AACN Essentials of Progressive Care Nursing 3rd Edition by Suzanne Burns 0071822925 9780071822923

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ISBN 10: 0071822925

ISBN 13: 9780071822923

Author: Suzanne M. Burns

Concise yet thorough guidance on how to safely and competently care for adult progressive care patients and their families Endorsed by the American Association of Critical-Care Nurses (AACN) and written by top clinical experts in acute and progressive care nursing, this textbook covers all the must-know details on the care of adult progressive care patients and their families. Supported by helpful tables and algorithms, the book’s practical, building-block organization starts with the basics before proceeding to more complex concepts. The AACN Essentials of Progressive Care Nursing includes essential information to successfully prepare for PCCN certification in progressive care and much more! The AACN Essentials of Progressive Care Nursing is divided into four sections: THE ESSENTIALS — presents information that clinicians must understand to provide safe, competent nursing care to the majority of progressive care patients, regardless of their underlying medical diagnoses PATHOLOGICAL CONDITIONS — covers pathologic conditions and management strategies commonly encountered among adult, progressive care patients ADVANCED CONCEPTS IN CARING FOR THE PROGRESSIVE CARE PATIENT — presents advanced progressive care concepts or pathologic conditions that are less common or more specialized than expected in adult progressive care KEY REFERENCE INFORMATION — features normal laboratory and diagnostic values; pharmacology tables; algorithms for advanced cardiac life support; and summary tables of cardiac rhythms, ECG characteristics, and treatment guides

AACN Essentials of Progressive Care Nursing 3rd Table of contents:

Section I. The Essentials

1. Assessment of Progressive Care Patients and Their Families

Assessment Framework

Prearrival Assessment

Arrival Quick Check

Comprehensive Initial Assessment

Ongoing Assessment

Patient Safety Considerations in Admission Assessments

Prearrival Assessment: Before the Action Begins

Arrival Quick Check Assessment

Airway and Breathing

Circulation and Cerebral Perfusion

Chief Complaint

Drugs and Diagnostic Tests

Equipment

Comprehensive Initial Assessment

Past Medical History

Social History

Physical Assessment by Body System

Transition/Discharge Planning

Ongoing Assessment

Selected Bibliography

Progressive Care Assessment

Evidence-Based Practice

2. Planning Care for Progressive Care Patients and Their Families

Multidisciplinary Plan of Care

Planning Care Through Staffing Considerations

Patient Safety Considerations in Planning Care

Prevention of Common Complications

Physiologic Instability

Deep Venous Thrombosis

Hospital-Acquired Infections

Skin Breakdown

Sleep Pattern Disturbance

Psychosocial Impact

Patient and Family Education

Assessment of Learning Readiness

Strategies to Address Patient and Family Education

Outcome Measurement

Family-Focused Care

Transporting the Progressive Care Patient

Assessment of Risk for Complications

Level of Care Required During Transport

Preparation

Transport

Interfacility Transfers

Transitioning to the Next Stage of Care

Supporting Patients and Their Families During the Dying Process

Selected Bibliography

Family Interventions/Visitation

Infection Control

Patient and Family Education

Psychological Problems

Sleep Deprivation

Transport of Critically Ill Patients

Evidence-Based Practice

3. Interpretation and Management of Basic Cardiac Rhythms

Basic Electrophysiology

ECG Waveforms, Complexes, and Intervals

P Wave

QRS Complex

T Wave

U Wave

PR Interval

ST Segment

QT Interval

Basic Electrocardiography

Cardiac Monitoring

Determination of the Heart Rate

Determination of Cardiac Rhythm

Common Arrhythmias

Rhythms Originating in the Sinus Node

Normal Sinus Rhythm

Sinus Bradycardia

Sinus Tachycardia

Sinus Arrhythmia

Sinus Arrest

Arrhythmias Originating in the Atria

Premature Atrial Complexes

Wandering Atrial Pacemaker

Atrial Tachycardia

Atrial Flutter

Atrial Fibrillation

Supraventricular Tachycardia

Arrhythmias Originating in the Atrioventricular Junction

Premature Junctional Complexes

Junctional Rhythm, Accelerated Junctional Rhythm, and Junctional Tachycardia

Arrhythmias Originating in the Ventricles

Premature Ventricular Complexes

Ventricular Rhythm and Accelerated Ventricular Rhythm

Ventricular Tachycardia

Ventricular Fibrillation

Ventricular Asystole

Atrioventricular Blocks

First-Degree Atrioventricular Block

Second-Degree Atrioventricular Block

High-Grade Atrioventricular Block

Third-Degree Atrioventricular Block (Complete Block)

Temporary Pacing

Indications

Transvenous Pacing

Epicardial Pacing

Components of a Pacing System

Basics of Pacemaker Operation

Initiating Transvenous Ventricular Pacing

Initiating Epicardial Pacing

External (Transcutaneous) Pacemakers

Defibrillation and Cardioversion

Defibrillation

Automatic External Defibrillators

Cardioversion

Selected Bibliography

Evidence-Based Practice

4. Hemodynamic Monitoring

Hemodynamic Parameters

Cardiac Output

Components of Cardiac Output/Cardiac Index

Stroke Volume and Stroke Volume Index

Ejection Fraction

Factors Affecting Stroke Volume/Stroke Volume Index

Basic Components of Hemodynamic Monitoring Systems

Pulmonary Artery Catheter

Arterial Catheter

Pressure Tubing

Pressure Transducer

Pressure Amplifier

Pressure Bag and Flush Device

Alarms

Obtaining Accurate CVP and Arterial Values

Zeroing the Transducer

Leveling the Transducer to the Catheter Tip

Calibration of the Transducer/Amplifier System

Ensuring Accurate Waveform Transmission

Insertion and Removal of Catheters

Central Venous Catheters

Arterial Catheters

Obtaining and Interpreting Hemodynamic Waveforms

Patient Positioning

Interpretation

Artifacts in Hemodynamic Waveforms: Respiratory Influence

Continuous Mixed and Central Venous Oxygen Monitoring (SVO2/SCVO2)

Svo2/Scvo2 Monitoring Principles

Minimally Invasive Hemodynamic Monitoring

Thoracic Bioimpedance

Pulse Contour Measurement

Selected Bibliography

Hemodynamic Monitoring

Minimally Invasive Hemodynamic Monitoring

Therapeutics

Evidence-Based Practice Guidelines

5. Airway and Ventilatory Management

Tests, Monitoring Systems and Respiratory Assessment Techniques

Arterial Blood Gas Monitoring

Venous Blood Gas Monitoring

Pulse Oximetry

Assessing Pulmonary Function

Airway Management

Oropharyngeal Airway

Nasopharyngeal Airway

Laryngeal Mask Airway

Esophageal Tracheal Airway

Artificial Airways

Endotracheal Suctioning

Oxygen Therapy

Complications

Oxygen Delivery

Basic Ventilatory Management

Indications

General Principles

Patient-Ventilator System

Modes

Complications of Mechanical Ventilation

Weaning From Short-Term Mechanical Ventilation

Weaning From Long-Term Mechanical Ventilation

Respiratory Fatigue, Rest, and Conditioning

Wean Trial Protocols

Other Protocols for Use

Critical Pathways

Systematic Institutional Initiatives for the Management of the LTMV Patient Population

Troubleshooting Ventilators

Oral Feedings

Communication

Principles of Management

Selected Bibliography

General Critical Care

Ventilator Management

Weaning From Mechanical Ventilation

Communication

Evidence-Based Resources

6. Pain and Sedation Management

Physiologic Mechanisms of Pain

Peripheral Mechanisms

Spinal Cord Integration

Central Processing

Responses to Pain

Pain Assessment

A Multimodal Approach to Pain Management

Nonsteroidal Anti-Inflammatory Drugs

Side Effects

Opioids

Side Effects

Intravenous Opioids

Patient-Controlled Analgesia

Switching From IV to Oral Opioid Analgesia

Epidural Analgesia

Epidural Opioids

Epidural Local Anesthetics

Cutaneous Stimulation

Distraction

Imagery

Relaxation Techniques

Deep Breathing and Progressive Relaxation

Presence

Special Considerations for Pain Management in the Elderly

Assessment

Interventions

Sedation

Reasons for Sedation

Drugs for Sedation

Drugs for Delirium

Goals of Sedation, Monitoring, and Management

Selected Bibliography

Pain Management

Sedation

Evidence-Based Practice Guidelines

7. Pharmacology

Medication Safety

Medication Administration Methods

Intravenous

Intramuscular or Subcutaneous

Oral

Sublingual

Intranasal

Transdermal

Central Nervous System Pharmacology

Sedatives

Analgesics

Anticonvulsants

Cardiovascular System Pharmacology

Miscellaneous Agents

Parenteral Vasodilators

Antiarrhythmics

Vasodilators and Remodeling Agents

Vasopressor Agents

Inotropic Agents

Antibiotic Pharmacology

Aminoglycosides

Vancomycin

Pulmonary Pharmacology

Theophylline

Albuterol

Levalbuterol

Gastrointestinal Pharmacology

Stress Ulcer Prophylaxis

Acute Peptic Ulcer Bleeding

Variceal Hemorrhage

Renal Pharmacology

Diuretics

Hematologic Pharmacology

Anticoagulants

Factor Xa Inhibitors

Direct Thrombin Inhibitors

Glycoprotein IIb/IIIa Inhibitor

Thrombolytic Agents

Immunosuppressive Agents

Cyclosporine

Tacrolimus (FK506)

Sirolimus (Rapamycin)

Special Dosing Considerations

Drug Disposition in the Elderly

Therapeutic Drug Monitoring

Selected Bibliography

General

Evidence-Based Practice Guidelines

8. Ethical and Legal Considerations

The Foundation for Ethical Decision Making

Professional Codes and Standards

Position Statements and Guidelines

Institutional Policies

Legal Standards

Principles of Ethics

The Ethics of Care

Paternalism

Patient Advocacy

The Process of Ethical Analysis

Assessment

Plan

Implementation

Evaluation

Contemporary Ethical Issues

Informed Consent

Determining Capacity

Advance Directives

End-of-Life Issues

Resuscitation Decisions

Building an Ethical Environment

Values Clarification

Provide Information and Clarify Issues

Recognize Moral Distress

Engage in Collaborative Decision Making

Selected Bibliography

Professional Codes, Standards, and Position Statements

Evidence-Based Guidelines

On-line References of Interest: Related to Legal and Ethical Considerations

Section II. Pathologic Conditions

9. Cardiovascular System

Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems

Assessment of Chest Pain

Coronary Angiography

Percutaneous Coronary Interventions

Other Percutaneous Coronary Interventions

Pathologic Conditions

Acute Ischemic Heart Disease

Electrophysiology Studies

Heart Failure

Shock

Hypertension

Selected Bibliography

General Cardiovascular

Coronary Revascularization

Acute Ischemic Heart Disease

Heart Failure

Shock

Hypertension

Evidence-Based Practice Guidelines

10. Respiratory System

Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems

Chest X-Rays

Computed Tomography and Magnetic Resonance Imaging

Pulmonary Angiograms/CTPA and V/Q Scans

Chest Tubes

Thoracic Surgery and Procedures

Pathologic Conditions

Acute Respiratory Failure

Acute Respiratory Distress Syndrome (ARDS)

Acute Respiratory Failure in the Patient with Chronic Obstructive Pulmonary Disease

Acute Respiratory Failure in the Patient with Asthma

Interstitial Lung Disease

Pulmonary Hypertension

Pneumonia

Pulmonary Embolism

Selected Bibliography

Critical Care Management of Respiratory Problems

Chest X-Ray Interpretation

Miscellaneous

Evidence-Based Practice Guidelines

11. Multisystem Problems

Pathologic Conditions

Sepsis and Multiple Organ Dysfunction Syndrome

Overdoses

Etiology, Risk Factors, and Pathophysiology

Complex Wounds and Pressure Ulcers

Pressure Ulcer Stages

Healthcare Acquired Infections

Selected Infectious Diseases

Selected Bibliography

SIRS, Sepsis, and MODS

Overdose

Complex Wounds and Pressure Ulcers

Healthcare Acquired Infections

Selected Infectious Diseases

12. Neurologic System

Special Assessment Techniques and Diagnostic Tests

Level of Consciousness

Glasgow Coma Scale

Full Outline of UnResponsiveness (FOUR) Score

Mental Status

Motor Assessment

Sensation

Cranial Nerve Assessment and Assessment of Brain Stem Function

Vital Sign Alterations in Neurologic Dysfunction

Diagnostic Testing

Lumbar Puncture

Computed Tomography

Magnetic Resonance Imaging

Cerebral (Catheter) Angiography

Transcranial Doppler Ultrasound

Electroencephalography

Electromyography/Nerve Conduction Studies

Intracranial Pressure

Cerebral Blood Flow

Causes of Increased Intracranial Pressure

Clinical Presentation

Principles of Management of Increased ICP

Acute Ischemic Stroke

Etiology, Risk Factors, and Pathophysiology

Clinical Presentation

Diagnostic Tests

Principles of Management of Acute Ischemic Stroke

Hemorrhagic Stroke

Etiology, Risk Factors, and Pathophysiology

Clinical Presentation

Diagnostic Tests

Principles of Management of Intracerebral Hemorrhage

Seizures

Etiology, Risk Factors, and Pathophysiology

Clinical Presentation

Diagnostic Testing

Principles of Management of Seizures

Infections of the Central Nervous System

Meningitis

Encephalitis

Intracranial Abscess

Neuromuscular Diseases

Myasthenia Gravis

Guillain-Barré Syndrome

Amyotrophic Lateral Sclerosis

Selected Bibliography

Assessment and Diagnostic Testing

Intracranial Pressure

Acute Ischemic Stroke and Hemorrhagic Stroke

Seizures

Infections of the Central Nervous System

Neuromuscular Diseases

Evidence-Based Practice

13. Hematologic and Immune Systems

Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems

Complete Blood Count

Red Blood Cell Count

Hemoglobin

Hematocrit

Red Blood Cell Indices

Total White Blood Cell Count

White Blood Cell Differential

Platelet Count

Coagulation Studies

Additional Tests and Procedures

Pathologic Conditions

Anemia

Immunocompromise

Coagulopathies

Selected Bibliography

Anemia

Immunocompromised Patient

Coagulopathy

14. Gastrointestinal System

Pathologic Conditions

Acute Upper Gastrointestinal Bleeding

Liver Failure

Acute Pancreatitis

Intestinal Ischemia

Bowel Obstruction

Bariatric (Weight Loss) Surgery

Surgical Procedures

Nutritional Support for Acutely Ill Patients

Nutrition Requirements

Nutritional Case: Special Populations

Postgastrectomy Syndromes

Gastric Residual Volume

Aspiration

Bowel Sounds

Nausea and Vomiting

Osmolality or Hypertonicity of Formula

Diarrhea

Flow Rates and Hours of Infusion

Formula Selection

Selected Bibliography

Upper GI Bleeding

Liver Failure

Acute Pancreatitis

Intestinal Ischemia/Bowel Obstruction

Nutrition

On-line References of Interest

Bariatric (Gastric Bypass) Surgery

15. Renal System

Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems

Pathologic Conditions

Acute Renal Failure

Life-Threatening Electrolyte Imbalances

Renal Replacement Therapy

Access

Dialyzer/Hemofilters/Dialysate

Procedures

Indications for and Efficacy of Renal Replacement Therapy Modes

General Renal Replacement Therapy Interventions

Selected Bibliography

General Renal and Electrolyte

Renal Failure

Renal Replacement Therapy

Online References

16. Endocrine System

Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems

Blood Glucose Monitoring

Pathologic Conditions

Hyperglycemic States

Hyperglycemic Emergencies

Acute Hypoglycemia

Syndrome of Inappropriate Antidiuretic Hormone Secretion

Diabetes Insipidus

Selected Bibliography

Blood Glucose Monitoring

Hyperglycemia, DKA, and HHS

SIADH and Diabetes Insipidus

17. Trauma

Specialized Assessment Techniques, Diagnostic Tests, and Monitoring Systems

Primary and Secondary Trauma Survey Assessment

Diagnostic Studies

Mechanism of Injury

Physiologic Consequences of Trauma

Common Injuries in the Trauma Patient

Thoracic Trauma

Abdominal Trauma

Musculoskeletal Trauma

Complications of Traumatic Injury in Severe ­Multisystem Trauma

Acute Respiratory Distress Syndrome

Infection/Sepsis

Systemic Inflammatory Response Syndrome

Psychological Consequences of Trauma

Selected Bibliography

General Trauma

Selected Online References

Evidence-Based Practice

Section III. Advanced Concepts in Caring for the Critically Ill Patient

18. Advanced ECG Concepts

The 12-Lead Electrocardiogram

Axis Determination

Bundle Branch Block

Acute Coronary Syndrome

Preexcitation Syndromes

Advanced Arrhythmia Interpretation

Supraventricular Tachycardias

Polymorphic Ventricular Tachycardias

Differentiating Wide QRS Beats and Rhythms

ST-Segment Monitoring

Measuring the ST Segment

Choosing the Best Leads for ST-Segment Monitoring

Cardiac Pacemakers

Evaluating Pacemaker Function

VVI Pacemaker Evaluation

DDD Pacemaker Evaluation

Selected Bibliography

Evidence-Based Practice

19. Advanced Cardiovascular Concepts

Pathologic Conditions

Cardiomyopathy

Valvular Heart Disease

Pericarditis

Aortic Aneurysm

Cardiac Transplantation

Ventricular Assist Devices

Selected Bibliography

General Cardiovascular

Cardiomyopathy

Heart Transplantation

Valvular Disorders

Pericarditis

Thoraco-Abdominal Aneurysms

Ventricular Assist Devices

Intraaortic Balloon Pump

Evidence-Based Practice Guidelines

20. Advanced Neurologic Concepts

Subarachnoid Hemorrhage

Etiology, Risk Factors, and Pathophysiology

Clinical Presentation

Diagnostic Tests

Principles of Management of Aneurysmal Subarachnoid Hemorrhage

Traumatic Brain Injury

Etiology, Risk Factors, and Pathophysiology

Clinical Presentation

Diagnostic Tests

Principles of Management of Traumatic Brain Injury

Traumatic Spinal Cord Injury

Etiology, Risk Factors, and Pathophysiology

Clinical Presentation

Diagnostic Tests

Principles of Management of Acute Spinal Cord Injury

Future Spinal Cord Injury Treatment

Brain Tumors

Etiology, Risk Factors, and Pathophysiology

Clinical Presentation

Diagnostic Tests

Principles of Management of Intracranial Tumors

Special Considerations: Transsphenoidal Resection of Pituitary Tumors

Special Procedures: Invasive Monitoring of Intracranial Pressure

Intracranial Pressure Waveforms

Special Procedures: Management of a Patient With a Lumbar Drain

Selected Bibliography

Subarachnoid Hemorrhage

Traumatic Brain Injury

Spinal Cord Injury

Brain Tumors

Intracranial Pressure Monitoring

Evidence-Based Guidelines

Section IV. Key Reference Information

21. Normal Values Table

22. Pharmacology Tables

23. Advanced Cardiac Life Support Algorithms

24. Cardiac Rhythms, ECG Characteristics, and Treatment Guide

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