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 |