1. Assessment of Progressive Care Patients and Their Families
Mary Fran Tracy
Comprehensive Initial Assessment
Patient Safety Considerations in Admission Assessments
Prearrival Assessment: Before the Action Begins
Arrival Quick Check Assessment
Circulation and Cerebral Perfusion
Comprehensive Initial Assessment
Physical Assessment by Body System
2. Planning Care for Progressive Care Patients and Their Families
Mary Fran Tracy
Multidisciplinary Plan of Care
Planning Care Through Staffing Considerations
Patient Safety Considerations in Planning Care
Prevention of Common Complications
Assessment of Learning Readiness
Strategies to Address Patient and Family Education
Transporting the Progressive Care Patient
Assessment of Risk for Complications
Level of Care Required During Transport
Transitioning to the Next Stage of Care
Supporting Patients and Their Families During the Dying Process
Family Interventions/Visitation
Transport of Critically Ill Patients
3. Interpretation and Management of Basic Cardiac Rhythms
Carol Jacobson
ECG Waveforms, Complexes, and Intervals
Determination of the Heart Rate
Determination of Cardiac Rhythm
Rhythms Originating in the Sinus Node
Arrhythmias Originating in the Atria
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
First-Degree Atrioventricular Block
Second-Degree Atrioventricular Block
High-Grade Atrioventricular Block
Third-Degree Atrioventricular Block (Complete Block)
Initiating Transvenous Ventricular Pacing
External (Transcutaneous) Pacemakers
Defibrillation and Cardioversion
Automatic External Defibrillators
Leanna R. Miller
Components of Cardiac Output/Cardiac Index
Stroke Volume and Stroke Volume Index
Factors Affecting Stroke Volume/Stroke Volume Index
Basic Components of Hemodynamic Monitoring Systems
Obtaining Accurate CVP and Arterial Values
Leveling the Transducer to the Catheter Tip
Calibration of the Transducer/Amplifier System
Ensuring Accurate Waveform Transmission
Insertion and Removal of Catheters
Obtaining and Interpreting Hemodynamic Waveforms
Artifacts in Hemodynamic Waveforms: Respiratory Influence
Continuous Mixed and Central Venous Oxygen Monitoring (SVO2/SCVO2)
SVO2/SCVO2 Monitoring Principles
Minimally Invasive Hemodynamic Monitoring
Minimally Invasive Hemodynamic Monitoring
Evidence-Based Practice Guidelines
5. Airway and Ventilatory Management
Robert E. St. John and Maureen A. Seckel
Tests, Monitoring Systems and Respiratory Assessment Techniques
Complications of Mechanical Ventilation
Weaning From Short-Term Mechanical Ventilation
Weaning From Long-Term Mechanical Ventilation
Respiratory Fatigue, Rest, and Conditioning
Systematic Institutional Initiatives for the Management of the LTMV Patient Population
Weaning From Mechanical Ventilation
6. Pain and Sedation Management
Yvonne D’Arcy and Suzanne M. Burns
Physiologic Mechanisms of Pain
A Multimodal Approach to Pain Management
Nonsteroidal Anti-Inflammatory Drugs
Switching From IV to Oral Opioid Analgesia
Deep Breathing and Progressive Relaxation
Special Considerations for Pain Management in the Elderly
Goals of Sedation, Monitoring, and Management
Evidence-Based Practice Guidelines
Earnest Alexander
Medication Administration Methods
Central Nervous System Pharmacology
Cardiovascular System Pharmacology
Vasodilators and Remodeling Agents
Glycoprotein IIb/IIIa Inhibitor
Drug Disposition in the Elderly
Evidence-Based Practice Guidelines
8. Ethical and Legal Considerations
Sarah Delgado
The Foundation for Ethical Decision Making
Professional Codes and Standards
Position Statements and Guidelines
The Process of Ethical Analysis
Building an Ethical Environment
Provide Information and Clarify Issues
Engage in Collaborative Decision Making
Professional Codes, Standards, and Position Statements
On-line References of Interest: Related to Legal and Ethical Considerations
Section II. Pathologic Conditions
Barbara Leeper
Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems
Percutaneous Coronary Interventions
Other Percutaneous Coronary Interventions
Evidence-Based Practice Guidelines
Maureen A. Seckel
Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems
Computed Tomography and Magnetic Resonance Imaging
Pulmonary Angiograms/CTPA and V/Q Scans
Thoracic Surgery and Procedures
Acute Respiratory Distress Syndrome (ARDS)
Acute Respiratory Failure in the Patient with Chronic Obstructive Pulmonary Disease
Acute Respiratory Failure in the Patient with Asthma
Critical Care Management of Respiratory Problems
Evidence-Based Practice Guidelines
Ruth M. Kleinpell
Sepsis and Multiple Organ Dysfunction Syndrome
Etiology, Risk Factors, and Pathophysiology
Complex Wounds and Pressure Ulcers
Healthcare Acquired Infections
Complex Wounds and Pressure Ulcers
Healthcare Acquired Infections
Dea Mahanes
Special Assessment Techniques and Diagnostic Tests
Full Outline of UnResponsiveness (FOUR) Score
Cranial Nerve Assessment and Assessment of Brain Stem Function
Vital Sign Alterations in Neurologic Dysfunction
Cerebral (Catheter) Angiography
Transcranial Doppler Ultrasound
Electromyography/Nerve Conduction Studies
Causes of Increased Intracranial Pressure
Principles of Management of Increased ICP
Etiology, Risk Factors, and Pathophysiology
Principles of Management of Acute Ischemic Stroke
Etiology, Risk Factors, and Pathophysiology
Principles of Management of Intracerebral Hemorrhage
Etiology, Risk Factors, and Pathophysiology
Principles of Management of Seizures
Infections of the Central Nervous System
Assessment and Diagnostic Testing
Acute Ischemic Stroke and Hemorrhagic Stroke
Infections of the Central Nervous System
13. Hematologic and Immune Systems
Diane K. Dressler
Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems
Additional Tests and Procedures
Deborah A. Andris, Elizabeth Krzywda, Carol Rees Parrish, and Joe Krenitsky
Acute Upper Gastrointestinal Bleeding
Bariatric (Weight Loss) Surgery
Nutritional Support for Acutely Ill Patients
Nutritional Case: Special Populations
Osmolality or Hypertonicity of Formula
Flow Rates and Hours of Infusion
Intestinal Ischemia/Bowel Obstruction
On-line References of Interest
Bariatric (Gastric Bypass) Surgery
Carol Hinkle
Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems
Life-Threatening Electrolyte Imbalances
Dialyzer/Hemofilters/Dialysate
Indications for and Efficacy of Renal Replacement Therapy Modes
General Renal Replacement Therapy Interventions
Christine Kessler
Special Assessment Techniques, Diagnostic Tests, and Monitoring Systems
Syndrome of Inappropriate Antidiuretic Hormone Secretion
Allen C. Wolfe and BenjaminW. Hughes
Specialized Assessment Techniques, Diagnostic Tests, and Monitoring Systems
Primary and Secondary Trauma Survey Assessment
Physiologic Consequences of Trauma
Common Injuries in the Trauma Patient
Complications of Traumatic Injury in Severe Multisystem Trauma
Acute Respiratory Distress Syndrome
Systemic Inflammatory Response Syndrome
Psychological Consequences of Trauma
Section III. Advanced Concepts in Caring for the Critically Ill Patient
Carol Jacobson
Advanced Arrhythmia Interpretation
Polymorphic Ventricular Tachycardias
Differentiating Wide QRS Beats and Rhythms
Choosing the Best Leads for ST-Segment Monitoring
19. Advanced Cardiovascular Concepts
Barbara Leeper
Evidence-Based Practice Guidelines
20. Advanced Neurologic Concepts
Dea Mahanes
Etiology, Risk Factors, and Pathophysiology
Principles of Management of Aneurysmal Subarachnoid Hemorrhage
Etiology, Risk Factors, and Pathophysiology
Principles of Management of Traumatic Brain Injury
Etiology, Risk Factors, and Pathophysiology
Principles of Management of Acute Spinal Cord Injury
Future Spinal Cord Injury Treatment
Etiology, Risk Factors, and Pathophysiology
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
Intracranial Pressure Monitoring
Section IV. Key Reference Information
Suzanne M. Burns
Earnest Alexander
23. Advanced Cardiac Life Support Algorithms
Suzanne M. Burns
24. Cardiac Rhythms, ECG Characteristics, and Treatment Guide
Carol Jacobson