RESUMO
Dyspnea is a common symptom in patients with acute and chronic critical illness as well as in patients receiving palliative care. While dyspnea can be found in a variety of clinical arenas and across many specialties, the mechanisms that cause dyspnea are similar. Although not often the cause for admission to critical care, it may complicate and extend length of stay. This article defines and describes dyspnea and its pathophysiology. Critical care nurses should strive to implement interventions supported by evidence whenever possible. An evidence-based plan of care for the assessment, planning, intervention, and evaluation of the patient with dyspnea is outlined, using levels of recommendation based on the strength of available evidence. Two case studies are presented to illustrate its application to clinical practice.
Assuntos
Cuidados Críticos/métodos , Dispneia/terapia , Medicina Baseada em Evidências/métodos , Avaliação em Enfermagem/métodos , Planejamento de Assistência ao Paciente/organização & administração , Adulto , Idoso , Células Quimiorreceptoras/fisiopatologia , Dispneia/diagnóstico , Dispneia/etiologia , Feminino , Humanos , Masculino , Mecanorreceptores/fisiopatologia , Papel do Profissional de Enfermagem , Oxigenoterapia/enfermagem , Cuidados Paliativos/métodos , Exame Físico , Projetos de Pesquisa , Respiração Artificial/enfermagem , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
Diarrhea is one of many symptoms that may complicate the hospitalization of a critically ill patient. Diarrhea is caused by a variety of etiologies; identifying the etiology aids in the appropriate selection of interventions. Care of the patient with diarrhea should be guided by the evidence and best practices available in the literature. This article defines and describes diarrhea and its pathophysiology. An evidence-based plan of care for the assessment, planning, intervention, and evaluation of the patient with diarrhea is presented, using levels of recommendation based on the strength of the available evidence. A case study is presented to illustrate application to clinical practice. Commentary about the case is provided to review salient points of care.
Assuntos
Cuidados Críticos/métodos , Diarreia/terapia , Medicina Baseada em Evidências/métodos , Avaliação em Enfermagem/métodos , Planejamento de Assistência ao Paciente/organização & administração , Doença Aguda , Adulto , Algoritmos , Antibacterianos/uso terapêutico , Benchmarking , Criança , Doença Crônica , Árvores de Decisões , Diagnóstico Diferencial , Diarreia/diagnóstico , Diarreia/etiologia , Documentação/métodos , Nutrição Enteral/enfermagem , Feminino , Hidratação/enfermagem , Humanos , Controle de Infecções/métodos , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Guias de Prática Clínica como Assunto , Fatores de RiscoRESUMO
Fever occurs frequently in critically ill patients and requires knowledgeable assessment and treatment by critical care nurses. Fever can result from infection or inflammation and should be differentiated from simple hyperthermia. Although temperature measurement and fever management are not often priorities in the management of a critically ill patient, the physiologic consequences of fever may affect patient morbidity. This article defines and describes fever and its pathophysiology. An evidence-based plan of care for the assessment, planning, intervention, and evaluation of the patient with fever is outlined, using levels of recommendation based on the strength of the available evidence. A case study is presented to illustrate application to clinical practice. Commentary about the case is provided to review the salient points of care.
Assuntos
Cuidados Críticos/métodos , Medicina Baseada em Evidências/métodos , Febre/terapia , Avaliação em Enfermagem/métodos , Planejamento de Assistência ao Paciente/organização & administração , Adolescente , Algoritmos , Causalidade , Árvores de Decisões , Diagnóstico Diferencial , Febre/diagnóstico , Febre/etiologia , Humanos , Masculino , Monitorização Fisiológica/enfermagem , Guias de Prática Clínica como Assunto , Projetos de PesquisaRESUMO
Nausea and vomiting are commonly seen in the critically ill patient. While these symptoms are not often the cause for admission to critical care, they complicate and may extend the length of stay as well as the patient's feelings about his or her hospitalization. As with all care provided in critical care, we should strive to implement interventions supported by evidence whenever possible. The article includes definitions, a general description, and the pathophysiology of nausea and vomiting. As well, an evidence-based plan of care for the assessment, planning, intervention, and evaluation of the patient with nausea and vomiting is outlined, using levels of recommendation based on the strength of available evidence. A case study is presented to allow for clinical application: case study commentary reviews the salient points of care.