Additional Information
Book Details
Abstract
Awarded third place in the 2017 AJN Book of the Year Awards in the Critical Care- Emergency Nursing category. Learn to effectively address life-threatening and potentially life-threatening patient conditions, with Advanced Critical Care Nursing, 2nd Edition. Endorsed by the American Association of Critical-Care Nurses (AACN), this comprehensive, nursing-focused text centers on the clinical reasoning process as it helps you comprehend, analyse, synthesize, and apply advanced critical care knowledge and concepts. The book is organized within the structure of body systems along with synthesis chapters that address patient conditions involving multiple body systems. Numerous illustrations and graphs plus unfolding case studies further aid your understanding and help you apply text content. In all, Advanced Critical Care Nursing is the must-have resource dedicated to helping you oversee or care for critical care patients in any practice setting.
- Body systems organization emphasizes core systems and advanced concepts.
- Consistent chapter format features numerous illustrations, charts, and graphs in each chapter to enhance understanding.
- Synthesis chapters address patient conditions that involve multiple body systems — a common occurrence in critical care nursing.
- Unfolding case studies with decision point questions are included at the end of all disorders chapters, providing opportunities to apply advanced critical care content to actual scenarios.
- Medication tables incorporate common classifications of critical care drugs for specific disorders, including drugs, actions, and special considerations.
- NEW! Updated information throughout reflects the latest evidence-based content as well as national and international treatment guidelines.
- NEW! Streamlined content places a greater focus on the need-to-know information for today’s high acuity, progressive, and critical care settings.
- NEW! Expanded coverage of emerging and infectious diseases and multidrug-resistant infections keep readers up to date with the most topical diseases, such as the Zika virus.
- NEW! Additional content on alternative settings for critical care now includes the eICU and remote monitoring.
- NEW! Full-color design clarifies important concepts and improve the book's usability.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| CONTENTS | ES1 | ||
| ADVANCED CRITICAL CARE NURSING | i | ||
| Copyright | ii | ||
| CONTRIBUTORS | iii | ||
| REVIEWERS | vii | ||
| ACKNOWLEDGMENTS | ix | ||
| PREFACE | x | ||
| CONTENTS | xi | ||
| I - \rIntroduction | 1 | ||
| 1 - The Critical Care Environment | 1 | ||
| PHYSICAL ENVIRONMENT OF CARE | 1 | ||
| Acuity Adaptable Units | 1 | ||
| Progressive Care Units | 1 | ||
| Telemedicine | 2 | ||
| Long-Term Acute Care Hospitals | 2 | ||
| Ambulatory Settings | 2 | ||
| Home Care | 2 | ||
| HEALTHY WORK ENVIRONMENT STANDARDS | 2 | ||
| Skilled Communication | 3 | ||
| Crucial Conversations | 3 | ||
| Interprofessional Communication | 4 | ||
| Written Communication—Electronic Medical Record | 5 | ||
| True Collaboration | 5 | ||
| Nurse-Provider Relationship | 6 | ||
| Nurse-to-Nurse Collaboration | 6 | ||
| Nurse-to-Family Collaboration | 6 | ||
| Effective Decision-Making | 6 | ||
| Collaborative Interprofessional Decision-Making | 6 | ||
| Appropriate Staffing | 7 | ||
| Meaningful Recognition | 8 | ||
| Key Aspects of Individual Recognition | 8 | ||
| Team Recognition | 9 | ||
| Authentic Leadership | 9 | ||
| Key Characteristics of a Nurse Leader | 9 | ||
| Role of Accountability | 10 | ||
| Power of an Authentic Nurse Leader | 10 | ||
| CONCLUSION | 10 | ||
| REFERENCES | 10 | ||
| II - \rCardiac | 12 | ||
| 2 - Advanced Dysrhythmias | 12 | ||
| THE CARDIAC ACTION POTENTIAL | 12 | ||
| Normal Cardiac Cell Function | 12 | ||
| Action Potential of Ventricular Muscle Cells | 12 | ||
| Phase 0: Rapid Depolarization | 12 | ||
| Phase 1: Early Repolarization | 12 | ||
| Phase 2: Plateau | 12 | ||
| Phase 3: Rapid Repolarization | 12 | ||
| Phase 4: Electrical Diastole | 12 | ||
| Action Potential of Pacemaker Cells | 13 | ||
| Phase 4: Slow Diastolic Depolarization | 13 | ||
| Phases 0–4 | 13 | ||
| Ionic Channels and Pumps | 13 | ||
| Ionic Channels | 13 | ||
| Ionic Pumps | 14 | ||
| Implications for Patient Care | 14 | ||
| Classifications and Actions of Antidysrhythmic Agents | 14 | ||
| Prodysrhythmia | 14 | ||
| DYSRHYTHMOGENIC MECHANISMS | 14 | ||
| Alterations in Impulse Formation | 18 | ||
| Altered Automaticity | 18 | ||
| Abnormal Automaticity | 18 | ||
| Triggered Activity | 18 | ||
| Alterations in Impulse Conduction | 19 | ||
| Reentry | 19 | ||
| Ischemia | 20 | ||
| SUPRAVENTRICULAR TACHYCARDIAS | 20 | ||
| Inappropriate Sinus Tachycardia | 20 | ||
| Wolff-Parkinson-White Syndrome | 20 | ||
| III -\rPulmonary | 169 | ||
| 9 - ACUTE RESPIRATORY FAILURE AND ACUTE LUNG INJURY | 169 | ||
| Acute Respiratory Failure and Acute Lung Injury | 169 | ||
| DEFINITION | 169 | ||
| Nursing Assessment | 169 | ||
| MECHANISM OF HYPOXEMIC ACUTE | 169 | ||
| Ventilation/Perfusion Mismatching | 169 | ||
| Intrapulmonary Shunt | 169 | ||
| Alveolar Hypoventilation | 170 | ||
| Impaired Diffusion | 170 | ||
| Low Partial Pressure of Inspired Oxygen | 170 | ||
| MECHANISMS OF HYPERCAPNIC ACUTE RESPIRATORY FAILURE | 170 | ||
| Chest Wall/Respiratory Neuromuscular System | 171 | ||
| Central Nervous System | 171 | ||
| Lungs: Airways/Alveoli | 171 | ||
| ACUTE LUNG INJURY/ACUTE RESPIRATORY DISTRESS SYNDROME | 171 | ||
| EPIDEMIOLOGY AND RISK OF ACUTE LUNG INJURY/ACUTE RESPIRATORY DISTRESS SYNDROME | 172 | ||
| Pathophysiology of Acute Lung Injury/Acute Respiratory Distress Syndrome | 172 | ||
| Physical Assessment Findings | 174 | ||
| Respiratory System | 174 | ||
| Cardiovascular System | 174 | ||
| Integumentary System | 174 | ||
| Central Nervous System | 174 | ||
| DIAGNOSTIC EVALUATIONS | 174 | ||
| Laboratory and Microbiology Studies | 175 | ||
| INTERPROFESSIONAL PLAN OF CARE | 175 | ||
| Mechanical Ventilation | 175 | ||
| Positive End-Expiratory Pressure | 177 | ||
| Permissive Hypercapnia | 177 | ||
| Inverse Ratio Ventilation | 177 | ||
| Recruitment Maneuvers | 177 | ||
| High-Frequency Oscillatory Ventilation | 177 | ||
| Inhaled Nitric Oxide | 177 | ||
| Liquid Ventilation | 178 | ||
| OTHER INTERVENTIONS | 178 | ||
| Noninvasive Positive Pressure Ventilation | 178 | ||
| Prone Positioning | 178 | ||
| Medication/Fluid Use In ALI/ARDS | 178 | ||
| Steroids | 178 | ||
| Fluid and Diuretics | 179 | ||
| RESOLUTION OF ACUTE LUNG INJURY AND ACUTE RESPIRATORY DISTRESS SYNDROME | 180 | ||
| CONCLUSION | 180 | ||
| REFERENCES | 180 | ||
| 10 - Mechanical Ventilation and Weaning | 183 | ||
| VOLUME VERSUS PRESSURE MODES | 183 | ||
| Characteristics of Volume Ventilation | 183 | ||
| Characteristics of Pressure Ventilation | 183 | ||
| VOLUME VERSUS PRESSURE MODES: THE SCIENCE | 184 | ||
| Ventilating the Noncompliant Lung | 184 | ||
| Ventilating Patients with Severe Airflow Limitation | 185 | ||
| Permissive Hypercarbia | 186 | ||
| VENTILATOR PARAMETERS | 186 | ||
| INVASIVE MODES OF VENTILATION | 186 | ||
| Volume Modes | 186 | ||
| Assist Control | 186 | ||
| Synchronized Intermittent Mandatory Ventilation | 186 | ||
| Pressure Modes | 186 | ||
| Pressure Support Ventilation | 186 | ||
| Pressure Control and Pressure-Controlled Inverse Ratio Ventilation | 188 | ||
| Volume-Guaranteed Pressure Modes | 188 | ||
| Volume Support and Pressure-Regulated Volume Control | 188 | ||
| Volume Ventilation Plus | 188 | ||
| Airway Pressure Release Ventilation and Bi-Level Ventilation | 188 | ||
| High-Frequency Oscillation | 189 | ||
| Advanced Modes: Patient-Controlled Ventilation | 189 | ||
| Proportional-Assist Ventilation | 189 | ||
| Neurally Adjusted Ventilator Assist | 189 | ||
| NONINVASIVE VENTILATOR MODES | 189 | ||
| CPAP | 189 | ||
| BiPAP | 189 | ||
| RESPIRATORY WAVEFORM MONITORING | 190 | ||
| Pressure-Time and Flow-Time Waveforms | 190 | ||
| Pressure-Volume Loops | 192 | ||
| Flow-Volume Loops | 192 | ||
| Additional Uses of Respiratory Waveforms | 192 | ||
| WEANING FROM MECHANICAL VENTILATION | 194 | ||
| Assessment of Weaning Readiness | 194 | ||
| RESPIRATORY MUSCLE FATIGUE, REST, WORK, AND CONDITIONING | 195 | ||
| MODES AND METHODS OF VENTILATOR WEANING | 196 | ||
| COMPONENTS OF WEANING PROTOCOLS | 197 | ||
| Criteria for Entry (“Wean Screen”) | 197 | ||
| Weaning Trial Protocol | 197 | ||
| Signs of Intolerance and How to Rest | 198 | ||
| Timing of Tracheostomy and Weaning Trials | 198 | ||
| Interprofessional Plan of Care | 198 | ||
| CONCLUSION | 198 | ||
| REFERENCES | 199 | ||
| 11 - Thoracic Surgery | 201 | ||
| INTRODUCTION | 201 | ||
| THE THORAX | 201 | ||
| PULMONARY RESECTION | 201 | ||
| Clinical Presentation | 201 | ||
| Diagnostic Studies | 202 | ||
| Preoperative Evaluation | 202 | ||
| APPROACHES AND PROCEDURES | 203 | ||
| Wedge Resection | 203 | ||
| Segmentectomy | 204 | ||
| Lobectomy | 204 | ||
| Pneumonectomy | 206 | ||
| Lung Volume Reduction Surgery | 206 | ||
| PLEURAL SURGERY | 207 | ||
| Conditions of the Pleural Space | 207 | ||
| Pneumothorax | 207 | ||
| Pleural Effusion | 207 | ||
| Empyema | 207 | ||
| Pleural Tumors | 208 | ||
| Procedures of the Pleural Space | 208 | ||
| Pleurodesis | 208 | ||
| Pleurectomy | 208 | ||
| MEDIASTINAL DISEASE | 208 | ||
| Diagnostic Studies | 208 | ||
| Surgical Approaches | 208 | ||
| DIAPHRAGMATIC SURGERY | 208 | ||
| CHEST WALL DISORDERS | 209 | ||
| COMPLICATIONS OF THORACIC SURGERY | 209 | ||
| Intraoperative | 209 | ||
| Pulmonary Complications | 209 | ||
| Prolonged Air Leak | 209 | ||
| Bronchopleural Fistula | 209 | ||
| Atelectasis | 210 | ||
| Pneumonia | 210 | ||
| Acute Respiratory Failure and Acute Respiratory Distress Syndrome | 210 | ||
| Postpneumonectomy Pulmonary Edema | 210 | ||
| Pleural Effusion | 210 | ||
| Chylothorax | 210 | ||
| Lobar Torsion | 210 | ||
| Pulmonary Embolism | 211 | ||
| Cardiac Complications | 211 | ||
| Cardiac Dysrhythmias | 211 | ||
| Myocardial Ischemia and Infarction | 211 | ||
| Cardiac Herniation | 211 | ||
| Cardiac Tamponade | 211 | ||
| Neurologic Complications | 211 | ||
| INTERPROFESSIONAL CARE | 211 | ||
| Principles of Care | 211 | ||
| Intraoperative Management | 212 | ||
| Chest Drainage Management | 212 | ||
| Pain Management | 212 | ||
| Nutrition | 212 | ||
| Mechanical Ventilation | 213 | ||
| Respiratory Care | 213 | ||
| Mobilization | 213 | ||
| Critical Care | 213 | ||
| ESOPHAGEAL DISEASE | 213 | ||
| Esophageal Cancer | 213 | ||
| Esophageal Resection Procedures | 214 | ||
| Preoperative Evaluation | 214 | ||
| Postoperative Care | 215 | ||
| Complications Related to Esophageal Surgery | 215 | ||
| Achalasia | 215 | ||
| CONCLUSION | 215 | ||
| REFERENCES | 216 | ||
| IV -\rNervous System | 218 | ||
| 12 - Head Injury and Dysfunction\r | 218 | ||
| APPLIED PHYSIOLOGY | 218 | ||
| Cerebral Hemodynamics | 219 | ||
| MECHANISM OF INJURY | 220 | ||
| TYPES OF TRAUMATIC BRAIN INJURY | 222 | ||
| Focal Injuries | 222 | ||
| Skull Fractures | 223 | ||
| Contusions | 223 | ||
| Hematomas | 224 | ||
| Epidural Hematoma | 224 | ||
| Subdural Hematoma | 224 | ||
| Intracerebral Hematoma | 225 | ||
| Diffuse Injuries | 225 | ||
| Concussion | 225 | ||
| Diffuse Axonal Injuries | 225 | ||
| Traumatic Subarachnoid Hemorrhage | 225 | ||
| PATHOPHYSIOLOGY | 225 | ||
| Ischemia | 225 | ||
| Neurotoxicity | 226 | ||
| Impaired Metabolism | 226 | ||
| Inflammatory Factors | 227 | ||
| Types of Cerebral Edema | 227 | ||
| INTRACRANIAL PRESSURE AND CEREBRAL PERFUSION | 228 | ||
| HERNIATION | 230 | ||
| INTERPROFESSIONAL PLAN OF CARE FOR THE TRAUMATIC BRAIN INJURY PATIENT | 231 | ||
| Prehospital Phase | 231 | ||
| Early Hospital Management | 231 | ||
| Continued Critical Care Management | 232 | ||
| Rehabilitation | 232 | ||
| MONITORING | 232 | ||
| Intracranial Pressure Monitoring | 232 | ||
| NEUROIMAGING | 234 | ||
| Cerebral Oxygen Monitoring | 236 | ||
| Microdialysis | 237 | ||
| Continuous Electroencephalography | 237 | ||
| MANAGEMENT OF HYPOXIA AND HYPOTENSION | 237 | ||
| MANAGEMENT OF INTRACRANIAL PRESSURE | 238 | ||
| First-Level Approaches for Intracranial Pressure Management | 238 | ||
| Sedation and Analgesia | 238 | ||
| Osmotherapy | 239 | ||
| Cerebrospinal Fluid Drainage | 239 | ||
| Neuromuscular Blocking Agents | 241 | ||
| Second-Level Approaches for Intracranial Pressure Management | 241 | ||
| Barbiturates | 241 | ||
| Targeted Temperature Management – Normothermia Versus Hypothermia | 241 | ||
| Controlled Hyperventilation | 241 | ||
| Decompressive Craniectomy | 243 | ||
| STRATEGIES FOR NEUROPROTECTION | 243 | ||
| PREVENTION AND TREATMENT OF COMPLICATIONS AFTER TRAUMATIC BRAIN INJURY | 243 | ||
| Coagulopathy | 243 | ||
| Venous Thrombosis (Deep Vein Thrombosis) | 243 | ||
| Electrolyte Disturbances | 243 | ||
| Hyponatremia | 243 | ||
| Hypernatremia | 244 | ||
| Volume Depletion | 245 | ||
| Metabolic Response | 245 | ||
| Nutrition | 245 | ||
| Infectious Complications | 245 | ||
| Pulmonary Complications | 245 | ||
| Seizures | 246 | ||
| Gastrointestinal Prophylaxis | 246 | ||
| Paroxysmal Dysautonomia | 246 | ||
| OTHER MEDICATIONS USED FOR TRAUMATIC BRAIN INJURY | 247 | ||
| Lidocaine | 247 | ||
| Steroids | 247 | ||
| OUTCOMES | 247 | ||
| CONCLUSION | 247 | ||
| REFERENCES | 248 | ||
| 13 - Cerebrovascular Disorders | 253 | ||
| INTRODUCTION | 253 | ||
| PATIENTS AT RISK | 253 | ||
| Stroke Across the Lifespan | 254 | ||
| PREVENTION | 255 | ||
| DEFINITION | 255 | ||
| PATHOPHYSIOLOGY | 257 | ||
| Ischemic Stroke | 259 | ||
| Subarachnoid Hemorrhage | 259 | ||
| Intracerebral Hemorrhage | 263 | ||
| ASSESSMENT | 263 | ||
| Laboratory Findings | 269 | ||
| Radiographic Findings | 271 | ||
| MANAGEMENT | 274 | ||
| Initial Management | 274 | ||
| Neurologic Interventions | 275 | ||
| Pulmonary Interventions | 279 | ||
| Cardiac Interventions | 281 | ||
| Gastrointestinal Interventions | 281 | ||
| Genitourinary Interventions | 282 | ||
| Endocrine Interventions | 282 | ||
| Musculoskeletal Interventions | 282 | ||
| Integumentary Interventions | 282 | ||
| Rest and Comfort Interventions | 282 | ||
| Communication Interventions | 282 | ||
| Perception and Sensory Interventions | 283 | ||
| Psychosocial Support | 283 | ||
| Education | 283 | ||
| Palliative Care | 283 | ||
| ISCHEMIC STROKE | 283 | ||
| SUBARACHNOID HEMORRHAGE | 287 | ||
| INTRACEREBRAL HEMORRHAGE | 292 | ||
| EVIDENCE-BASED CARE | 293 | ||
| ETHICAL CONSIDERATIONS | 293 | ||
| CONCLUSION | 294 | ||
| REFERENCES | 294 | ||
| 14 - TRAUMATIC SPINAL CORD INJURY\r | 301 | ||
| V -\rGastrointestinal | 362 | ||
| 16 - Gastrointestinal Bleeding | 362 | ||
| APPLIED PHYSIOLOGY AND PATHOPHYSIOLOGY | 362 | ||
| PREVENTION | 366 | ||
| ASSESSMENT | 367 | ||
| Physical Assessment Findings | 367 | ||
| Laboratory Findings | 369 | ||
| Radiology Findings | 369 | ||
| Diagnostic Evaluations | 369 | ||
| PLAN OF CARE | 370 | ||
| CONCLUSION | 373 | ||
| REFERENCES | 373 | ||
| 17 - Liver Dysfunction and Failure | 375 | ||
| INTRODUCTION | 375 | ||
| ACUTE LIVER FAILURE | 375 | ||
| ACUTE-ON-CHRONIC LIVER DYSFUNCTION AND FAILURE | 375 | ||
| VI -\rRenal | 436 | ||
| 21 - Electrolyte Emergencies | 436 | ||
| APPLIED PHYSIOLOGY | 436 | ||
| POTASSIUM | 437 | ||
| Applied Physiology | 437 | ||
| Laboratory Findings | 437 | ||
| Hyperkalemia | 437 | ||
| Physical Assessment Findings | 439 | ||
| Laboratory Findings | 439 | ||
| Treatment | 439 | ||
| Hypokalemia | 440 | ||
| Applied Physiology and Pathophysiology | 440 | ||
| Physical Assessment Findings | 442 | ||
| Laboratory Findings | 442 | ||
| Treatment | 442 | ||
| SODIUM | 442 | ||
| Applied Physiology and Pathophysiology | 442 | ||
| Hypernatremia | 442 | ||
| Physical Assessment Findings | 443 | ||
| Laboratory Findings | 444 | ||
| Treatment | 444 | ||
| Hyponatremia | 444 | ||
| Physical Assessment Findings | 446 | ||
| Laboratory Findings | 446 | ||
| Treatment | 446 | ||
| CALCIUM | 446 | ||
| Applied Physiology and Pathophysiology | 446 | ||
| Hypercalcemia | 447 | ||
| Physical Assessment Findings | 447 | ||
| Laboratory Findings | 448 | ||
| Treatment | 448 | ||
| Hypocalcemia | 448 | ||
| Physical Assessment Findings | 449 | ||
| Laboratory Findings | 449 | ||
| Treatment | 449 | ||
| MAGNESIUM | 450 | ||
| Applied Physiology and Pathophysiology | 450 | ||
| Laboratory Values | 450 | ||
| Hypermagnesemia | 450 | ||
| Physical Assessment Findings | 450 | ||
| Laboratory Findings | 450 | ||
| Treatment | 450 | ||
| Hypomagnesemia | 451 | ||
| Physical Assessment Findings | 451 | ||
| Laboratory Findings | 451 | ||
| Treatment | 451 | ||
| PHOSPHORUS | 451 | ||
| Applied Physiology and Pathophysiology | 451 | ||
| Hyperphosphatemia | 452 | ||
| Physical Assessment Findings | 452 | ||
| Laboratory Findings | 452 | ||
| Treatment | 452 | ||
| Hypophosphatemia | 452 | ||
| Physical Assessment Findings | 453 | ||
| Laboratory Findings | 453 | ||
| Treatment | 453 | ||
| CONCLUSION | 453 | ||
| REFERENCES | 453 | ||
| 22 - Complex Acid-Base Disorders and Associated Electrolyte Imbalances | 455 | ||
| ACID-BASE PHYSIOLOGY | 455 | ||
| Definitions and Normal Values | 455 | ||
| Understanding Compensation | 455 | ||
| Application of Acid-Base Principles | 456 | ||
| The Anion Gap | 457 | ||
| PRIMARY ACID-BASE DISORDERS | 457 | ||
| Metabolic Acidosis | 457 | ||
| Causes of Metabolic Acidosis | 457 | ||
| Elevated Anion Gap Metabolic Acidosis | 458 | ||
| Non–Anion Gap Metabolic Acidosis | 458 | ||
| Manifestations of Metabolic Acidosis | 458 | ||
| Electrolyte Imbalances Associated with Metabolic Acidosis | 458 | ||
| Hyperkalemia | 458 | ||
| Ionized Calcium Increase | 458 | ||
| Treatment of Metabolic Acidosis | 459 | ||
| Bicarbonate Therapy | 460 | ||
| Alternative Treatments of Metabolic Acidosis | 460 | ||
| METABOLIC ALKALOSIS | 461 | ||
| Causes of Metabolic Alkalosis | 461 | ||
| Manifestations of Metabolic Alkalosis | 461 | ||
| Electrolyte Imbalances Associated with Metabolic Alkalosis | 461 | ||
| Hypokalemia | 461 | ||
| Low-Ionized Calcium | 462 | ||
| Hypophosphatemia and Hypomagnesemia | 462 | ||
| Special Patient Populations Requiring Aggressive Treatment of Metabolic Alkalosis | 462 | ||
| RESPIRATORY ACIDOSIS | 463 | ||
| Causes of Respiratory Acidosis | 463 | ||
| Compensation in Respiratory Acidosis | 463 | ||
| Manifestations of Respiratory Acidosis | 463 | ||
| Treatment of Respiratory Acidosis | 463 | ||
| RESPIRATORY ALKALOSIS | 464 | ||
| Causes of Respiratory Alkalosis | 464 | ||
| Compensation in Respiratory Alkalosis | 464 | ||
| Manifestations of Respiratory Alkalosis | 464 | ||
| Treatment of Respiratory Alkalosis | 465 | ||
| MIXED ACID-BASE DISORDERS | 465 | ||
| CONCLUSION | 465 | ||
| REFERENCES | 466 | ||
| 23 - Acute Kidney Injury | 467 | ||
| PREVENTION OF ACUTE KIDNEY INJURY | 467 | ||
| DEFINITION | 467 | ||
| APPLIED PATHOPHYSIOLOGY | 468 | ||
| Types of Acute Kidney Injury | 468 | ||
| Prerenal Acute Kidney Injury | 468 | ||
| Intrarenal Acute Kidney Injury | 469 | ||
| Postrenal Acute Kidney Injury | 470 | ||
| ASSESSMENT | 471 | ||
| Uremic Complications | 471 | ||
| Cardiovascular Manifestations | 471 | ||
| Respiratory Manifestations | 472 | ||
| Hematologic Manifestations | 472 | ||
| Gastrointestinal Manifestations | 472 | ||
| Neurologic Manifestations | 472 | ||
| INTERVENTIONS | 473 | ||
| Fluid Balance | 473 | ||
| Alterations in Electrolyte Balance | 474 | ||
| Metabolic Acidosis | 474 | ||
| RENAL REPLACEMENT THERAPY | 474 | ||
| Peritoneal Dialysis | 474 | ||
| Hemodialysis | 475 | ||
| Continuous Renal Replacement Therapies | 475 | ||
| Drug Therapy During Renal Replacement | 480 | ||
| NUTRITION IN ACUTE KIDNEY INJURY WITH RENAL REPLACEMENT THERAPY | 480 | ||
| INTERPROFESSIONAL PLAN OF CARE | 481 | ||
| ON THE HORIZON | 481 | ||
| CONCLUSION | 481 | ||
| REFERENCES | 481 | ||
| VII -\rEndocrine | 483 | ||
| 24 - Glycemic Control | 483 | ||
| PATIENTS AT RISK | 484 | ||
| DEFINITION | 484 | ||
| CLASSIFICATION OF DIABETES MELLITUS | 484 | ||
| PHYSIOLOGY OF GLUCOSE METABOLISM | 484 | ||
| Functions of the Pancreatic Hormones | 485 | ||
| PATHOPHYSIOLOGY OF DIABETES MELLITUS AND HYPERGLYCEMIA | 486 | ||
| ACUTE COMPLICATIONS OF DIABETES MELLITUS | 488 | ||
| Diabetic Ketoacidosis | 488 | ||
| Causes or Precipitating Factors of Diabetic Ketoacidosis | 488 | ||
| HYPEROSMOLAR HYPERGLYCEMIC STATE | 490 | ||
| HYPERGLYCEMIA | 495 | ||
| HYPOGLYCEMIA | 495 | ||
| PATIENT AND FAMILY EDUCATION | 496 | ||
| CONCLUSION | 496 | ||
| ACKNOWLEDGMENT | 497 | ||
| REFERENCES | 497 | ||
| 25 - Pituitary, Thyroid, and Adrenal Disorders | 499 | ||
| APPLIED PATHOPHYSIOLOGY | 499 | ||
| DISORDERS OF ANTIDIURETIC HORMONE | 501 | ||
| Diabetes Insipidus | 502 | ||
| Definition and Types of Diabetes Insipidus | 502 | ||
| Patients at Risk | 502 | ||
| Clinical Presentation | 502 | ||
| Diagnostic Evaluation | 502 | ||
| Interprofessional Plan of Care | 502 | ||
| Syndrome of Inappropriate Antidiuretic Hormone | 503 | ||
| Definition and Types of Syndrome of Inappropriate Antidiuretic Hormone | 503 | ||
| Patients at Risk | 503 | ||
| Clinical Presentation | 504 | ||
| Diagnostic Evaluation | 504 | ||
| Interprofessional Plan of Care | 504 | ||
| Conclusion | 504 | ||
| THYROID GLAND DISORDERS | 504 | ||
| Hyperthyroidism (Thyrotoxicosis/Thyroid Storm) | 504 | ||
| Patients at Risk | 504 | ||
| Clinical Presentation | 505 | ||
| Diagnostic Evaluation | 505 | ||
| Interprofessional Plan of Care | 505 | ||
| Conclusion | 506 | ||
| Hypothyroidism and Myxedema Coma | 506 | ||
| Patients at Risk | 506 | ||
| Clinical Presentation | 506 | ||
| Diagnostic Evaluation | 507 | ||
| Interprofessional Plan of Care | 507 | ||
| Conclusion | 507 | ||
| ADRENAL INSUFFIENCY IN CRITICAL ILLNESS | 507 | ||
| Definition of Adrenal Insufficiency | 507 | ||
| Patients at Risk | 507 | ||
| Clinical Presentation | 507 | ||
| Diagnostic Evaluation | 508 | ||
| Interprofessional Plan of Care | 508 | ||
| Conclusion | 508 | ||
| REFERENCES | 509 | ||
| VIII -\rHematologic | 511 | ||
| 26 - Blood Conservation and Blood Component Replacement | 511 | ||
| CONTROVERSIES IN TRANSFUSION | 511 | ||
| BLOOD CONSERVATION | 513 | ||
| Increasing Erythropoiesis | 513 | ||
| Minimizing Perioperative and Iatrogenic Blood Loss | 513 | ||
| Optimizing Hemostasis and Blood Transfusion Practices | 513 | ||
| ALTERNATIVES TO TRANSFUSION | 513 | ||
| Recombinant Human Erythropoietin | 513 | ||
| Vitamin K | 515 | ||
| BLOOD COMPONENT REVIEW | 515 | ||
| Whole Blood | 515 | ||
| Description | 515 | ||
| Indications | 516 | ||
| Red Blood Cells | 516 | ||
| Description | 516 | ||
| IX -\rMultisystem | 545 | ||
| 28 - Shock and End Points of Resuscitation | 545 | ||
| INTRODUCTION | 545 | ||
| HISTORY OF SHOCK | 545 | ||
| CELLULAR METABOLISM AND DYSFUNCTION DURING SHOCK | 545 | ||
| OXYGEN DELIVERY, CONSUMPTION, AND DEBT | 546 | ||
| Oxygen Delivery | 546 | ||
| Oxygen Consumption | 546 | ||
| Oxygen Delivery Dependence and Oxygen Debt | 547 | ||
| CLASSIFICATIONS OF SHOCK | 548 | ||
| Hypovolemic Shock | 548 | ||
| Cardiogenic Shock | 549 | ||
| Obstructive Shock | 549 | ||
| Distributive Shock | 550 | ||
| Septic Shock | 550 | ||
| Neurogenic Shock | 550 | ||
| Anaphylactic Shock | 550 | ||
| GENERAL PHASES OF SHOCK | 551 | ||
| Compensatory Phase | 551 | ||
| Decompensated Phase | 552 | ||
| Irreversible Shock Phase | 552 | ||
| RESUSCITATION MEASURES IN SHOCK | 552 | ||
| Initial Evaluation | 552 | ||
| Airway and Breathing | 552 | ||
| Circulation | 553 | ||
| Fluid Resuscitation | 553 | ||
| Fluid Delivery and Warming Mechanisms | 553 | ||
| Isotonic Crystalloids | 553 | ||
| Hypertonic Crystalloids | 554 | ||
| Colloid Solutions | 554 | ||
| Albumin | 554 | ||
| Hydroxyethyl Starch Solutions | 555 | ||
| Blood Transfusion Therapy and Adjuncts | 555 | ||
| END POINTS OF RESUSCITATION | 555 | ||
| Global End Points of Resuscitation | 556 | ||
| Heart Rate | 556 | ||
| Blood Pressure | 556 | ||
| Urine Output | 556 | ||
| Serum Lactate Levels | 556 | ||
| Arterial Base Deficit | 557 | ||
| Shock Index | 557 | ||
| Monitoring Technology | 557 | ||
| Hemodynamic Indices | 557 | ||
| Preload | 558 | ||
| Afterload | 558 | ||
| Contractility | 558 | ||
| Mixed Venous Oxygen Saturation | 558 | ||
| Hemodynamic Monitoring | 558 | ||
| Pulse Pressure Variation /Stroke Volume Variation | 558 | ||
| Passive Leg Raising | 559 | ||
| Esophageal Doppler | 559 | ||
| Point of Care Ultrasonography | 559 | ||
| REGIONAL RESUSCITATION END POINTS | 559 | ||
| Regional Tissue Perfusion | 559 | ||
| NUTRITIONAL SUPPORT IN SHOCK | 560 | ||
| COMPLICATIONS OF SHOCK | 560 | ||
| CONCLUSION | 561 | ||
| REFERENCES | 562 | ||
| 29 - Optimizing Hemodynamics: Strategies for Fluid and Medication Titration in Hypoperfusion States | 565 | ||
| HYPOPERFUSION STATES AND SYSTEMIC RESPONSES | 565 | ||
| Neurohormonal Regulation | 565 | ||
| MONITORING HEMODYNAMIC MEASURES | 566 | ||
| IDENTIFYING AND INTERPRETING HEMODYNAMIC MEASURES | 568 | ||
| Blood Pressure | 568 | ||
| Preload Measures | 569 | ||
| Afterload Measures | 570 | ||
| Contractility Measures | 571 | ||
| Overall Cardiovascular Performance and Perfusion Indicators | 571 | ||
| Putting It Together: Differentiating Hypoperfusion States | 572 | ||
| SHOCK-SPECIFIC THERAPY | 574 | ||
| Hypovolemic Shock | 574 | ||
| Cardiogenic Shock | 575 | ||
| Mechanical Circulatory Support in Cardiogenic Shock | 576 | ||
| Distributive Shock | 576 | ||
| TITRATABLE MEDICATIONS USED IN MANAGING SHOCK | 577 | ||
| Inotropic Agents | 581 | ||
| Dobutamine | 581 | ||
| Dopamine | 581 | ||
| Epinephrine | 582 | ||
| Milrinone | 582 | ||
| Vasopressor Agents | 582 | ||
| Norepinephrine | 583 | ||
| Phenylephrine | 583 | ||
| Vasopressin | 583 | ||
| Vasodilator Agents | 584 | ||
| Nitroglycerin | 584 | ||
| Nitroprusside | 584 | ||
| Nesiritide | 584 | ||
| Others | 585 | ||
| NURSING CARE OF THE HYPOPERFUSED PATIENT | 585 | ||
| CONCLUSION | 585 | ||
| REFERENCES | 586 | ||
| 30 - Trauma\r | 588 | ||
| INTRODUCTION | 588 | ||
| Development of the Trauma System | 588 | ||
| MECHANISM OF INJURY | 588 | ||
| BLUNT TRAUMA | 589 | ||
| Motor Vehicle Crash | 589 | ||
| Restraint-System Injuries | 590 | ||
| Key Crash Information | 591 | ||
| Auto-Pedestrian Accidents | 592 | ||
| Falls | 592 | ||
| Blast Injuries | 592 | ||
| Penetrating Trauma | 592 | ||
| Gunshot Wounds | 592 | ||
| Stab Wounds and Impalements | 592 | ||
| APPLIED PATHOPHYSIOLOGY | 593 | ||
| Shock | 593 | ||
| Systemic Inflammatory Response During Traumatic Shock | 594 | ||
| Hypermetabolic Response to Trauma | 594 | ||
| Physiologic Sequelae During Trauma Resuscitation | 595 | ||
| Hypothermia | 595 | ||
| Acidosis | 597 | ||
| Coagulopathy | 597 | ||
| Abdominal Compartment Syndrome | 598 | ||
| Rhabdomyolysis | 598 | ||
| PATHOPHYSIOLOGY OF SPECIFIC INJURIES | 598 | ||
| Brain and Spinal Cord Injury | 598 | ||
| Facial Trauma | 598 | ||
| Chest Trauma | 598 | ||
| Abdominal Trauma | 599 | ||
| Musculoskeletal Injuries | 600 | ||
| Extremity Injuries | 601 | ||
| Dislocation Injuries | 601 | ||
| Pelvic Ring Fractures | 602 | ||
| ASSESSMENT AND INTERVENTION | 602 | ||
| Primary Survey | 602 | ||
| Airway | 602 | ||
| Breathing | 602 | ||
| Circulation | 602 | ||
| Damage Control Resuscitation | 603 | ||
| Disability | 604 | ||
| Secondary Survey | 604 | ||
| Assessment and Intervention of Specific Injuries | 605 | ||
| EARLY CRITICAL CARE RESUSCITATION | 605 | ||
| Using Hemodynamic Monitoring to Guide Resuscitation | 605 | ||
| Reversing the Lethal Triad of Hypothermia, Acidosis, and Coagulopathy | 609 | ||
| Hypothermia | 609 | ||
| Acidosis | 610 | ||
| Coagulation | 611 | ||
| Managing Abdominal Compartment Syndrome | 611 | ||
| Identifying, Preventing, and Managing Rhabdomyolysis | 611 | ||
| Providing Analgesia and Sedation | 612 | ||
| Evaluation for Missed Injuries | 612 | ||
| CRITICAL CARE MANAGEMENT OF COMPLICATIONS FOLLOWING TRAUMA | 612 | ||
| Acute Respiratory Distress Syndrome | 612 | ||
| Nutritional Considerations for the Trauma Patient | 612 | ||
| Assessing and Treating Infection | 613 | ||
| Preventing Deep Venous Thrombosis | 613 | ||
| Providing Psychosocial Support | 614 | ||
| CONCLUSION | 614 | ||
| REFERENCES | 615 | ||
| 31 - Sepsis and Multiple Organ Dysfunction Syndrome | 619 | ||
| DEFINITIONS AND PATIENT IDENTIFICATION | 619 | ||
| EPIDEMIOLOGY OF SEPSIS AND MULTIPLE ORGAN DYSFUNCTION SYNDROME | 619 | ||
| PATHOPHYSIOLOGY OF SEPSIS | 620 | ||
| PATHOPHYSIOLOGY OF MULTIPLE ORGAN DYSFUNCTION SYNDROME | 621 | ||
| Inflammation | 621 | ||
| Mitochondrial Dysfunction | 622 | ||
| Activation of Coagulation | 622 | ||
| Impairment of Fibrinolysis | 622 | ||
| Alteration in Microcirculation | 624 | ||
| MECHANISMS OF ORGAN DYSFUNCTION IN MODS | 624 | ||
| Cardiovascular System | 624 | ||
| Respiratory System | 625 | ||
| Gastrointestinal System | 625 | ||
| Hepatic System | 625 | ||
| Renal System | 626 | ||
| Neurologic System | 626 | ||
| Hematologic System | 626 | ||
| ASSESSMENT OF MULTIPLE ORGAN DYSFUNCTION SYNDROME | 626 | ||
| INTERVENTIONS | 628 | ||
| Initial Resuscitation | 629 | ||
| Management of Infection | 629 | ||
| Source Identification | 629 | ||
| Antibiotic Therapy | 630 | ||
| Source Control | 630 | ||
| Additional Hemodynamic Support | 630 | ||
| Vasopressors | 630 | ||
| Inotropic Therapy | 630 | ||
| Steroids | 630 | ||
| Blood Product Administration | 630 | ||
| Mechanical Ventilation | 631 | ||
| Sedation, Analgesia, and Neuromuscular Blockade | 631 | ||
| Glucose Monitoring | 631 | ||
| Considerations for Nutrition | 631 | ||
| Renal Replacement | 631 | ||
| Bicarbonate Therapy | 631 | ||
| Deep Vein Thrombosis Prophylaxis | 631 | ||
| Stress Ulcer Prophylaxis | 632 | ||
| Consideration for Limitation of Support | 632 | ||
| CONCLUSION | 632 | ||
| REFERENCES | 633 | ||
| 32 - Caring for the Immunocompromised Patient | 636 | ||
| INTRODUCTION | 636 | ||
| DEFINITIONS | 636 | ||
| PATIENTS AT RISK | 637 | ||
| ASSESSMENT | 637 | ||
| Physical Findings | 637 | ||
| Diagnostic Test Results | 639 | ||
| INFECTION PREVENTION | 641 | ||
| ENHANCEMENT OF IMMUNE FUNCTION | 642 | ||
| TREATMENT OF INFECTION | 643 | ||
| CONCLUSION | 643 | ||
| REFERENCES | 644 | ||
| 33 - Caring for the Patient in the Immediate Postoperative Period\r | 646 | ||
| PATIENTS AT RISK FOR POSTOPERATIVE COMPLICATIONS | 646 | ||
| OVERVIEW OF ANESTHESIA AND THE ANESTHETIC AGENTS | 646 | ||
| GENERAL ANESTHESIA | 646 | ||
| INTRAVENOUS AGENTS | 647 | ||
| NEUROMUSCULAR BLOCKING AGENTS | 647 | ||
| REGIONAL ANESTHESIA | 649 | ||
| Local Anesthetics | 649 | ||
| Central Neuraxial Blocks | 649 | ||
| Peripheral Nerve Blocks | 649 | ||
| Cervical Plexus | 650 | ||
| Brachial Plexus | 650 | ||
| Intercostal Nerve Block and Interpleural Catheter Placement | 650 | ||
| Celiac Plexus Block | 650 | ||
| Lumbar Plexus | 651 | ||
| PATIENT TRANSFER TO THE PERIANESTHESIA CARE UNIT OR CRITICAL CARE UNIT FROM THE OPERATING ROOM | 651 | ||
| Respiratory Care and Complications | 653 | ||
| Cardiovascular Care and Complications | 655 | ||
| Central Nervous System Care and Complications | 656 | ||
| Electrolytes | 656 | ||
| Nutrition | 656 | ||
| Thermoregulation | 657 | ||
| Postanesthesia Shivering | 657 | ||
| Acute Postoperative Pain and Comfort Management | 658 | ||
| Postoperative Nausea and Vomiting | 658 | ||
| Skin Integrity and Mobility | 658 | ||
| CONCLUSION | 658 | ||
| REFERENCES | 659 | ||
| 34 - Caring for the Critically Ill Pregnant Patient | 661 | ||
| INTRODUCTION | 661 | ||
| PREGNANCY AND CRITICAL ILLNESS | 661 | ||
| NORMAL PHYSIOLOGIC CHANGES IN PREGNANCY | 661 | ||
| Reproductive System | 661 | ||
| Cardiovascular System | 661 | ||
| Pulmonary System | 662 | ||
| Gastrointestinal System | 662 | ||
| Renal System | 662 | ||
| MONITORING OF THE CRITICALLY ILL OBSTETRIC PATIENT | 662 | ||
| Maternal Monitoring | 664 | ||
| Fetal Monitoring | 664 | ||
| Maintenance of Cardiac Output | 664 | ||
| Airway and Oxygenation Support | 664 | ||
| Pharmacologic Concerns | 665 | ||
| Nutritional Considerations/Glycemic Control | 665 | ||
| Prevention of Thromboembolism | 665 | ||
| Labor and Delivery Considerations | 665 | ||
| Environment of Safety | 666 | ||
| Psychosocial Care | 667 | ||
| Pain Management | 667 | ||
| POSTDELIVERY CARE | 667 | ||
| Prevention of Hemorrhage | 667 | ||
| Support of Breastfeeding | 667 | ||
| Support of Maternal-Infant Bonding | 667 | ||
| CARDIAC DISEASE IN PREGNANCY | 667 | ||
| General Considerations | 667 | ||
| Women with Preexisting Valvular Heart Disease | 668 | ||
| Women with Congenital Heart Disease | 668 | ||
| Left to Right Shunts | 668 | ||
| Marfan Syndrome | 668 | ||
| Cyanotic Lesions | 668 | ||
| Cardiac Disease Arising During Pregnancy | 668 | ||
| Peripartum Cardiomyopathy | 668 | ||
| Ischemic Heart Disease | 669 | ||
| Shock | 669 | ||
| Cardiac Arrest | 669 | ||
| Hypertensive Disease | 669 | ||
| Classification | 669 | ||
| Management | 669 | ||
| Complications | 670 | ||
| PULMONARY DYSFUNCTION IN PREGNANCY | 670 | ||
| Mechanical Ventilation | 670 | ||
| Asthma | 670 | ||
| Acute Respiratory Distress Syndrome | 670 | ||
| Pulmonary Embolism | 670 | ||
| Amniotic Fluid Embolism/Anaphylactoid Syndrome of Pregnancy | 670 | ||
| ACUTE FATTY LIVER OF PREGNANCY | 671 | ||
| TRAUMA IN PREGNANCY | 671 | ||
| Causes/Types/Incidence | 671 | ||
| Gestational Considerations | 671 | ||
| Management | 671 | ||
| CONCLUSION | 671 | ||
| REFERENCES | 672 | ||
| 35 - Caring for the Pediatric Patient in an Adult Critical Care Unit | 674 | ||
| INTRODUCTION | 674 | ||
| LEVELS OF PICU CARE | 674 | ||
| MODELS OF CO-RESIDENCE | 674 | ||
| Service Line Model | 674 | ||
| Geographic Model | 674 | ||
| REGIONALIZATION OF CARE | 674 | ||
| Pediatric Intensivist Coverage | 674 | ||
| Tiered Care | 674 | ||
| Localized Community Care | 675 | ||
| STANDARDIZING CARE FOR CHILDREN | 675 | ||
| Standardizing Documentation Across the Institution | 675 | ||
| Standardized Equipment | 675 | ||
| Standardizing Emergency Equipment | 679 | ||
| PEDIATRIC RESUSCITATION PRIORITIES | 679 | ||
| NUTRITION | 680 | ||
| CHILD AND FAMILY-CENTERED CARE | 680 | ||
| Decreasing Family Stressors | 680 | ||
| Family Presence | 680 | ||
| Siblings and Childhood Friends | 681 | ||
| QUALITY MONITORING | 681 | ||
| INFECTION PREVENTION | 682 | ||
| THE CHILD’S RESPONSE TO CRITICAL CARE | 684 | ||
| CONSIDERATIONS IN PEDIATRIC CARE | 684 | ||
| Pediatric Assessment | 684 | ||
| Blood Pressure | 684 | ||
| Pulse | 685 | ||
| Temperature | 685 | ||
| Respiratory Rate | 685 | ||
| Fluid Balance in Children | 685 | ||
| Medication Administration in Children | 686 | ||
| PAIN IN CHILDREN | 686 | ||
| Delirium in Children | 687 | ||
| Neuromuscular Blockade | 687 | ||
| INTENTIONAL INJURIES IN THE PEDIATRIC PATIENT | 687 | ||
| PARENTAL PERMISSION AND CHILD ASSENT | 691 | ||
| TRANSITIONS FOR THE CHILD AND FAMILY IN CRITICAL CARE | 691 | ||
| Out of the PICU | 691 | ||
| Palliative Care | 691 | ||
| COMPETENT PEDIATRIC INTENSIVE CARE NURSING | 691 | ||
| Initial Pediatric Orientation | 691 | ||
| Ongoing Competencies | 692 | ||
| CONCLUSION | 692 | ||
| REFERENCES | 693 | ||
| 36 - Caring for the Critically Ill Elderly Patient | 696 | ||
| THE AGING POPULATION | 696 | ||
| XI -\rSpecial Considerations In Critical Care | 746 | ||
| 39 - Pain and Sedation\r | 746 | ||
| PATIENTS AT RISK | 746 | ||
| ACUTE VERSUS CHRONIC PAIN | 746 | ||
| Peripheral Versus Central Pain | 748 | ||
| Pain Theory | 748 | ||
| Nociception and Inflammation | 749 | ||
| RESPONSE TO PAIN | 749 | ||
| Stress Response Theory | 751 | ||
| Guidelines Proposed by The Joint Commission | 752 | ||
| MEASURING AND ASSESSING PAIN | 752 | ||
| MANAGEMENT OF PAIN AND DISCOMFORT | 757 | ||
| Nonpharmacologic Interventions | 757 | ||
| Comfort Measures | 757 | ||
| Complementary Therapies | 758 | ||
| Pharmacologic Interventions | 760 | ||
| Oral Nonopioid Analgesics | 760 | ||
| Intravenous Nonopioids | 762 | ||
| Opioid Analgesics | 763 | ||
| Agonists | 764 | ||
| Partial Agonists | 764 | ||
| Mixed Agonist-Antagonists | 764 | ||
| Routes of Administration | 764 | ||
| Frequency and Titration of Opioids | 765 | ||
| Recognizing and Managing Opioid Side Effects | 765 | ||
| Respiratory Depression | 765 | ||
| Tolerance and Dependence | 765 | ||
| Coanalgesics | 766 | ||
| ASSESSMENT AND MANAGEMENT OF SEDATION | 767 | ||
| Sedating Agents | 770 | ||
| NEUROMUSCULAR BLOCKADE | 772 | ||
| CONCLUSION | 777 | ||
| REFERENCES | 777 | ||
| 40 - Comorbid Conditions | 779 | ||
| INTRODUCTION | 779 | ||
| CRITICAL CARE PREDICTIVE SCORING SYSTEMS | 779 | ||
| Scoring Systems Defined | 779 | ||
| Impact of Comorbidities on Length of Stay and Treatment | 779 | ||
| COMORBIDITIES USED IN SCORING SYSTEMS | 780 | ||
| Metastatic Cancer/Hematologic Malignancy | 780 | ||
| HIV, AIDS, and Immunosuppression | 781 | ||
| Chronic and End-Stage Liver Disease | 781 | ||
| Chronic Kidney Disease and End-Stage Renal Disease | 781 | ||
| OTHER COMORBIDITIES AS PREDICTORS OF OUTCOME | 781 | ||
| Respiratory Conditions | 781 | ||
| Cardiovascular Disease | 782 | ||
| Diabetes Mellitus | 783 | ||
| Age | 783 | ||
| Obesity | 783 | ||
| Social and Psychological Comorbidities | 783 | ||
| CARE OF PATIENTS WITH MULTIPLE COMORBIDITIES | 783 | ||
| CONCLUSION | 783 | ||
| REFERENCES | 784 | ||
| 41 - Oncologic Emergencies\r | 786 | ||
| HYPERCALCEMIA OF MALIGNANCY | 786 | ||
| Patients at Risk | 786 | ||
| Pathophysiology | 786 | ||
| Clinical Presentation | 786 | ||
| Laboratory Findings | 787 | ||
| Diagnostic Evaluation | 787 | ||
| Interprofessional Plan of Care | 787 | ||
| Rehydration | 787 | ||
| Antiresorptive Therapy | 787 | ||
| Calcitonin | 788 | ||
| Denosumab | 788 | ||
| Corticosteroid Therapy | 788 | ||
| Renal Replacement Therapies | 788 | ||
| Symptom Management | 788 | ||
| Psychosocial Support | 788 | ||
| ACUTE TUMOR LYSIS SYNDROME | 788 | ||
| Patients at Risk | 788 | ||
| Pathophysiology | 789 | ||
| Clinical Presentation | 789 | ||
| Laboratory Findings | 789 | ||
| Interprofessional Plan of Care | 789 | ||
| Dialysis | 790 | ||
| SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION | 790 | ||
| Patients at Risk | 790 | ||
| Pathophysiology | 790 | ||
| ANSWERS TO DECISION POINT QUESTIONS | 837 | ||
| r3 ACUTE CORONARY SYNDROMES | 837 | ||
| INDEX | 849 | ||
| A | 849 | ||
| B | 854 | ||
| C | 855 | ||
| D | 860 | ||
| E | 862 | ||
| F | 864 | ||
| G | 865 | ||
| H | 866 | ||
| I | 869 | ||
| J | 871 | ||
| K | 871 | ||
| L | 871 | ||
| M | 872 | ||
| N | 875 | ||
| O | 877 | ||
| P | 877 | ||
| Q | 881 | ||
| R | 881 | ||
| S | 883 | ||
| T | 886 | ||
| U | 888 | ||
| V | 889 | ||
| W | 890 | ||
| X | 890 | ||
| Y | 890 | ||
| Z | 890 |