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A
AACE. See American Association of Clinical Endocrinologists
AACN. See American Association of Critical-Care Nurses
AACN Essentials of Critical Care Nursing, 67, 74
Abdominal aneurysm, 456
Abdominal trauma
assessment of, 390
etiology and pathophysiology of, 390
principles of management of, 390–391
Aberration, mechanisms of, 424, 425f, 428t
ABGs. See Arterial blood gases
Abnormal venous waveform, of CVP, 83, 85f
Absorption atelectasis, 107
Accelerated junctional rhythm, ECG characteristics of, 51, 51f
ACE inhibitors. See Angiotensin-converting enzyme inhibitors
Acetaminophen, 157, 270, 272t, 273, 497t
Acetazolamide, 497t
Acid-base analysis, 95–97, 96t
Acid-base imbalance, 369, 370t
Acidosis, 353
ACLS. See Advanced Cardiac Life Support
ACPO. See Acute colonic pseudo-obstruction
ACS. See Acute coronary syndromes
ACT. See Activated coagulation time
Activated coagulation time (ACT), 305
Activated partial thromboplastin time (aPTT), 305
Acute asthma
clinical presentation of, 247–248
etiology and pathophysiology of, 247
principles of management of, 248–250
Acute colonic pseudo-obstruction (ACPO), 334, 335
Acute coronary syndromes (ACS), 204, 206, 206f, 408–411, 409f, 410f, 411f
Acute hypoglycemia. See Hypoglycemia, acute
Acute ischemic heart disease
clinical presentation of, 206, 208t–209t
diagnostic tests for
unstable angina, 207–208, 210f
electrophysiology studies for, 214, 214f
etiology and pathophysiology of, 204–206
principles of management of, 207–213, 210f–211f, 210t, 211t
Acute ischemic stroke
clinical presentation of, 293–294
conditions that mimic, 294
diagnostic tests for, 294
etiology and pathophysiology of, 292–293
principles of management of, 294–296, 294t, 295t
risk factors for, 292–293
secondary complications of, 294, 295–296
Acute pancreatitis. See Pancreatitis
Acute peptic ulcer bleeding, 171
Acute renal failure (ARF), 349–354, 362
causes of, 351t
clinical phases of, 351
clinical presentation of, 351
diagnostic tests for, 352
etiology and pathophysiology of, 350–351
principles of management of, 352–354
risk factors for, 350–351
Acute respiratory distress syndrome (ARDS), 97, 107, 116, 327
clinical presentation of, 243
etiology and pathophysiology of, 243, 243t
principles of management of, 244
Acute respiratory failure (ARF)
clinical presentation of, 241–242
etiology and pathophysiology of, 238–241, 240t
principles of management of, 242–243
Acute upper gastrointestinal bleeding. See Gastrointestinal (GI) system
Acyclovir, 497t
Adalat. See Nifedipine
Addiction, pain killers, 141
ADH. See Antidiuretic hormone
Admissions assessments, patient safety considerations in, 4–5
Adrenergic nervous system, 216
Advance directives, 189–190
Advanced Cardiac Life Support (ACLS) guidelines, 63
Advanced cardiovascular life support, algorithms for, 512f–514f
AED. See Automatic external defibrillator
Affordable Care Act (ACA), 183
Aging, physiological effects of, 10t
Airway, 6–7. See also Bi-level positive airway pressure; Continuous positive airway pressure; Laryngeal mask airway
in ABCDE acronym, 4t
patent, maintenance of, 270, 272
principles of management of, 93–108
artificial, 102–105, 103f, 104f, 106t
endotracheal suctioning, 105–107, 106t
esophageal tracheal, 102
laryngeal mask, 102
during seizures, 298
Alarm settings, for mechanical ventilation, 113, 113t
Albuterol, 170
Alcohol. See also Overdoses
isopropyl, 269
Alcohol withdrawal syndrome, 269–270, 270t, 271f, 273
Algorithms
for advanced cardiovascular life support, 512f–514f
for blunt chest trauma, 388f
for bradycardia, 513f
for hypoxia, 249f
for sedation, 149
for ventilator alarms, 124f
Alpha-adrenergic blocking agents, 162
Alphabet board to enhance communication, 126
Alveolar hypoventilation, 107
Ambrisentan (Letairis), 251
American Association of Clinical Endocrinologists (AACE), 367
American Association of Critical-Care Nurses (AACN), 181, 182, 393t
American College of Cardiology, 46, 218
American Diabetes Association, 367
American Heart Association, 46, 218
American Nurses Association (ANA), 181, 182, 192
American Society of Anesthesiology Patient Classification Status, 148, 148t
American Spinal Injury Association (ASIA), 481, 482f–483f
American Stroke Association, 46
AMI. See Myocardial infarction
Aminoglycosides, 168
Aminophylline, 497t
Amiodarone, 42, 52, 53, 54, 165, 507t, 508t
AML. See Amyotrophic lateral sclerosis
Amlodipine (Norvasc), 166
Ammonium chloride, 497t
Ampicillin, 497t
Ampicillin/sulbactam, 497t
Amyotrophic lateral sclerosis (AML), 299–300
ANA. See American Nurses Association
Analgesia
oral opioid, 140
patient-controlled, 139–140, 238, 389, 393
regional, 140
titrating epidural, 143
Anastomotic leaks, assessment for, 336
Anemia
clinical signs and symptoms of, 307
etiology and pathophysiology of, 306–307
principles of management of, 307–308
risk factors for, 306–307
sickle cell, 306
Aneurysmal subarachnoid hemorrhage (ASAH), 469
Aneurysms. See also Aortic aneurysm
abdominal, 456
surgery for, 457
thoracic, 456
Angiogram/graphy. See also Magnetic resonance angiography
pulmonary, 236–237
Angiotensin receptor blockers (ARBs), 163
Angiotensin-converting enzyme inhibitors (ACE), 14, 163, 219
ANP. See Atrial natriuretic peptide
Antacids, 170
Antiarrhythmics, 42, 46, 164–166, 506t–508t
Anticoagulants, 173–175
Anticonvulsants, 158–161, 509t
Antidepressants, 270
Antidiuretic hormone (ADH), 222, 354, 375, 377, 489. See also Syndrome of inappropriate antidiuretic hormone
Antidotes, for drug overdoses, 273
Antidromic, 420
Antiplatelet agents, 207, 312t
Antithrombin agents, 207
assessment of, 13–14
coping styles for, 24
and fear, of sedation, 146
reduction of, 213, 325, 452, 485–486
Aortic and mitral disease, 450
Aortic aneurysm, 454f
clinical presentation of, 456
complications of, 457–458
diagnostic tests for, 456
etiology and pathophysiology and, 455–456
pain in, 457
principles of management of, 456–457
Aortic dissection, 456
Aortic insufficiency
clinical presentation of, 450
etiology of, 447t
Aortic rupture, 456
Aortic stenosis
clinical presentation of, 450
etiology of, 447t
Apixaban, for atrial fibrillation, 48
aPTT. See Activated partial thromboplastin time
ARDS. See Acute respiratory distress syndrome
ARF. See Acute renal failure; Acute respiratory failure
Arginine vasopressin (AVP) system, 216–217
Arrhythmia interpretation, advanced, 418–427
Arrhythmias, 39
detection of
evidence-based practice for, 36t
monitoring for, 36t
ventricular, management of, 53t
Arrival quick check, assessment of, 4, 5–6, 5t
Arterial blood gases (ABGs), 12, 117
oxygen relating to, 97–98, 97f
for pulmonary function, 100–101
for pulse oximetry, 98–99, 98f, 100t
for venous blood gas, 98
sampling of, 94
values for, 94t
Arterial catheters, 74, 76–77, 80–81, 82t
Arterial pressures, systemic, 83
Arterial puncture, 94
Arterial values, accuracy of, 77
Arterial vasodilating agents, 161–162
Artifacts, in hemodynamic waveforms, 85, 86f, 87f
Artificial airway, 102–105, 103f, 104f, 106t
ASAH. See Aneurysmal subarachnoid hemorrhage
Ascites, 326
ASIA. See American Spinal Injury Association
for atrial fibrillation, 46
Assessment
of abdominal trauma, 390
admissions, patient safety considerations in, 4–5
for anastomotic leaks, 336
of anxiety, 13–14
of arrival quick check, 4, 5–6, 5t
of brain stem function, 283–284
of cardiovascular system, 10t, 11–12, 199–228
of chief complaint, 7
of communication, 13
of coping styles, 14
of cranial nerve, 283–284, 284t
of endocrine system, 10t, 13, 365–367
framework for, 3–5
of gastrointestinal system, 10t, 12–13
of hematologic system, 10t, 13, 303–306, 304t
of immune system, 10t, 13, 303–306, 304t
of integumentary system, 10t, 13, 15t
of learning readiness, 24, 24t
of neurologic system, 279–285
physical, 8t
of progressive care patients and families, 3–16
of pulmonary function, 100–101
of respiratory system, 10t, 12, 93–101, 231–238
of trauma, 381–383, 382t–383t, 384t, 385t
Assist-control ventilation, 114
Assurance, for families, 26
Asthma. See Acute asthma
Asynchronous (fixed-rate) pacing mode, 61
Atenolol, 162
Atherosclerotic plaque, 204–205, 204f, 205t
Atrial capture, 435
Atrial fibrillation
Cox-Maze procedures, 49
ECG characteristics of, 45–46, 45f, 518
principles of management of, 47t
radiofrequency ablation and, 48–49
treatment for, 518
nonpharmacological, 48–49
Wolff-Parkinson-White syndrome and, 420–422, 422f
Atrial flutter, 43f
CHADS2 risk index, 46
ECG characteristics of, 43, 46f, 518
principles of management of, 47t
Atrial natriuretic peptide (ANP), 217
Atrial sensing, 435–436
Atrial septostomy, 251
Atrial tachycardia, 42f
ECG characteristics of, 42–43, 43f, 517
Atrioventricular (AV) block
second-degree, 55–56, 55f, 56f, 521
Atrioventricular (AV) junction, 33
Atrioventricular nodal reentry tachycardia (AVNRT), 49, 419, 420f, 421f
Atrioventricular (AV) node, 33
Atropine, 40, 41, 54, 58, 166, 508t
Atypical antipsychotics, 155
Automatic external defibrillator (AED), 63
AV. See Atrioventricular
AV nodal passive SVTs, 419
AV reentrant tachycardia (AVRT), 419
AVNRT. See Atrioventricular nodal reentry tachycardia
AVP. See Arginine vasopressin
AVRT. See AV reentrant tachycardia
Axis determination, 403–404, 404f, 404t, 405f
Aztreonam, 498t
B
Bariatric surgery, 335–337
nausea and vomiting with, 336
nutrition after, 337–338
patient education for, 337
postoperative medication alterations for, 337
principles of management of, 336
procedure of, 335–336
skin breakdown and, 337
Barotrauma, 116
Basic tenets, 22–23
Basiliximab (Simulect), 461
Benadryl. See Diphenhydramine
Beneficence, 184
Benign tumor, of brain, 487
Benzodiazepine antagonist, 154–155
Benzodiazepines, 14
as sedative, 147
for seizures, 160
Best interest standard, 190–191
Beta-adrenergic blocking agents, 162–163
Beta-blockers, 507t
for atrial fibrillation, 46
for atrial tachycardia, 43
for junctional rhythms, 51
as overdose antidote, 273
for PVC, 52
for PVT, 422
for supraventricular tachycardias, 50
for WAP, 42
Betamethasone dipropionate, 153
BGM. See Blood glucometer
Bi-level positive airway pressure (BiPAP), 115, 245, 336
Biopsy, endomyocardial, 462f
BiPAP. See Bi-level positive airway pressure
Biventricular pacing, 436–438
ECG relating to, 438f
Bladder and bowel movement, after SCI, 485
Bleeding. See also Gastrointestinal (GI) system
during cardiac transplantation, 461
in trauma patients, 390
VAD associated with, 465
Block. See also Atrioventricular block; Bundle branch block
Wenckebach, 55
Blockers. See Beta-blockers; Calcium channel blockers
Blocking agents
alpha-adrenergic, 162
beta-adrenergic, 162–163
Blood
cerebral blood flow, 289
complete blood count, 303
minimizing loss of, 308
red blood cell count, 13, 303–304
volume, increase in, 290
white blood cell count, 303, 304, 305
Blood glucometer (BGM), 365–367, 366f, 366t
Blood glucose monitoring, 365–367, 366f, 366t
Blood pressure (BP). See also Systolic blood pressure
CO and, 85
fluid management and, 291
hemodynamics as study of, 67, 85
hypertension and, 225–228, 226t
management of, 295
SCI and, 485
Blood urea nitrogen (BUN), renal dysfunction and, 349
Blunt cardiac injury, 388
Blunt chest trauma, algorithms for, 388f
BNP. See Brain natriuretic peptide
Body substance isolation, 20
Bowel movement, after SCI, 485
Bowel obstruction. See also Large-bowel obstruction; Small-bowel obstruction
clinical presentation of, 334
diagnostic tests for, 334
etiology and pathophysiology of, 333–334
principles of management of, 334–335
risk factors for, 333–334
BP. See Blood pressure
Bradycardia. See also Sinus bradycardia
algorithms for, 513f
Brain injury. See Traumatic brain injury
Brain natriuretic peptide (BNP), 217, 220
Brain stem function, assessment of, 283–284
Brain stem stroke, 293–294
Brain tumors
anatomic location of, 487
benign versus malignant, 487
clinical presentation of, 487, 488t
diagnostic tests for, 487–488
etiology and pathophysiology of, 487
histologic origins of, 487
infections with, 488–489
primary versus secondary, 487
principles of management of, 488–489
risk factors for, 487
surgery for, 488–489
Breathing, 6–7. See also Spontaneous breathing trials
in ABCDE acronym, 4t
deep, and progressive relaxation, for pain management, 144–145
spontaneous, 114–115
techniques, 24
Bretylium, 507t
Brevital Sodium. See Methohexital
Bronchodilators, 509t
Brugada syndrome, 416–417
BS. See Bowel sounds
BUN. See Blood urea nitrogen
Bundle branch block, 34, 404–408, 407f. See also Left bundle branch block; Right bundle branch block
Bupivacaine, 142
Burns Wean Assessment Program (BWAP), 120, 121t
Butorphanol, 153
Butyrophenones, 138
BWAP. See Burns Wean Assessment Program
C
CABG. See Coronary artery bypass grafting
Calcium, 498t
Calcium channel blockers, 152, 507t–508t
as antiarrhythmic agent, 165–166
for atrial fibrillation, 46
for atrial flutter, 43
for hypertension, 163–164
IPAH and, 166
as overdose antidote, 273
for supraventricular tachycardias, 50
Calcium imbalance
hypercalcemia
clinical presentation for, 356
diagnostic tests for, 356
ECG changes for, 356
etiology and pathophysiology of, 356
principles of management of, 358
risk factors for, 356
hypocalcemia
clinical presentation for, 356
diagnostic tests for, 356
ECG changes for, 356
etiology and pathophysiology of, 356
principles of management of, 358
risk factors for, 356
Candidate selection, for cardiac transplantation, 458, 458t
Capacity, determination of, 189
Capture, in pacing, 60, 431–433, 432f, 435, 436, 522
Carbamazepine, 509t
Carbon dioxide (CO2), 93, 95, 96, 97
Carbon dioxide tension (PaCO2), 93, 94t, 96t, 97
Cardiac catheterization, 199–200, 200t, 202t
Cardiac function
improvement of, 445–446
maximization of, 451
Cardiac injury, blunt, 388
Cardiac monitoring, 35–38, 36t
Cardiac output (CO), 67–69, 68f
blood pressure and, 85
cardiac index and
components of, 69–70
high, 69
low, 69
decrease in, 442
optimization of, 464–465
PEEP/CPAP and, 115
in sepsis, 266
Cardiac pacemakers, 429–438, 431t
Cardiac resynchronization therapy (CRT), 436–438
Cardiac rhythm
determination of, 38
interpretation and management of, 33–64
Cardiac tamponade, 388
Cardiac transplantation
bleeding during, 461
candidate selection for, 458, 458t
posttransplant psychological adjustment after, 462–463
pretransplant process for, 458
principles of management of, 459–463
surgical techniques for, 458–459, 460f
Cardiogenic shock, 221–222, 221t
Cardiomyopathy, 442f. See also Dilated cardiomyopathies; Hypertrophic cardiomyopathies; Restrictive cardiomyopathies
clinical presentation of, 443–444
complications of, 446
coping with, 446
diagnostic tests for, 444–445
etiology and pathophysiology of, 442–443, 442t
principles of management of, 445–446
Cardiopulmonary resuscitation (CPR), 54, 55, 63, 190
Cardiovascular complications, of transport, 27t, 28
Cardiovascular function, stabilization of, 459, 461
Cardiovascular system
advanced concepts of, 441–466
assessment of, 10t, 11–12, 199–228
medication for, 161–167
pathologic conditions of, 203–228, 441–466
Cardizem. See Diltiazem
Care, ethic of, 186
Cascade effect, 339
CAT. See Computed axial tomography
Catecholamines, 167
Catheter-associated urinary tract infections (CA-UTI), 275
Catheters
arterial, 74, 76–77, 80–81, 82t
care of, 78
for CVP, 78–80
epidural, pain management for, 140–141
insertion and removal of, 78–81
CA-UTI. See Catheter-associated urinary tract infections
CAVH. See Continuous arteriovenous hemofiltration
CBC. See Complete blood count
CBF. See Cerebral blood flow
CDC. See U.S. Centers for Disease Control and Prevention
Cefazolin, 498t
Cefepime, 498t
Cefonicid, 498t
Cefoperazone, 498t
Cefotaxime, 498t
Cefotetan, 498t
Cefoxitin, 498t
Ceftazidime, 498t
Ceftizoxime, 498t
Ceftriaxone, 498t
Cefuroxime, 498t
Centers for Medicare and Medicaid Services (CMS), 183
Central line-associated blood stream infection (CLA-BSI), 275
Central nervous system (CNS), 10, 107, 138
infections of, 298–299
medication for, 153–161
Central processing, pain and, 134–135
Central sympatholytic agents, 164
Central venous pressure (CVP), 67, 76–78, 98
abnormal venous waveform of, 83, 85f
catheters for, 78–80
Z-point technique with, 81
Central venous pressure/right atrial pressure (CVP/RAP), 71–72
Cephalosporin, 323
Cerebellar or brain stem stroke, 293–294
Cerebral angiography, 288
for SAH, 471
Cerebral blood flow (CBF), 289
Cerebral hemisphere, stroke in, 293
Cerebral metabolic demand, increase in, 291
Cerebral perfusion, 7
in ABCDE acronym, 4t
Cerebrospinal fluid (CSF), 285–286, 287
drainage of, 292
Cervical spine radiograph, 384
CGM. See Continuous glucose monitoring
CHADS2 risk index, atrial fibrillation and, 46
Chemoreceptor trigger zone (CTZ), 138
Chemotherapy, 489
Chest pain, assessment of, 199, 200t
Chest tubes, 237, 237f, 237t, 238f
for trauma patient, 389
Chest x-rays, 231–236
for cardiomyopathies, 444, 445
interpretation of, 232, 232t, 233f
for pericarditis, 453
variants and abnormalities of, 233–235, 233f, 234f, 234t
Chief complaint, 7
in ABCDE acronym, 4t
Child-Pugh classification, 326, 326t
Chloramphenicol, 508t
Chlordiazepoxide, 147
Chlorpromazine, 498t
Chronic obstructive pulmonary disease (COPD), 107, 109, 115, 154, 164
clinical presentation of, 245
diagnostic tests for, 245
etiology and pathophysiology of, 244–245, 244t
exacerbation of, 244–250
principles of management of, 245–247, 245t, 247t, 249f
Chronic renal failure (CRF), 350, 351
Cialis. See Tadalafil
Cimetidine, 170
CIN. See Contrast-induced nephropathy
Cineventriculogram, 200
Ciprofloxacin, 498t
Circle of Willis, 470f
Circulation, 7
in ABCDE acronym, 4t
Circus movement tachycardia (CMT), 49, 419–420, 421f
Cisatracurium, 498t
Cisatricurium, 505t
Cisplatin, 168
CLA-BSI. See Central line-associated blood stream infection
Clindamycin, 498t
Clobetasol propionate, 153
Clonidine, 164
CMS. See Centers for Medicare and Medicaid Services
CMT. See Circus movement tachycardia
CNS. See Central nervous system
CO. See Cardiac output
CO2. See Carbon dioxide
Coagulopathies
clinical signs and symptoms of, 313–314
etiology and pathophysiology of, 310–313
principles of management of, 314
risk factors for, 310–313
Cocaine, 272t
Code for Nurses, 181, 182, 192
Colorimetric CO2 monitoring devices, 100, 100f
Communication
assessment of, 13
enhancing methods of, 125–127
mechanical ventilation and, 125–128
pretransfer, 29t
problems of, 125
teaching methods of, 127–128
Community-acquired pneumonia, 253t, 255t
Compartment syndrome, 391
Complete blood count (CBC), 303
Complex wounds, 273–274
Complications
of aortic aneurysm, 457–458
of cardiomyopathy, 446
of DVT, 20
of hospital-acquired infections, 20
of mechanical ventilation, 115–117
of pancreas, 332
of pericarditis, 454
of physiologic instability, 20
of psychosocial impact, 22–24
of SAH, 473–474
secondary, of acute ischemic stroke, 294, 295–296
in severe multisystem trauma, 392t, 393–395
of skin breakdown, 21–22
of sleep pattern disturbance, 22, 22t
of SPI, 486
of TBI, 478
of valvular disease, 452
Comprehensive initial assessment, 4, 8–15, 8t
Computed axial tomography (CAT), 383–384, 390
Computed tomography (CT), 236
for bowel obstruction, 334
for brain tumors, 487
for neurologic dysfunction, 286, 287, 291
for SAH, 470
for SCI, 481
for stroke, 296
for TBI, 477
Concordance, 426
Confidentiality, 185
Conivaptan, 498t
Conjugated estrogens, 498t
Constipation, 139
Continuous arteriovenous hemofiltration (CAVH), 359
Continuous glucose monitoring (CGM), 366
Continuous mixed and central venous oxygen monitoring (SVO2/SCVO2), 86–87
Continuous positive airway pressure (CPAP), 119, 121–122, 244, 336
Continuous renal replacement therapies (CRRTs), 359, 360–362, 361f, 362
Continuous venovenous hemodialysis (CVVHD), 359, 360, 361f, 362
Continuous venovenous hemofiltration (CVVH), 359, 360, 362
Contractility, 73
Contrast-induced nephropathy (CIN), 350–351, 352
Control settings, for mechanical ventilation, 112–113
Control ventilation, 114
Contusion, 475
COPD. See Chronic obstructive pulmonary disease
Coping styles
anxiety and, 24
assessment of, 14
with VAD, 465
Corneal reflux, 284
Coronary angiography, 199–200, 200t, 201f
Coronary artery bypass grafting (CABG), 207, 210, 212f
Cosyntropin, 498t
Cough and gag reflexes, 284
Cox-Maze procedures, 49
CPAP. See Continuous positive airway pressure
CPR. See Cardiopulmonary resuscitation
Cranial nerve assessment, 283–284, 284t
CRF. See Chronic renal failure
Critical care, transferring from, 17
CRRTs. See Continuous renal replacement therapies
CRT. See Cardiac resynchronization therapy
CSF. See Cerebrospinal fluid
CT. See Computed tomography
CTZ. See Chemoreceptor trigger zone
Cuff pressure measurement, 105, 105f
Cushing response, 285
Cutaneous stimulation, 143, 144f
CVP. See Central venous pressure
CVP/RAP. See Central venous pressure/right atrial pressure
CVVH. See Continuous venovenous hemofiltration
CVVH and CVVHD (CVVHDF), 359, 360, 362
CVVHD. See Continuous venovenous hemodialysis
CVVHDF. See CVVH and CVVHD
Cyanide, 273
Cyclosporine, 168, 177, 461, 498t, 509t
D
Dabigatran, 175
for atrial fibrillation, 48
Dalteparin, 174
Dantrolene, 498t
Daptomycin, 499t
DDD pacemaker evaluation, 434–438, 436f
d-dimer, 305
Death, by neurologic criteria, 280
Decision making
collaborative, 194
ethical, 181–188
Deep breathing and progressive relaxation, for pain management, 144–145
Deep tissue injury, 273–274
Deep venous thrombosis (DVT), 336, 489
complications of, 20
with TBI, 478
Defibrillation, 62–64, 63f, 64f
drugs for, 147
Demerol. See Meperidine
Department of Health and Human Services (DHHS), 183
Depolarization, 400, 402f, 406, 406f
Depolarizing agents, 505t
Depression, 23
neurologic, 272
respiratory, 139
Desoximetasone, 153
Dexamethasone, 499t
DHHS. See Department of Health and Human Services
DI. See Diabetes insipidus
Diabetes, 367
Diabetes insipidus (DI), 375
clinical presentation of, 378
diagnostic tests for, 378
etiology and pathophysiology of, 377, 377f
principles of management of, 378–379, 378t
risk factors for, 377
Diabetic ketoacidosis (DKA), 367
clinical presentation of, 372
infection with, 373
pathogenesis of, 370f
principles of management of, 372–374
Diagnostic peritoneal lavage (DPL), 383–384, 386, 390
in ABCDE acronym, 4t
Dialyzer/hemofilters/dialysate, 360
DIC. See Disseminated intravascular coagulation
Diffuse injury, 476
Digoxin, 166, 170, 273, 499t, 508t
Dilated cardiomyopathies
clinical presentation of, 443–444
diagnostic tests for, 444–445
etiology of, 442t
pathophysiology of, 442
principles of management of, 445
Dilaudid. See Hydromorphone
Diltiazem (Cardizem), 43, 166, 499t, 508t
Diphenhydramine (Benadryl), 138, 199, 499t
Direct thrombin inhibitors, 175, 312t
Disseminated intravascular coagulation (DIC), 305, 312–313, 312t, 313t
Distraction techniques, 24, 143
Distributive shock, 222
Diuretics
with ARF, 353
osmotic, 172–173
DKA. See Diabetic ketoacidosis
DNR. See “Do not resuscitate”
“Do not resuscitate” (DNR) order, 193
Dobutamine, 40, 167, 499t, 506t
Dolasetron, 499t
overdose relating to, 270
as vasoconstricting agent, 167
as vasopressor agent, 166–167
Doripenem, 499t
Doxycycline, 499t
DPL. See Diagnostic peritoneal lavage
Droperidol, 499t
Drugs, 7. See also Overdoses; specific drugs
in ABCDE acronym, 4t
for delirium, 147
for elderly, disposition of, 178
for sedation, 147
therapeutic, monitoring of, 178
Dual-chamber pacemakers, 434–438
Dual-chamber pacing modes, 431t
DVT. See Deep venous thrombosis
Dying process, support of patients and families during, 31
E
ECG. See Electrocardiogram/graphy
Echocardiography
for cardiomyopathies, 445
for pericarditis, 453
ECMO. See Extracorporeal membrane oxygenation
cerebral, 290
rating scale for, 11t
EDH. See Epidural hematoma
Education, 220–221, 227–228, 479
for families, 24–25
Educational sessions, principles for, 25t
EEG. See Electroencephalography
EF. See Ejection fraction
Ejection fraction (EF), 70
Elderly
drug disposition in, 178
pain management for, 145
Electrocardiogram/graphy (ECG), 36f. See also 12-lead electrocardiogram
for atrial fibrillation, 518
for atrial flutter, 518
for atrial tachycardia, 517
biventricular pacing and, 438f
characteristics of, 39–43, 39f, 40f, 41f, 42f, 43f, 45f, 46f, 50–57, 50f, 51f, 52f, 53f, 54f, 55f, 56f, 58, 419, 423, 516–522
CVP and, 81
first-degree AV block, 521
high-grade AV block, 521
for imbalance
calcium, 356
for junctional rhythm, 519
for MI, 408f, 409, 409f, 410–411, 410f, 411f, 411t, 413f, 415f
monitoring, electrodes of, 36–38, 36t, 37f
for monomorphic ventricular tachycardia, 520
for NSR, 516
P wave and, 402, 403, 419, 424–425, 425f
for PAC, 517
for pericarditis, 453
for PJCs, 518
for PVCs, 519
QRS beats and rhythm and, 424–427, 425f, 426f
QRS complex and, 402, 403, 404, 414, 419
second-degree AV block, 521
for sinus arrest, 516
for sinus arrhythmias, 516
for sinus bradycardia, 516
for sinus tachycardia, 516
ST-segment of, 402, 403, 403f, 409, 410, 416
third-degree AV block, 522
for torsades de pointes, 520
for ventricular asystole, 520
for ventricular paced rhythm, 522
for ventricular rhythm and accelerated ventricular rhythm, 519
for VF, 520
for VT, 520
for WAP, 517
waveforms in, 34–35
Electrodes, of ECG monitoring, 36–38, 36t, 37f
Electroencephalography (EEG), 288–289
Electrolyte
imbalance of, 327, 353, 354–358
fluid volume deficit with, 369
principles of management of, 357–358
replacement of, 373
Electromyography (EMG), 289
Electrophysiology, 33–34
Emboli
Embolism, 293. See also Pulmonary embolism
EMG. See Electromyography
EMLA. See Eutectic mixture of local anesthetic
EN. See Enteral nutrition
EN formula
osmolality or hypertonicity of, 341–342, 342t
selection of, 343
Enalaprilat, 499t
Encephalitis, 299
Encephalopathy, hepatic, 326–327
Endocrine system
assessment of, 10t, 13, 365–367
diagnostic tests for, 365–367
monitoring systems for, 365–367
pathologic conditions of, 367–379
End-of-life issues, 190–192
Endogenous secretions and exogenous additions, 339
Endomyocardial biopsy, 462f
Endothelin receptor antagonists, 166, 251
Endotracheal suctioning, 105–107, 106t
complications of, 106
extubation, 106
indications for, 105–106
procedure for, 106
Endotracheal tube (ET), 100, 102–104, 103f, 104f, 105
Endovascular treatment, 295
End-tidal carbon dioxide (CO2) monitoring, 100–101
Enoxaparin, 174
Enteral nutrition (EN), 338–339, 338t, 339t, 341, 342t
Eosinophils, 305
Epicardial pacing, 59f, 60, 62
Epidural analgesia, 141–143, 142f
Epidural catheter pain management, 140–141
Epidural hematoma (EDH), 475, 475f
Epidural local anesthetics, 142–143
for GI bleeding, 323
as inotropic agent, 167
for sinus bradycardia, 54
for sinus tachycardia, 40
Epoprostenol (Flolan), 166, 251
Equipment
in ABCDE acronym, 4t
in standard room setup, 5t, 7–8
Ertapenem, 499t
Erythromycin, 499t
Erythropoietin, 499t
Esmolol, 162, 227t, 499t, 507t
Esomeprazole, 171
Esophageal and gastric varices, 327
Esophageal tracheal airway, 102
ET. See Endotracheal tube
Ethacrynic acid, 499t
Ethanol, 268
Ethical analysis, 188
Ethical decision making, 181–188
Ethical environment, 193–194
Ethical issues, 188–191
Ethics, 181–194
of care, 186
principles of, 183–186
Ethylene, 269
Etidronate, 499t
European Society of Cardiology, 46
Eutectic mixture of local anesthetic (EMLA), 153
Euvolemia, 472–473
Evidence-based practice
bedside cardiac monitoring, for arrhythmia detection, 36t
for family interventions, 25t
for family needs assessment, 8t, 14
for family visitation, in critical care, 26t
for pain management, 137t
strategies for central line infection, 276t
strategies for sepsis, 267, 268t
strategies for urinary tract infection, 275t
for ST-segment monitoring, 430t
of ventilator-associated pneumonia, for prevention, 255t
for VTE in trauma patients, 393t
Exogenous vasopressin (Pitressin), 378
Extracorporeal membrane oxygenation (ECMO), 220
Extraocular eye movements, 284, 285f
Extubation, 106–107
F
Factor Xa inhibitors, 175
Families
assurance for, 26
being comfortable, 26
receiving information, 26
remaining near the patient, 26
support, 26
visitation, 26–27
Family education and support, for TBI, 479
Family-focused care, 25–27
FAST. See Focused abdominal
FDP. See Fibrin degradation products
Fenoldopam, 500t
Fentanyl (Sublimaze), 138, 142, 153, 157, 500t
Fibrillation. See Atrial fibrillation; Ventricular fibrillation
Fibrin degradation products (FDP), 313
Fibrinogen, 305
Fibrinolytic therapy, 207, 211t, 294–295, 294t
Fidelity, 185
Filgastrim, 500t
First-degree AV block, 55f
ECG characteristics of, 55, 55f, 521
FK506. See Tacrolimus
Flolan. See Epoprostenol
Flow rates, hours of infusion and, 342–343, 343t
Flucytosine, 508t
Fluid. See also Cerebrospinal fluid
imbalance of, correction of, 352–353, 352t
management of, 291
positive balance of, hyponatremia and, 117
replacement of, 372, 372t, 378
restriction of, 376
Fluid resuscitation, 331
Fluid volume deficit, electrolyte imbalance with, 369
Flumazenil, 154–155, 273, 500t
Fluocinonide, 153
Fluoroquinolones, 152
Focused abdominal sonograph for trauma (FAST), 384, 390
Foscarnet, 500t
FOUR. See Full Outline of UnResponsiveness
Fracture
skull, 474
stabilization of, 393
Frank-Starling curve, 214, 216f
FSP. See Fibrin split products
Full Outline of UnResponsiveness (FOUR) score, 281, 281t
G
GABA. See Gamma-aminobutyric acid
Gag and cough reflexes, 284
Gallium nitrate, 500t
Gamma-aminobutyric acid (GABA) receptors, 154
Ganciclovir, 500t
Gastric residual volume (GRV), 339–340, 339t, 340t
Gastric varices, 327
Gastritis
causes of, 319t
hemorrhagic, 319
NSAIDs and, 319
pathogenesis of, 319f
Gastrointestinal (GI) system
bleeding of, 117, 306, 317–325
acute peptic ulcer, 171
control and prevention of, 314
control or stoppage of, 322–324, 322f, 323t
epinephrine for, 323
identify site of, 322
interventional radiologic technique for control of, 324, 325
pharmacologic treatments for, 323–324, 323t, 324t
surgical therapies for, 324–325, 325f
clinical presentation of, 319–320
complications of transport for, 27t, 28
diagnostic tests for, 320–321
etiology and pathophysiology of, 317–319, 318f, 318t
medication for, 170–172
nutrition relating to, 337–343
pathologic conditions of, 317–337
principles of management of, 321–325
risk factors for, 317–319
GCS. See Glasgow Coma Scale
Generalized seizures, 297
Gesturing to enhance communication, 126
GFR. See Glomerular filtration rate
Glasgow Coma Scale (GCS), 280–281, 280f, 280t, 474, 476, 477
Glomerular filtration rate (GFR), 350
Glucose management, 295
Glycoprotein IIb/IIIa inhibitor, 175–176, 207, 312t
Glycopyrrolate, 500t
Graft protection, 461–462
Grafting. See Coronary artery bypass grafting
Granisetron, 500t
GRV. See Gastric residual volume
GSW. See Gunshot wound
Guillain-Barré syndrome, 286, 299
Gunshot wound (GSW), 474
H
H2 antagonists, 170–171
Hand washing, 21
Health Information Portability and Accountability Act (HIPAA), 183
Heart. See also Acute ischemic heart disease
rate of
decreased, 69
determination of, 38, 38f, 39t
ECG of, 7
increased, 69
rhythm of, 70
Heart failure (HF)
clinical presentation of, 218, 218t
diagnostic tests for, 218–219
etiology and pathophysiology of, 214–218, 215f, 217f
patient education for, 220–221
principles of management of, 219–221
Heart Rhythm Society, 46
Heated moisture exchanger (HME), contraindications for, 111, 112t
Hematologic system
assessment of, 10t, 13, 303–306, 304t
coagulation studies for, 305
diagnostic tests for, 303–306
medication for, 173–177
pathologic conditions of, 306–314
Hematoma
Hemodialysis, 360, 361f, 362. See also Continuous venovenous hemodialysis
Hemodynamic compromise, 115–116
Hemodynamic monitoring, 67–88
assessing and accuracy of, 80t
as minimally invasive, 87–88
Hemodynamic stability, 272
Hemodynamic stabilization, 321–322, 321t
Hemodynamic support, for SCI, 485
Hemodynamic waveforms
obtaining and interpreting of, 80f, 81–85, 83f
Hemolytic-uremic syndrome, 311–312
Hemorrhage. See also Aneurysmal subarachnoid hemorrhage; Intracerebral hemorrhage; Subarachnoid hemorrhage
intracerebral, 296
subarachnoid, 286
trauma and, 383
variceal, 171–172
Hemorrhagic stroke
clinical presentation of, 296
diagnostic tests for, 296
etiology and pathophysiology of, 296
principles of management of, 296–297
risk factors for, 296
Hemostasis
normal, 314
Heparin, 173–174, 175, 199, 312t, 500t
Hepatic encephalopathy, 326–327
Hepatorenal syndrome, 327
Herniation, 291
HF. See Heart failure
HHS. See Hyperosmolar hyperglycemic states
High-grade AV block, 56–57, 57f
ECG characteristics of, 57, 521
HIPAA. See Health Information Portability and Accountability Act
HME. See Heated moisture exchanger
Hospital-acquired infections, 274–276
CDC’s recommendation for, 21
complications of, 20
interventions for, 21
prevention of, 20–21
Hospital-acquired pneumonia, 21, 252, 253–254
Hunt and Hess scale, 469, 470t
Hydantoin, 158–160
Hydrochloric acid, 500t
Hydrocortisone, 500t
Hydromorphone (Dilaudid), 138, 142, 500t
Hypercalcemia. See Calcium imbalance
Hyperglycemic emergencies, 368–374
Hyperglycemic states, 367
Hyperkalemia. See Potassium imbalance
Hypermagnesemia. See Magnesium imbalance
Hyperosmolar disorders. See Sodium imbalance
Hyperosmolar hyperglycemic states (HHS), 367, 369–371
clinical presentation of, 372
diagnostic tests for, 372
infection with, 373
principles of management of, 372–374, 372t
Hyperoxygenation, 106
Hyperphosphatemia. See Phosphate imbalance
Hypertension. See also Idiopathic pulmonary arterial hypertension; Pulmonary hypertension
calcium channel blockers for, 163–164
causes of, 225–226
clinical presentation of, 226
diagnostic tests for, 226
etiology and pathophysiology of, 225–226, 226t
patient education on, 227–228
principles of management of, 227–228, 227t
Hypertrophic cardiomyopathies
clinical presentation of, 444
diagnostic tests for, 445
etiology of, 442t
pathophysiology of, 442–443
principles of management of, 445–446
Hyperventilation, 27–28
Hypocalcemia. See Calcium imbalance
Hypoglycemia, acute
clinical presentation of, 374–375
diagnostic tests for, 375
etiology and pathophysiology of, 374, 374t
principles of management of, 375, 375t
risk factors for, 374
Hypokalemia. See Potassium imbalance
Hypomagnesemia. See Magnesium imbalance
Hyponatremia, 117
Hypoosmolar disorders. See Sodium imbalance
Hypophosphatemia. See Phosphate imbalance
Hypovolemic shock, 222, 222t, 320f
Hypoxia, algorithms for, 249f