Advanced Practice in Critical Care A Case Study Approach

by McGloin, Sarah; McLeod, Anne

• ISBN13: 9781405185653
• ISBN10: 1405185651
• Edition: 1st
• Format: Paperback
• Copyright: 2010-04-26
• Publisher: Wiley-Blackwell

Summary

Advanced Practice in Critical Care provides experienced critical care nurses with a clear and distinct evidence base for contemporary critical care practice. Central to the book is the application of research and evidence to practice and therefore, case studies and key critical care clinical situations are used throughout to guide the reader through the patient care trajectory.

Author Biography

Sarah McGloin is Senior Lecturer in Acute Care at Anglia Ruskin University, UK.

Anne McLeod is Senior Lecturer Critical Care at City University, UK.

Table of Contents

Preface	p. ix
Contributors and acknowledgements	p. xi
Challenges in contemporary critical care	p. 1
Introduction	p. 1
Critical care without walls	p. 1
Advanced practice	p. 2
Interprofessional roles within critical care	p. 5
Conclusion	p. 7
References	p. 7
The Physiological basis of critical illness	p. 9
Introduction	p. 9
Patient scenario	p. 9
Mechanisms of cellular damage	p. 10
Impact of reduced perfusion on energy production	p. 12
Evaluation of ischaemia: reperfusion injury	p. 13
The inflammatory response and the role of mediators	p. 14
Mechanisms for haemostasis in relation to critical illness	p. 19
Conclusion	p. 25
References	p. 25
The patient with haemodynamic compromise leading to renal dysfunction	p. 26
Introduction	p. 26
Patient Scenario	p. 26
Underlying physiology and pathophysiology	p. 27
Assessment and diagnosis	p. 31
Evidence-based care	p. 35
Ongoing patient scenario	p. 39
Progressing pathophysiology	p. 40
Ongoing assessment	p. 47
Evidence-based care	p. 54
Conclusion	p. 65
Reference	p. 65
The septic Patient	p. 71
Introduction	p. 71
Patient scenario	p. 71
Underlying physiology and pathophysiology	p. 72
Assessment and diagnosis	p. 76
Evidence-based care	p. 81
Ongoing patient scenario	p. 83
Progressing pathophysiology	p. 84
Ongoing assessment	p. 91
Evidence-based care	p. 91
Conclusion	p. 100
Reference	p. 101
The patient with acute respiratory failure	p. 105
Introduction	p. 105
Patient scenario	p. 105
Underlying physiology and pathophysiology	p. 106
Assessment and diagnosis	p. 109
Arterial blood gas analysis	p. 114
Evidence-based care	p. 122
Ongoing patient scenario	p. 127
Progressing pathophysiology	p. 127
Ongoing assessment	p. 128
Evidence-based care	p. 136
Conclusion	p. 140
References	p. 140
The patient with chronic respiratory failure	p. 143
Introduction	p. 143
Patient scenario	p. 144
Underlying physiology and pathophysiology	p. 144
Assessment and diagnosis	p. 145
Evidence-based care	p. 148
Ongoing patient scenario	p. 152
Weaning from ventilatory support	p. 153
Ongoing care	p. 157
Conclusion	p. 158
References	p. 158
The patient with an intracranial insult	p. 161
Introduction	p. 161
Patient scenario	p. 161
Underlying physiology and pathophysiology	p. 162
Assessment and diagnosis	p. 167
Evidence-based care	p. 168
Ongoing patient scenario	p. 172
Progressing pathophysiology	p. 174
Ongoing assessment	p. 177
Evidence-based care	p. 180
Conclusion	p. 185
References	p. 185
The patient with a traumatic injury	p. 188
Introduction	p. 188
Patient scenario	p. 188
Mechanisms of injury	p. 189
Assessment and diagnosis	p. 190
Primary and secondary surveys	p. 191
Underlying physiology and pathophysiology	p. 192
Evidence-based care	p. 193
Continuing patient scenario	p. 196
Evidence-based care	p. 197
Ongoing patient scenario	p. 200
Progressing pathophysiology	p. 201
Ongoing assessment	p. 203
Evidence-based care	p. 207
Management of his pelvic injury	p. 211
Conclusion	p. 212
References	p. 212
The patient with a diabetic emergency	p. 215
Introduction	p. 215
Patient scenario	p. 215
Underlying physiology and pathophysiology	p. 216
Underlying pathophysiology	p. 217
Assessment and diagnosis	p. 221
Evidence-based care	p. 223
Ongoing care	p. 225
Conclusion	p. 226
References	p. 226
The long-term patient in intensive care unit	p. 228
Introduction	p. 228
Patient scenario	p. 228
Impact of being in the critical care environment	p. 228
Psychological effects	p. 230
Underlying physiology and physiological effects	p. 235
Quality of life	p. 240
Rehabilitation process	p. 241
Conclusion	p. 245
References	p. 245
Ethical considerations in critical care	p. 247
Introduction	p. 247
Patient scenario	p. 247
Admission to critical care	p. 247
What are ethics?	p. 248
Biomedical ethical model	p. 250
The role of outreach	p. 252
Ongoing patient scenario	p. 254
Futile situations	p. 254
Withdrawal/withholding of treatment or euthanasia?	p. 254
Patient autonomy	p. 256
The process of withdrawing or withholding treatment	p. 256
Role of the nurse	p. 257
Collaborative decision-making	p. 257
Conclusion	p. 258
References	p. 258
Index	p. 261
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