriction
- Signs and Symptoms
- Reduced Afterload
- Excessive Afterload
- Outcomes
- Interventions and Rationale
- For Reduced Afterload
- For Excessive Afterload
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- For Lethal Dysrhythmias or Asystole
- For Nonlethal Dysrhythmias
- For Heart Rate <60 Beats/Min
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Family Coping Due to Critically Ill Family Member
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Gas Exchange Due to Alveolar Hypoventilation
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Health Maintenance Due to Cognitive or Perceptual Learning Limitations
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Nutritional Intake Due to Lack of Exogenous Nutrients and Increased Metabolic Demand
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Peripheral Tissue Perfusion Due to Decreased Blood Flow
- Sign and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Sleep Due to Fragmented Sleep
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Spiritual Status Due to Change in Health Status That Alters Ability to Experience Meaning in Life Through Self-Expression
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Swallowing Due to Neuromuscular Impairment, Fatigue, and Limited Awareness
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Impaired Ventilatory Weaning Due to Physical, Psychosocial, or Situational Factors
- Signs and Symptoms
- Mild Impairment
- Moderate Impairment
- Severe Impairment
- Outcomes
- Interventions and Rationale
- Impaired Verbal Communication Due to Cerebral Speech Center Injury
- Signs and Symptoms
- Outcome
- Interventions and Rationale
- Ineffective Tissue Perfusion Due to Decreased Cerebral Blood Flow
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- For Ischemia
- For Hemorrhage
- Signs and Symptoms
- Outcomes
- Interventions and Rationales
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Lack of Knowledge of Treatment Regime Due to Lack of Previous Exposure to Information
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Powerlessness Due to Lack of Control Over Current Situation or Disease Progression
- Signs and Symptoms
- Severe
- Moderate
- Low
- Outcomes
- Interventions and Rationale
- Relocation Stress Due to Transfer Out of the Critical Care Unit
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Risk Factors
- Outcomes
- Interventions and Rationale
- Risk Factors
- Outcomes
- Interventions and Rationale
- Situational Low Self-Esteem Due to Feelings of Guilt About Physical Deterioration
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Stress Overload Due to Critical Illness and Stressors of the Critical Care Environment
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Unilateral Neglect Due to Perceptual Disruption
- Signs and Symptoms
- Outcomes
- Interventions and Rationale
- Appendix B. Physiologic Formulas for Critical Care
- Hemodynamic Equations
- Mean (Systemic) Arterial Pressure (MAP)
- Systemic Vascular Resistance (SVR)
- Systemic Vascular Resistance Index (SVRI)
- Pulmonary Vascular Resistance (PVR)
- Pulmonary Vascular Resistance Index (PVRI)
- Left Cardiac Work Index (LCWI)
- Left Ventricular Stroke Work Index (LVSWI)
- Right Cardiac Work Index (RCWI)
- Right Ventricular Stroke Work Index (RVSWI)
- Corrected Q–T Interval (Q–Tc)
- Body Surface Area (BSA)
- Pulmonary Formulas
- Shunt Equation (Qs/Qt)
- Pulmonary Capillary Oxygen Content (CcO2)
- Arterial Oxygen Content (CaO2)
- Alveolar Pressure of Oxygen (PAO2)
- Arterial/Inspired Oxygen Ratio
- Arterial/Alveolar Oxygen Ratio
- Alveolar-Arterial Gradient
- Dead Space Equation (Vd/Vt)
- Static Compliance (CST)
- Dynamic Compliance (CDY)
- Neurologic Formulas
- Cerebral Perfusion Pressure (CPP)
- Arteriojugular Oxygen Difference (Ajdo2)
- Endocrine Formulas
- Serum Osmolality
- Fluid Volume Deficit in Liters
- Kidney Formulas
- Anion Gap
- Clearance
- Nutritional Formulas
- Body Mass Index (BMI)
- Caloric and Protein Needs
- Estimating Caloric Needs
- Estimating Protein Needs
- Appendix C. Canadian Laboratory Values∗
- Index
- SPECIAL FEATURES
- IBC
- Patient-Centered Care
- Patient-Centered Critical Care
- Patient and Family Education Plans
- Pharmacologic Management
- Safety
- Social Determinants of Health
- Summary of Key Concepts
- Supporting Nurse Well-being
- Teamwork and Collaboration
- Edition: 10
- Published: January 17, 2025
- Imprint: Elsevier
- Language: English
- Paperback ISBN: 9780443115813
- LooseLeaf ISBN: 9780443118531
- Paperback ISBN: 9780443118524
- eBook ISBN: 9780443118548
LU
Linda D. Urden
Professor Emeritus Linda D. Urden works at the Hahn School of Nursing and Health Science and Beyster Institute for Nursing Research, University of San Diego in San Diego, California.
Affiliations and expertise
Professor Emeritus, Hahn School of Nursing and Health Science, University of San Diego, San Diego, CaliforniaKS
Kathleen M. Stacy
Critical Care Clinical Nurse Specialist, Clinical Professor Kathleen M. Stacy works at the Hahn School of Nursing and Health Science, University of San Diego, San Diego, California.
Affiliations and expertise
Critical Care Clinical Nurse Specialist, Clinical Professor, Hahn School of Nursing and Health Science, University of San Diego, San Diego, CaliforniaML
Mary E. Lough
Nurse Scientist, Critical Care Clinical Nurse Specialist Mary E. Lough works at Stanford Health Care; Clinical Assistant Professor, Stanford University, Stanford, California.
Affiliations and expertise
Implementation Scientist, Clinical Nurse, Specialist, Center for Professional Practice, Stanford Health Care, Stanford, California; Clinical Associate Professor, Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, California; Clinical Professor, Department of Physiological Nursing, University of California at San Francisco, San Francisco, CaliforniaKS
Kimberly Sanchez
Nurse Scientist, Clinical Nurse Specialist
Kimberly Sanchez works at the Keck Medical Center of USC, Los Angeles, California.
Affiliations and expertise
Nurse Scientist, Clinical Nurse Specialist, Nursing, Keck Medical Center of USC, Los Angeles, California