AACN clinical issues最新文献_第9页

Heat loss and continuous renal replacement therapy. 热损失和持续肾替代治疗。

AACN clinical issues Pub Date : 2004-04-01 DOI: 10.1097/00044067-200404000-00008

Susan Jones

引用次数: 8

Malignant hyperthermia: pathophysiology, clinical presentation, and treatment. 恶性高热:病理生理、临床表现和治疗。

AACN clinical issues Pub Date : 2004-04-01 DOI: 10.1097/00044067-200404000-00009

E Jane McCarthy

引用次数: 21

Can there be a standard for temperature measurement in the pediatric intensive care unit? 儿科重症监护病房是否有温度测量标准?

AACN clinical issues Pub Date : 2004-04-01 DOI: 10.1097/00044067-200404000-00011

Sarah A Martin, Andrea M Kline

{"title":"Can there be a standard for temperature measurement in the pediatric intensive care unit?","authors":"Sarah A Martin, Andrea M Kline","doi":"10.1097/00044067-200404000-00011","DOIUrl":"https://doi.org/10.1097/00044067-200404000-00011","url":null,"abstract":"Temperature measurement is a commonly used assessment parameter when caring for the critically ill child. Interpreting the temperature measurement mode and what constitutes clinically significant thermal instability are poorly defined. Thus, decisions made regarding patient management based on temperature measurement can be challenging for caregivers. Infants and children have unique physioanatomic considerations that impact maintaining thermoregulation. Numerous routes for taking temperature measurements are described including the oral, axillary, tympanic (aural), rectal, skin, urinary bladder, pulmonary artery, esophageal, nasopharyngeal, supralingual (pacifier), and temporal-artery. Numerous studies on temperature measurement have been conducted on children of various ages using a variety of thermometers and routes in both the inpatient and outpatient setting. Although there are limited studies reported on the critically ill child, research data pertinent to the critically ill child from subjects in the neonatal intensive care unit, pediatric intensive care unit, operating room, and inpatient units are summarized.","PeriodicalId":79311,"journal":{"name":"AACN clinical issues","volume":"15 2","pages":"254-66"},"PeriodicalIF":0.0,"publicationDate":"2004-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00044067-200404000-00011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40899728","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: 45

Leadership in action: creating a change in practice. 领导行动:在实践中创造变革。

AACN clinical issues Pub Date : 2004-04-01 DOI: 10.1097/00044067-200404000-00002

Denise Buonocore

{"title":"Leadership in action: creating a change in practice.","authors":"Denise Buonocore","doi":"10.1097/00044067-200404000-00002","DOIUrl":"https://doi.org/10.1097/00044067-200404000-00002","url":null,"abstract":"Change is common and important in improving patient outcomes in the current healthcare market. Because of the tremendous increase in credible research and publication of research findings, clinicians now use evidence-based findings to guide their practice. The rapid changes in the healthcare environment require effective leaders that can implement change strategies to improve patient outcomes. Evidence has shown that clinicians may have difficulty integrating new knowledge into clinical practice. The advanced practice nurse (APN) equipped with advanced clinical knowledge and knowledge of the change process is perfectly situated in the healthcare setting to be an agent of change. This article focuses on the specific steps of the change process APNs can use to effect change in practice in their institutions. An example from the author's own clinical practice in implementing an intensive insulin drip protocol is outlined. The key elements important in successful development and implementation of a change in practice are presented. By improving the understanding of the change process, APNs as change agents can meet the challenge of leading the way to change in their clinical setting.","PeriodicalId":79311,"journal":{"name":"AACN clinical issues","volume":"15 2","pages":"170-81"},"PeriodicalIF":0.0,"publicationDate":"2004-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00044067-200404000-00002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40977855","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: 47

Troubled units: creating change. 困难单位:创造改变。

AACN clinical issues Pub Date : 2004-04-01 DOI: 10.1097/00044067-200404000-00006

Anne LaVoice Hawkins, Lucinda Stephens Kratsch

引用次数: 7

Shivering in acutely ill vulnerable populations. 患重病的弱势群体瑟瑟发抖。

AACN clinical issues Pub Date : 2004-04-01 DOI: 10.1097/00044067-200404000-00012

Barbara J Holtzclaw

引用次数: 15

Mentoring matters: creating, connecting, empowering. 指导很重要:创造、联系、授权。

AACN clinical issues Pub Date : 2004-04-01 DOI: 10.1097/00044067-200404000-00005

Mary G McKinley

引用次数: 64

Biological mediators of acute inflammation. 急性炎症的生物介质。

AACN clinical issues Pub Date : 2004-01-01 DOI: 10.1097/00044067-200401000-00002

James A Rankin

{"title":"Biological mediators of acute inflammation.","authors":"James A Rankin","doi":"10.1097/00044067-200401000-00002","DOIUrl":"https://doi.org/10.1097/00044067-200401000-00002","url":null,"abstract":"Inflammation may be defined as the normal response of living tissue to injury or infection. It is important to emphasize two components of this definition. First, that inflammation is a normal response and, as such, is expected to occur when tissue is damaged. Indeed, if injured tissue did not exhibit signs of inflammation this would be considered abnormal. Secondly, inflammation occurs in living tissue, hence the need for an adequate blood supply to the tissues in order for an inflammatory response to be exhibited. The inflammatory response may be triggered by mechanical injury, chemical toxins, invasion by microorganisms, and hypersensitivity reactions. Three major events occur during the inflammatory response: the blood supply to the affected area is increased substantially, capillary permeability is increased, and leucocytes migrate from the capillary vessels into the surrounding interstitial spaces to the site of inflammation or injury. The inflammatory response represents a complex biological and biochemical process involving cells of the immune system and a plethora of biological mediators. Cell-to-cell communication molecules known collectively as cytokines play an extremely important role in mediating the process of inflammation. An extensive exposition of this complex phenomenon is beyond the scope of this article. Rather, the author provides a review of inflammation, an overview of the role of certain biological mediators in inflammation, and a discussion of the implications of certain biological response modifiers in clinical practice.","PeriodicalId":79311,"journal":{"name":"AACN clinical issues","volume":"15 1","pages":"3-17"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00044067-200401000-00002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24200161","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: 213

The puzzle of sepsis: fitting the pieces of the inflammatory response with treatment. 败血症的难题:将炎症反应的碎片与治疗相匹配。

AACN clinical issues Pub Date : 2004-01-01 DOI: 10.1097/00044067-200401000-00003

Jane Cunneen, Martina Cartwright

{"title":"The puzzle of sepsis: fitting the pieces of the inflammatory response with treatment.","authors":"Jane Cunneen, Martina Cartwright","doi":"10.1097/00044067-200401000-00003","DOIUrl":"https://doi.org/10.1097/00044067-200401000-00003","url":null,"abstract":"Sepsis is a complex syndrome characterized by simultaneous activation of inflammation and coagulation in response to microbial insult. These events manifest as systemic inflammatory response syndrome (SIRS)/sepsis symptoms through release of proinflammatory cytokines, procoagulants, and adhesion molecules from immune cells and/or damaged endothelium.Conventional treatments have focused on source control, antimicrobials, vasopressors, and fluid resuscitation; however, a new treatment paradigm exists: that of treating the host response to infection with adjunct therapies including early goal directed therapy, drotrecogin alfa (activated), and immunonutrition. The multimechanistic drotrecogin alfa (activated) has been shown to reduce mortality in the severely septic patient when combined with traditional treatment. Therapies targeting improved oxygen and blood flow and reduction of apoptosis and free radicals are under investigation. Early sepsis diagnosis through detection of pro calcitonin, C reactive protein, sublingual CO2, and genetic factors may be beneficial. Ultimately, intervention timing may be the most important factor in reducing severe sepsis mortality.","PeriodicalId":79311,"journal":{"name":"AACN clinical issues","volume":"15 1","pages":"18-44"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00044067-200401000-00003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24199495","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: 41

Insights into novel biological mediators of clinical manifestations in cancer. 对癌症临床表现的新型生物介质的见解。

AACN clinical issues Pub Date : 2004-01-01 DOI: 10.1097/00044067-200401000-00009

Otto H Sanchez

引用次数: 6