Menu Expand
AACN Core Curriculum for High Acuity, Progressive and Critical Care Nursing - E-Book

AACN Core Curriculum for High Acuity, Progressive and Critical Care Nursing - E-Book

(2017)

Additional Information

Book Details

Abstract

From the experts at the American Association of Critical-Care Nurses (AACN) comes the definitive resource for critical care certification and clinical practice. This new seventh edition has been thoroughly updated to reflect the current state of high acuity, progressive, and critical care nursing practice and includes expanded coverage of pain management, palliative care, and end-of-life care; transplantation; and key AACN initiatives. It also reflects the most current literature, national and international guidelines, clinical studies, and of course, the newest content on the CCRN® exam.

  • Authored by the experts at the American Association of Critical-Care Nurses (AACN), this is the definitive guide to critical care nursing certification and clinical practice.
  • NEW! Significantly updated content corresponds to the most recent CCRN® examination blueprint and reflects the most current literature, national and international guidelines, clinical studies, AACN/ANA scope of practice, and ECCO 3.0.
  • NEW! Expanded coverage of key content reflects the healthcare needs of today’s patients, including pain management, palliative care, and end-of-life care; nutritional support; transplantation; and key AACN initiatives.
  • Concise outline format is organized by body system to make information easy to digest.
  • NEW! Clinical Pearls and Key Concepts boxes highlight key content and serve as a convenient quick reference.
  • NEW! Improved navigation includes printed index tabs to help distinguish chapters and find information fast.
  • Basic to advanced levels of coverage, with an emphasis on clinical nursing practice, prepare you for the full range of knowledge you will encounter on the CCRN exam and in practice.
  • Coverage of the AACN Synergy Model is featured in the new opening chapter.
  • Professional Care and Ethical Practice is integrated into the Core Curriculum series framework.
  • A new chapter on Critical Care Patients with Special Needs includes bariatric and geriatric patients in critical care, as well as high-risk obstetric patients.
  • Features new content on chest tubes, liver transplantation for acute liver failure, spirituality, and spiritual aspects of care.
  • Integrates pain as the 5th vital sign and includes JCAHO, HCFA, and AHCPR guidelines relating to pain management.
  • Features AHRQ evidence-based practice guidelines as reference sources for practice interventions.
  • New organization for Patient Care presents patient problems, needs, etc. in order of clinical priority.
  • Expanded Nursing Interventions includes considerations related to patient/family education, patient transfer, and discharge planning.
  • Web-based resources for CDC, AHA, NINR, National Guideline Clearinghouse, NIH Consensus Conference Proceedings, ADA.

Table of Contents

Section Title Page Action Price
Front Cover cover
Inside Front Cover ifc1
AACN Core Curriculum for High Acuity, Progressive, and Critical Care Nursing i
Copyright Page ii
Contributors iii
Reviewers vi
Preface x
Acknowledgements xiii
Table of Contents xv
1 Professional Caring and Ethical Practice 1
American Association of Critical-Care Nurses Mission, Vision, and Values (AACN, 2016) 1
Mission 1
Vision 1
Values 1
Synergy of Caring 1
What Nurses Do (American Nurses Association [ANA], 2017) 1
What Acute and Critical Care Nurses Do (Bell, 2015) 1
The Environment of Critical Care 2
The “Synergy” of the AACN Synergy Model for Patient Care 3
AACN Synergy Model for Patient Care (AACN Certification Corporation, 2016a) 4
Origin of the Synergy Model 4
Purpose 4
Overview of the Synergy Model 4
Application of the Synergy Model 12
Family Presence: Visitation in the Adult ICU (AACN Practice Alert, 2016) 13
Healthy Work Environment Standards (AACN, 2016) 13
General Legal Considerations Relevant to Critical Care Nursing Practice 14
National Governing Bodies 14
State Nurse Practice Acts 14
Scope of Practice 14
Standards of Care 14
Certification in a Specialty Area 15
Professional Liability 15
Documentation 18
Good Samaritan Laws 19
Ethical Clinical Practice 20
Foundation of Ethical Nursing Practice 20
Emergence of Clinical Ethics 20
Standard Ethical Theory 21
Ethical Principles (ANA, 2015b) 21
Common Ethical Distinctions 22
Advance Care Planning 22
The Law in Clinical Ethics (Department of Health & Human Services, 2016) 24
Clinical Ethics Assessment 29
Nurse’s Role as Patient Advocate and Moral Agent 30
References 31
Environment of Professional Caring and the AACN Synergy Model for Patient Care 31
Legal Aspects of Care 32
Ethical Aspects of Care 32
Bibliography 32
Environment of Professional Caring and the AACN Synergy Model for Patient Care 32
Legal Aspects of Care 33
Ethical Aspects of Care 33
2 Pulmonary System 34
Systemwide Elements 34
Anatomy and Physiology Review 34
Assessment 54
Patient Care 76
Specific Patient Health Problems 102
Acute Respiratory Failure (ARF) 102
Chest Trauma 105
Acute Respiratory Distress Syndrome (ARDS) 105
Pulmonary Embolism 107
Chronic Obstructive Pulmonary Disease (COPD) 110
Asthma and Status Asthmaticus 114
Pneumonia 116
Ventilator Associated Pneumonia (VAP) and Event (VAE) 120
Drowning 121
Pulmonary Problems in Surgical/Thoracic Surgery Patients 122
Air Leak Syndromes 124
Acute Pulmonary Inhalation Injuries 125
Neoplastic Lung Disease 125
Pulmonary Fibrosis 128
Obstructive Sleep Apnea 129
End-Stage Pulmonary Conditions: Lung Transplantation 131
Bibliography 136
Anatomy/Physiology and Assessment 136
Mechanical Ventilation 136
Acute Respiratory Failure 137
Acute Respiratory Distress Syndrome 137
Pulmonary Embolism 137
Chronic Obstructive Pulmonary Disease 137
Asthma and Status Asthmaticus 138
Pneumonia 138
Ventilator Associated Events 138
Prevention 139
Drowning 139
Thoracic Surgery 139
Airleak Syndromes 140
Neoplastic Lung Disease 140
Pulmonary Fibrosis 140
Obstructive Sleep Apnea 141
End-Stage Pulmonary Conditions Eligible for Lung Transplantation 141
3 Cardiovascular System 142
Systemwide Elements 142
Anatomy and Physiology Review 142
Assessment 154
Diagnostic Studies 161
Patient Care 197
Specific Patient Health Problems 200
Acute Coronary Syndrome 200
Acute Myocardial Infarction—ST-Segment Elevation MI (STEMI) 200
Non-ST Elevation Myocardial Infarction (see Acute Coronary Syndrome (NSTEMI-ACS and Unstable Angina) 210
Chronic Stable Angina Pectoris 213
Coronary Artery Disease (CAD) 216
Heart Failure 219
Pericardial Disease 224
Myocarditis 231
Infective Endocarditis (IE) 234
Cardiomyopathy 239
Cardiac Rhythm Disorders 245
Symptomatic Bradycardia 245
Symptomatic Tachycardia 250
Absent or Ineffective Pulse 255
Mitral Regurgitation (MR) 258
Mitral Stenosis 261
Aortic Regurgitation (AR) 263
Aortic Stenosis 266
Atrial Septal Defect (ASD) 269
Ventricular Septal Defect (VSD) 272
Patent Ductus Arteriosus (PDA) 275
Coarctation of the Aorta 277
Hypertensive Crisis 279
Aortic and Peripheral Arterial Disease 284
Shock 290
Mechanical Circulatory Support Devices (MCS) 297
End-Stage Heart Disease: Cardiac Transplantation 303
Cardiac Trauma 306
References 306
Bibliography 306
Websites 309
4 Neurologic System 310
Systemwide Elements 310
Anatomy and Physiology Review 310
Assessment 345
Patient Care 360
Specific Patient Health Problems 369
Increased Intracranial Pressure (ICP) or Intracranial Hypertension (IH) 369
Stroke 378
Intracranial Aneurysms 378
Arteriovenous Malformation (AVM) 382
Ischemic Stroke 387
Intracerebral /Intraparenchymal Hemorrhagic Stroke 396
Brain Tumor 399
Spinal and Spinal Cord Tumors 402
Intracranial Infections 404
Bacterial Meningitis 404
Viral Encephalitis 407
Neuromuscular/Autoimmune Disease 409
Guillain-Barré Syndrome 409
Myasthenia Gravis (MG) 411
Seizures 413
Encephalopathy 416
Coma 417
Brain Death 418
Bibliography 419
Physiologic Anatomy 419
Patient Care 419
Diagnostic Procedures, Bedside Monitoring, and Assessment 419
Intracranial Aneurysms 420
Arteriovenous Malformation 420
Acute Ischemic Stroke 420
Intracerebral Hemorrhage 421
Brain Tumor 421
Spinal Cord Tumor 422
Intracranial Infections 422
Guillain-Barré Syndrome 422
Myasthenia Gravis 422
Seizures 422
Encephalopathy 422
Coma 422
Brain Death 423
5 Renal System 424
Systemwide Elements 424
Anatomy and Physiology Review 424
Assessment 436
Patient Care 442
Specific Patient Health Problems 450
Renal Trauma 450
Acute Kidney Injury 450
Chronic Kidney Disease 462
Electrolyte Imbalances—Potassium Imbalance: Hyperkalemia 468
Electrolyte Imbalances—Potassium Imbalance: Hypokalemia 473
Electrolyte Imbalances—Sodium Imbalance: Hypernatremia 475
Electrolyte Imbalances—Sodium Imbalance: Hyponatremia 477
Electrolyte Imbalances—Calcium Imbalance: Hypercalcemia 478
Electrolyte Imbalances—Calcium Imbalance: Hypocalcemia 480
Electrolyte Imbalances—Phosphate Imbalance: Hyperphosphatemia 481
Electrolyte Imbalances—Phosphate Imbalance: Hypophosphatemia 482
Electrolyte Imbalances—Magnesium Imbalance: Hypermagnesemia 483
Electrolyte Imbalances—Magnesium Imbalance: Hypomagnesemia 484
Rhabdomyolysis 485
End-Stage Renal Condition: Renal Transplant 486
Bibliography 489
Anatomy and Physiology Review 489
Assessment 489
Patient Care 489
Acute Kidney Injury 490
Chronic Kidney Disease 490
Electrolyte Imbalances 490
Rhabdomyolysis 490
End-Stage Renal Conditions 491
6 Endocrine System 492
Systemwide Elements 492
Anatomy and Physiology Review 492
Hypothalamus 492
Pituitary Gland 493
Thyroid Gland 495
Parathyroid Glands 495
Adrenal Glands 496
Pancreas 497
Pineal Gland and Thymus Gland 498
Gonadal Hormones (Testosterone, Estrogen, Progesterone) 498
Assessment 498
Patient Care 501
Specific Patient Health Problems 502
Altered Glucose Metabolism 502
Altered Antidiuretic Hormone (ADH) Production 509
Altered Thyroid Hormone Production 512
Acute Adrenal Insufficiency or Crisis 515
Acute Hyperparathyroidism and Hypoparathyroidism 516
Bibliography 516
Physiologic Anatomy 516
Patient Assessment 516
Thyrotoxicosis, Myxedema Coma 516
Diabetes Insipidus; Syndrome of Inappropriate Antidiuretic Hormone 516
Diabetic Ketoacidosis; Hyperglycemic Hyperosmolar State; Hyperglycemia; Hypoglycemia 517
Acute Adrenal Insufficiency 517
Acute Hyperparathyroidism and Hypoparathyroidism 517
7 Hematologic and Immune Systems 518
Systemwide Elements 518
Anatomy and Physiology 518
Assessment of Hematologic and Immunologic Systems 521
Patient Care 524
Specific Patient Health Problems 527
Thrombocytopenia 527
Disseminated Intravascular Coagulation 529
Medication-Induced Coagulopathy 533
Thromboembolic Disorders 535
Anemia 536
Sickle Cell Anemia 538
Neutropenia 540
Acute Leukemia 541
Hematopoietic Stem Cell Transplantation (HSCT) 543
Organ Transplant Rejection 545
HIV Infection 547
Anaphylactic Reaction 549
References 550
Bibliography 550
Websites 551
8 Gastrointestinal System 552
Systemwide Elements 552
Anatomy and Physiology Review 552
Accessory Organs of Digestion (Fig. 8.4) 559
Patient Assessment 563
Patient Care 569
Specific Patient Health Problems 570
Abdominal Trauma 570
Bowel Infarction/Ischemia 570
Bowel Obstruction 572
Abdominal Compartment Syndrome (ACS) 574
Acute Abdomen 575
Acute Liver Failure 577
Gastrointestinal Bleeding 579
Gastrointestinal Bariatric Surgery 583
Chronic Liver Failure: Decompensated Cirrhosis 583
Carcinoma of the Gastrointestinal Tract 587
Acute Pancreatitis 590
Hepatitis 593
End-Stage Gastrointestinal System Condition: Liver Transplantation 596
Nutritional Support in the Critically Ill Patient 597
Bibliography 599
Physiologic Anatomy 599
Patient Assessment 599
Acute Abdomen 599
Abdominal Compartment Syndrome 599
Acute Liver Failure 599
Chronic Liver Failure: Decompensated Cirrhosis 599
Acute Pancreatitis 600
Gastrointestinal Bleeding 600
Carcinoma of the Gastrointestinal Tract 600
Gastroesophageal Reflux 600
Hepatitis 600
Liver Transplantation 600
Inflammatory Bowel Disease 600
Gastrointestinal Motility 601
Nutritional Support 601
9 Multisystem 602
Systemic Inflammatory Response Syndrome and Septic Shock 602
Systemwide Elements 602
Anatomy and Physiology Review 602
Assessment 611
Patient Care 614
Multiple Organ Dysfunction Syndrome 617
Systemwide Elements 617
Anatomy and Physiology Review 617
Assessment 620
Patient Care 621
Multisystem Trauma 622
Systemwide Elements 622
Trauma Concepts and Physiology Review 622
Assessment 627
Patient Care 632
Head and Spinal Trauma 634
Thoracic Trauma: Pulmonary and Cardiac 646
Pulmonary Trauma 646
Cardiac Trauma 649
Abdominal Trauma 652
Burns 655
Systemwide Elements 655
Anatomy and Physiology Review 655
Assessment 663
Patient Care 668
Hypothermia 671
Systemwide Elements 671
Anatomy and Physiology Review 671
Assessment 675
Patient Care 678
Toxin Exposure 681
Systemwide Elements 681
Anatomy and Physiologic Review 681
Assessment 687
Patient Care 690
Interventions for Ingestion of Toxic Substance (Fig. 9.6) 692
General Management Strategies for Gastric Decontamination 694
Treatment for Body Stuffing/Body Packing 695
Additional Interventions for the Purposeful Ingestion 695
References 695
Bibliography 695
Systemic Inflammatory Response Syndrome and Septic Shock 695
Websites 696
Multiple Organ Dysfunction Syndrome 696
Multisystem Trauma 696
Head and Spinal Trauma 697
Thoracic Trauma 697
Abdominal Trauma 698
Burns 698
Hypothermia 698
Toxin Exposure 699
10 Psychosocial Aspects of High Acuity and Critical Care 700
Systemwide Elements 700
Review of Psychosocial Concepts 700
Assessment 704
Sleep Deprivation 705
Pain, Agitation, Delirium (PAD) 706
ASD and PTSD 708
Delirium (Acute Confusional State) 709
Powerlessness 711
Anxiety 712
Depression 714
Substance Misuse, Dependence, and Withdrawal 715
Aggression and Violence 717
Suicide 718
Dying Process and Death 720
Reference 721
Bibliography 722
Psychosocial 722
Websites 722
Pain/ Anxiety/ Delirium 722
Anxiety/Depression 723
Websites 723
PTSD 723
Substance Dependence Abuse and Withdrawal 723
11 Critical Care Patients With Special Needs 725
Bariatric Patients 725
Systemwide Elements 725
Anatomy and Physiology Review 725
Assessment 727
Patient Care 728
Care of the Bariatric Surgery Patient 730
Related Bariatric Care Issues 731
Care of the Older Adult 732
Age-Related Biologic and Behavioral Differences 732
Age-Related Changes in Medication Action 732
Comprehensive Geriatric Assessment 736
High-Risk Obstetric Patients 741
Systemwide Elements 741
Anatomy and Physiology Review 741
Specific Patient Health Problems 741
Postpartum Hemorrhage (PPH) 741
Hypertensive Disorders of Pregnancy 744
Hemolysis, Elevated Liver Enzymes, Low Platelet Count (HELLP) Syndrome 748
Amniotic Fluid Embolism (AFE) 749
Acute Fatty Liver of Pregnancy (AFLP) 750
Special Considerations 751
Trauma 751
Cardiopulmonary (CPR) Concerns in Pregnant Patients 752
Patient Transport 752
Members of the Transport Team 753
Indications for Transport 753
Modes of Interfacility Transport 754
Risks and Stresses of Transport 755
Overriding Priorities in Patient Transport 756
Preparation for Transport 757
Patient Care During Transport 759
Legal and Ethical Issues Related to Transport 760
Sedation in Critically Ill Patients 760
Systemwide Elements 760
Considerations With Sedation 760
Practice Considerations With Sedation 761
Specific Patient Health Problems 768
Procedural Sedation and Analgesia for the Patient in High Acuity Settings 768
Pain in the Critically Ill Patient 772
Systemwide Elements 772
Anatomy and Physiology Review 772
Background 777
Assessment 779
Patient Care 784
Patient Education 788
Specific Clinical Problems Related to Pain Therapy 788
Specific Patient Health Problems 791
Palliative and End-of-Life Care 792
Systemwide Elements 792
Concept Review 792
Assessment for PC, Hospice, or EOLC Services 796
Patient Care 797
Transitioning Goals of Care to End-of-Life (Box 11.5) 798
Additional Considerations (see Chapter 10, Psychosocial Aspects of High Acuity and Critical Care) 800
References 800
Palliative and End-of Life Care 801
Bibliography 801
Bariatric Patients 801
Websites 801
Older Patients 801
Normal Changes With Aging 802
Comprehensive Geriatric Assessment 802
High-Risk Obstetric Patients 802
Patient Transport 803
Members of the Transport Team 803
Indications and Equipment for Transport 803
Modes of Interfacility Transport 803
Risks and Stresses of Transport 803
Overriding Priorities in Patient Transport 804
Preparation for Transport 804
Patient Care During Transport 804
Legal and Ethical Issues Related to Transport 804
Sedation in Critically Ill Patients 804
Pain in the Critically Ill Patient 805
Websites, Resources, and Organizations 807
Palliative and End-of Life Care 807
Websites 808
Index 809
A 809
B 813
C 815
D 818
E 820
F 822
G 822
H 823
I 826
J 828
K 828
L 828
M 829
N 831
O 832
P 832
Q 836
R 836
S 837
T 840
U 841
V 841
W 842
Y 842
Z 842