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Euglycemic Diabetic Ketoacidosis Associated With SGLT2 Inhibitor Therapy: A Case Report. 与SGLT2抑制剂治疗相关的糖尿病酮症酸中毒1例报告。
IF 2.2
AACN Advanced Critical Care Pub Date : 2023-03-15 DOI: 10.4037/aacnacc2023830
Gwen Klinkner, Maggie Steingraber-Pharr
{"title":"Euglycemic Diabetic Ketoacidosis Associated With SGLT2 Inhibitor Therapy: A Case Report.","authors":"Gwen Klinkner,&nbsp;Maggie Steingraber-Pharr","doi":"10.4037/aacnacc2023830","DOIUrl":"https://doi.org/10.4037/aacnacc2023830","url":null,"abstract":"<p><p>Sodium-glucose cotransporter-2 inhibitors are now considered second-line treatment agents for type 2 diabetes and offer a unique treatment approach with added cardiorenal benefits. Drugs in this class increase the risk of euglycemic diabetic ketoacidosis, which may be difficult to diagnose if clinicians are not aware of the risk factors and subtle symptoms. This article describes a case of euglycemic diabetic ketoacidosis in a patient with coronary artery disease who was taking a sodium-glucose cotransporter-2 inhibitor and experienced acute mental status changes immediately after heart catheterization.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 1","pages":"27-32"},"PeriodicalIF":2.2,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Update of Antiepileptic Drug Dosing and Administration. 抗癫痫药物给药和给药的最新进展。
IF 2.2
AACN Advanced Critical Care Pub Date : 2023-03-15 DOI: 10.4037/aacnacc2023161
Gabriela Saavedra, Robert M Woods, Kyle A Hultz
{"title":"Update of Antiepileptic Drug Dosing and Administration.","authors":"Gabriela Saavedra,&nbsp;Robert M Woods,&nbsp;Kyle A Hultz","doi":"10.4037/aacnacc2023161","DOIUrl":"https://doi.org/10.4037/aacnacc2023161","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 1","pages":"5-10"},"PeriodicalIF":2.2,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9078666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diabetes Case Reports. 糖尿病病例报告。
IF 2.2
AACN Advanced Critical Care Pub Date : 2023-03-15 DOI: 10.4037/aacnacc2023400
Mary Fran Tracy
{"title":"Diabetes Case Reports.","authors":"Mary Fran Tracy","doi":"10.4037/aacnacc2023400","DOIUrl":"https://doi.org/10.4037/aacnacc2023400","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 1","pages":"25-26"},"PeriodicalIF":2.2,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9078668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diabetes-Related Gastroparesis in the Acute Care Setting: A Case Report. 急性护理环境中的糖尿病相关胃轻瘫:一例报告。
IF 2.2
AACN Advanced Critical Care Pub Date : 2023-03-15 DOI: 10.4037/aacnacc2023730
Kristine Batty, Patricia Pugh, Alyson Schwartzbauer, Tricia Carvalho, Andrew P Demidowich
{"title":"Diabetes-Related Gastroparesis in the Acute Care Setting: A Case Report.","authors":"Kristine Batty,&nbsp;Patricia Pugh,&nbsp;Alyson Schwartzbauer,&nbsp;Tricia Carvalho,&nbsp;Andrew P Demidowich","doi":"10.4037/aacnacc2023730","DOIUrl":"https://doi.org/10.4037/aacnacc2023730","url":null,"abstract":"<p><p>Diabetes-related gastroparesis is a challenging complication of diabetes that often results in flares of intractable vomiting and recurrent hospitalizations. Currently, there is no standard of care or guidelines for the management of diabetes-related gastroparesis in the acute care setting, leading to inconsistent and suboptimal care for these patients. Consequently, patients with diabetes-related gastroparesis may have prolonged inpatient lengths of stay and frequent readmissions affecting their overall health and well-being. Successful management of diabetes-related gastroparesis requires a coordinated multimodal approach to address the different components of an acute flare, including nausea and vomiting, pain, constipation, nutrition, and dysglycemia. This case report demonstrates how the development and implementation of an acute care diabetes-related gastroparesis treatment protocol demonstrates efficacy and promise for better quality of care for this population.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 1","pages":"47-52"},"PeriodicalIF":2.2,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Modifying Type of Insulin to Manage Steroid-Induced Hyperglycemia: A Case Report. 改变胰岛素类型以控制类固醇诱导的高血糖:1例报告。
IF 2.2
AACN Advanced Critical Care Pub Date : 2023-03-15 DOI: 10.4037/aacnacc2023222
Faith M Pollock
{"title":"Modifying Type of Insulin to Manage Steroid-Induced Hyperglycemia: A Case Report.","authors":"Faith M Pollock","doi":"10.4037/aacnacc2023222","DOIUrl":"https://doi.org/10.4037/aacnacc2023222","url":null,"abstract":"<p><p>Steroid-induced hyperglycemia was diagnosed in an older hospitalized patient after he was treated with the intermediate-acting glucocorticoid methylprednisolone. Before hospital admission, the patient did not have a diagnosis of diabetes. His elevated admission glucose level of 167 mg/dL along with his significant hyperglycemia after glucocorticoid initiation prompted the medical team to obtain a hemoglobin A1c result, 8.4%, which confirmed the diagnosis of type 2 diabetes. The capillary blood glucose level was elevated into the 200 to 399 mg/dL range for most of the patient's hospital stay while he was receiving subcutaneous insulin therapy of glargine and aspart correction and prandial bolus dosing. When the patient's subcutaneous insulin therapy was changed from glargine to neutral protamine Hagedorn insulin, the target glucose level range of 140 to 180 mg/dL was attained. From this case report, we determined that it is important to consider modifying subcutaneous insulin therapy by using another type of insulin when target glucose values are not achieved during the treatment of steroid-induced hyperglycemia.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 1","pages":"39-46"},"PeriodicalIF":2.2,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Practice Integration as an Effective Educational Strategy. 实践整合是有效的教育策略。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-12-15 DOI: 10.4037/aacnacc2022171
Kathrine Anne Winnie, Kimberly Sanchez, Elizabeth Winfrey, Amber Furlow, Lani Thong, Christopher Mitchell, Jennifer Cannon
{"title":"Practice Integration as an Effective Educational Strategy.","authors":"Kathrine Anne Winnie,&nbsp;Kimberly Sanchez,&nbsp;Elizabeth Winfrey,&nbsp;Amber Furlow,&nbsp;Lani Thong,&nbsp;Christopher Mitchell,&nbsp;Jennifer Cannon","doi":"10.4037/aacnacc2022171","DOIUrl":"https://doi.org/10.4037/aacnacc2022171","url":null,"abstract":"Bundles are composed of individually established practices supported by research that, when combined, structure patient care. Implementing bundles improves patient outcomes. The ABCDEF initiative is an example of a bundled approach that improves outcomes of critically ill patients that are related to the likelihood of hospital death within 7 days, delirium and coma days, physical restraint use, intensive care unit readmission, and discharge disposition, with outcomes being proportional to the number of appropriate components performed. The purpose of this quality improvement project was to implement practice integration as an educational strategy to increase nursing knowledge of complex topics and, specifically, components of the ABCDEF bundle. Nurses' knowledge of all the BDE components of the ABCDEF bundle increased after implementing practice integration. Findings from this project support the use of resources to implement practice integration as an educational strategy for comprehensive concepts, specifically the BDE components of the ABCDEF bundle.","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 4","pages":"319-328"},"PeriodicalIF":2.2,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10694011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Messenger RNA Technology. 信使RNA技术。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-12-15 DOI: 10.4037/aacnacc2022615
Linda Harrington
{"title":"Messenger RNA Technology.","authors":"Linda Harrington","doi":"10.4037/aacnacc2022615","DOIUrl":"https://doi.org/10.4037/aacnacc2022615","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 4","pages":"308-311"},"PeriodicalIF":2.2,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10352764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementing Standardized Post-Intensive Care Syndrome Education by an Advanced Practice Registered Nurse in the Pediatric Intensive Care Unit. 儿科重症监护室高级执业注册护士实施标准化重症监护后综合征教育。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-12-15 DOI: 10.4037/aacnacc2022911
Abigayle L Alger, Tonie Owens, Elizabeth A Duffy
{"title":"Implementing Standardized Post-Intensive Care Syndrome Education by an Advanced Practice Registered Nurse in the Pediatric Intensive Care Unit.","authors":"Abigayle L Alger,&nbsp;Tonie Owens,&nbsp;Elizabeth A Duffy","doi":"10.4037/aacnacc2022911","DOIUrl":"https://doi.org/10.4037/aacnacc2022911","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 4","pages":"368-371"},"PeriodicalIF":2.2,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10352766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reducing Tracheostomy Medical Device-Related Pressure Injury: A Quality Improvement Project. 减少气管切开术医疗器械相关压力损伤:一个质量改进项目。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-12-15 DOI: 10.4037/aacnacc2022874
Hazel Holder, Brittany Ray Gannon
{"title":"Reducing Tracheostomy Medical Device-Related Pressure Injury: A Quality Improvement Project.","authors":"Hazel Holder,&nbsp;Brittany Ray Gannon","doi":"10.4037/aacnacc2022874","DOIUrl":"https://doi.org/10.4037/aacnacc2022874","url":null,"abstract":"<p><strong>Objective: </strong>To reduce the incidence of medical device-related pressure injuries associated with tracheostomies performed with the percutaneous dilation technique using a standardized multidisciplinary intervention.</p><p><strong>Methods: </strong>The intervention was developed using the Agency for Healthcare Research and Quality Preventing Pressure Injuries Toolkit. A fenestrated polyurethane foam dressing was sutured in place under the tracheostomy flange during insertion to reduce the risk of medical device-related pressure injuries. The sutures were removed in pairs over a period of 7 to 10 days.</p><p><strong>Results: </strong>Comparison of data from 2018 to 2021 demonstrated a decrease in the incidence of tracheostomy medical device-related pressure injuries from 13% to 0% in the first year, which was maintained for the following 3 years. This improvement was supported by electronic medical record audits, daily interdisciplinary rounds, weekly practice assessments, and primary nurse evaluations.</p><p><strong>Conclusion: </strong>Implementation of a standardized process, supported by an interdisciplinary clinical team, can reduce medical device-related pressure injuries among patients undergoing percutaneous dilation tracheostomy.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 4","pages":"329-335"},"PeriodicalIF":2.2,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10605024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Role of the Advanced Practice Registered Nurse in Crisis Response. 高级执业注册护士在危机应对中的作用。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-12-15 DOI: 10.4037/aacnacc2022710
Kiersten Henry, Alison Wogatske
{"title":"Role of the Advanced Practice Registered Nurse in Crisis Response.","authors":"Kiersten Henry,&nbsp;Alison Wogatske","doi":"10.4037/aacnacc2022710","DOIUrl":"https://doi.org/10.4037/aacnacc2022710","url":null,"abstract":"<p><p>As clinical leaders, advanced practice registered nurses are often called upon to respond to crises. Although frameworks for emergency preparedness and response have been established by the National Organization of Nurse Practitioner Faculties and the International Council of Nurses, the advanced practice registered nurse community is not consistently prepared to participate in crisis response. Merging of the previously established frameworks allows identification of additional opportunities for advanced practice registered nurses to be educated and engaged in emergency preparedness and all-hazards response, including preparation activities, communication, safety and security, incident management, assessment, intervention, and recovery. Additional areas of focus are leadership, ethics, and end-of-life care. Use of the existing frameworks combined with the lessons learned from the COVID-19 response can empower advanced practice registered nurses to improve their readiness to respond to future crises.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 4","pages":"339-348"},"PeriodicalIF":2.2,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10694009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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