Kathy Booker is Director and Professor, Millikin University School of Nursing, Illinois, USA. She has held former positions as Specialty Director of the Adult Advanced Practice Program in the School of Nursing, Yale University, Connecticut, USA, and Dean of the College of Professional Studies at Millikin University. She has been certified as a Critical Care Registered Nurse (CCRN) for over twenty years, currently holding alumnus status CCRN. She practiced as a critical care RN and Clinical Nurse Specialist for over twenty-five years.

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• Contributors, xv Critical Care Nursing: Monitoring and Treatment for Advanced Nursing Practice, xviiKathy J. Booker1 Philosophy and treatment in US critical care units, 1Kathy J. BookerUS critical care units, 1Organization of critical care delivery, 1Monitoring and surveillance in critical care, 2Surveillance, 2Nursing certification and competency in critical care units, 3US national critical care organizations, 4American Association of Critical Care Nurses, 4Society of Critical Care Medicine, 5Acute care advanced practice nursing, 5Clinical nurse specialists, 6Acute care nurse practitioners, 6Critical care and ACNP outcomes research, 7Evolution of families in the critical care unit, 8Progression and development of rapid response teams, 92 Vital measurements and shock syndromes in critically ill adults, 13Kathy J. Booker and Laura Kierol AndrewsMonitoring basic vital signs, 13Temperature monitoring, 14Hypothermia, 14Complications of cooling, 15Hyperthermia, 17Heatstroke management, 17Malignant hyperthermia, 17Heart rate monitoring, 18Blood pressure monitoring, 19Oscillometric blood pressure measurement, 20Aneroid measurement, 20Arterial pressure measurement, 20Respiratory monitoring, 21Capnography, 21Shock conditions in critically ill adults, 22Cardiogenic shock, 23Anaphylactic shock, 24Hypovolemic shock, 24Sepsis syndromes, 26SIRS, sepsis, and septic shock, 26Monitoring and treatment priorities in sepsis syndromes, 28Sepsis diagnosis, 28Body temperature, 29Cultures, 29Intravascular catheters, 29Other infectious complications in critically ill adults, 29Pulmonary infections, 29Urinary tract infections, 30Monitoring during transport, 303 Monitoring for respiratory dysfunction, 35Alexander P. Johnson and Jennifer AbrahamAcid-base disturbances & anion gap, 35Metabolic acidosis, 35Metabolic alkalosis, 37Respiratory acidosis, 37Respiratory alkalosis, 38Mixed acid–base disorders, 38Oxygenation, 38Estimation of the PaO2, 38A–a Gradient, 39PaO2/FiO2 (P/F) ratio, 39Acute respiratory failure, 40Capnography, 40Monitoring ventilation with PetCO2, 40Monitoring blood flow, 41Modes of mechanical ventilation, 41Continuous positive airway pressure (CPAP) with pressure support, 41Synchronized intermittent mandatory ventilation (SIMV), 42Assist/control ventilation (AC), 42Pressure control ventilation, 42Airway pressure release ventilation (APRV), 42Pressure-regulated volume control (PRVC), 42Inverse ratio ventilation, 43Oscillatory ventilation, 43Overview of protective lung ventilation in ARDS, 43ARDSNet protocol goals, 43Monitoring for complications during mechanical ventilation, 43High peak airway pressures on mechanical ventilation, 43Response to bagging—monitoring and treatment, 44Auto-PEEP effect, 44Weaning from mechanical ventilation, 44Postextubation stridor: monitoring and treatment, 46Noninvasive positive pressure ventilation, 47Tension pneumothorax, 47Emergent treatment—needle thoracostomy, 47Chest radiograph interpretation, 48Sleep-disordered breathing in the critical care unit, 48Obstructive sleep apnea, 50Central sleep apnea, 50Obesity hypoventilation syndrome, 51CPAP and BiPAP therapy, 51Approach to cardiogenic dyspnea in acute heart failure, 524 Electrocardiographic monitoring for cardiovascular dysfunction, 57Catherine WinklerPhysiologic guidelines, 57Goals of monitoring, 58Post cardiopulmonary resuscitation, 59Evidence-based treatment guidelines, 60Acute coronary syndromes, 60Evidence-based treatment guidelines, 62Cardiac arrhythmias, 64Evidence-based treatment guidelines, 65Acute heart failure, 67Electrolyte abnormalities, 67Monitoring elements, 68Evidence-based treatment guidelines, 68Critical illnesses, 68Evidence-based treatment guidelines, 68Drug overdose, 69Evidenced-based guidelines, 69Unnecessary arrhythmia monitoring and underutilization of ischemia and QT-interval monitoring, 695 Hemodynamic monitoring in critical care, 73Kathy J. BookerHemodynamic monitoring overview, 73Hemodynamic monitoring systems, 75Pulmonary artery catheter monitoring, 75Central venous pressure monitoring and management, 76Central venous pressure trending limitations, 77Arterial line monitoring and management, 78Hemodynamic monitoring guidelines and outcomes, 78Functional indicators of hemodynamic monitoring, 79Perioperative optimization, 79Transesophageal monitoring, 79Volume responsiveness, 80Pulse contour analysis, 81FloTrac/Vigileo®, 82Transpulmonary dilution techniques, 82Passive leg raising, 83SVV protocols for management, 846 Monitoring for neurologic dysfunction, 87Janice L. Hinkle and Carey HeckPhysiological guidelines, 87Increased intracranial pressure, 87Decreased cerebral blood flow, 88Cerebral response to increased intracranial pressure, 88Rapid assessment of neurologic dysfunction in intensive care unit patients, 89Evidence-based treatment guidelines, 90Intracranial pressure monitoring, 93Evidence-based treatment guidelines, 93Measuring brain temperature, 94Evidence-based treatment guidelines, 95Brain tissue O2 monitoring, 95Monitoring elements, 95Evidence-based treatment guidelines, 95Microdialysis, 95Monitoring elements, 95Evidence-based treatment guidelines, 95Electrophysiological monitoring, 96Monitoring elements, 96Evidence-based treatment guidelines, 96The BiSpectral index monitoring, 96Monitoring elements, 96Evidence-based treatment guidelines, 96Transcranial Doppler ultrasonograpy, 97Monitoring elements, 97Evidence-based treatment guidelines, 97Shunts, 98Monitoring elements, 98Evidence-based treatment guidelines, 98Neuromuscular transmission, 98Monitoring elements, 98Evidence-based treatment guidelines, 98Management of cervical stabilization devices, 98Monitoring elements, 98Evidence-based treatment guidelines, 99Induced coma and sedation protocols, 100Monitoring elements, 100Evidence-based treatment guidelines, 100Research-based neurologic protocols, 1007 Monitoring for renal dysfunction, 104Dawn CooperAcute kidney injury, 104Physiological guidelines, 105Prerenal injury, 105Intrarenal injury, 106Acute tubular necrosis, 107Acute intersitial nephritis, 107Post renal injury, 108Monitoring elements, 108History and physical assessment, 108Laboratory analysis and data trending, 109Diagnostic imaging, 111Renal biopsy, 111Evidenced-based treatment guidelines, 112Prevention, 112Hemodynamic monitoring, 112Volume expansion, 112Management of electrolyte and acid–base imbalance, 112Pharmacologic interventions, 113Prevention of radiocontrast nephropathy, 114Nutrition, 114Renal replacement therapy, 114Intermittant hemodialysis, 114Continuous renal replacement therapies, 114Peritoneal dialysis, 1158 Monitoring for blood glucose dysfunction in the intensive care unit, 119Laura Kierol AndrewsDiabetes management in the ICU, 119Effects of hyperglycemia, 119Hyperglycemia management recommendations, 120Glucose monitoring, 120Carbohydrate administration, 120Insulin therapy, 121Hypoglycemia management, 1219 Monitoring for hepatic and GI dysfunction, 126Eleanor R. FitzpatrickPhysiologic guidelines, 126Gastrointestinal dysfunction, 126Gastrointestinal bleeding, 128Monitoring elements: nasogastric decompression, 128Evidence-based treatment guidelines, 129Gastric pH, 129Evidence-based treatment guidelines, 130Monitoring elements: laboratory tests for GI bleeding, 130Evidence-based treatment guidelines, 130Endoscopic procedures, 130Evidence-based treatment guidelines, 131Evidence-based treatment guidelines for stress ulcers, 132Monitoring elements: gastric tonometry and capnometry, 133Evidence-based treatment guidelines, 134Radiographic diagnostics, 134Evidence-based treatment guidelines, 135Ultrasonography, 135Evidence-based treatment guidelines, 135Intraabdominal pressure management, 135Intraabdominal pressure measurement, 136Treatment of abdominal compartment syndrome, 137Diagnostics for liver function, 137Evidence-based treatment guidelines, 138Liver support devices, 138Evidence-based treatment guidelines, 139Balloon tamponade therapy, 139Evidence-based treatment guidelines, 140ICP monitoring in acute liver failure, 140Evidenced-based treatment guidelines, 140Ascites management, 141Evidence-based treatment guidelines: paracentesis, 141Nutritional assessment and treatment, 142Evidence-based treatment guidelines, 142Critical monitoring in acute pancreatitis, 142Evidence-based treatment guidelines for acute pancreatitis, 143Monitoring elements: pancreatitis, 143Evidence-based treatment guidelines for acute pancreatitis, 14310 Traumatic injuries: special considerations, 146Catherine Bond and Mary Beth VoightsPrimary, secondary, and tertiary surveys, 146Fluid resuscitation, 151Fluid choice, 151End points of resuscitation, 152Intracompartmental monitoring, 152Complications, 153Thromboembolic events, 153Anticoagulation, 154Pain management, 154Early mobilization, 154Thoracic injury management, 154Abdominal trauma, 155Abdominal compartment syndrome, 158Musculoskeletal injuries and management, 159Ongoing hemorrhage, 160Pelvic fractures, 161Crush syndrome management, 161Pain management in orthopedic injury, 162Burns, 162Burn classification, 162Fluid management in burn therapy, 16411 Oncologic emergencies in critical care, 167Lisa M. BarbarottaEvolution of oncology critical management, 167Sepsis in the immunocompromised host, 167Physiologic guidelines, 167Assessment and monitoring in neutropenic patients, 168Neutropenia management, 168Evidence-based guidelines, 169Research, 171Stem cell transplant, 171Infection, 172Graft-versus-host disease, 172Hepatic veno-occlusive disease, 173Pulmonary complications, 174Hematologic complications, 175Hemorrhagic complications, 175Thrombocytopenia, 175Management, 176Thrombotic microangiopathy, 177Physiologic guidelines, 177Management, 179Hyperviscosity syndromes, 179Physiologic guidelines, 179Management, 180Hyperleukocytosis and leukostasis, 180Physiologic guidelines, 180Management, 181Tumor lysis syndrome, 181Physiologic guidelines, 181Treatment, 183Management of electrolyte imbalances, 184Hyperkalemia, 184Hyperphosphatemia with secondary hypocalcemia, 184Hyperuricemia, 185Acute kidney injury, 186Evidence-based treatment guidelines, 186Structural emergencies, 186Cardiac tamponade, 187Physiologic guidelines, 187Management, 189Malignant airway obstruction, 189Physiologic guidelines, 189Management, 190Carotid blowout syndrome, 192Physiologic guidelines, 192Management, 19412 End-of-life concerns, 201Kathy J. BookerIntroduction, 201Assessment and communication issues, 201Family presence, 202Advanced directives, 202Surrogate decision making, 202Delivering bad news, 204Palliative care in the ICU, 204Symptom management, 206Brain death, 20613 Monitoring for overdoses, 210Linda M. DalessioIntroduction, 210General management of drug overdoses, 210Drug screening, 210New and emerging therapies, 211Indexing of drug and toxins seen in overdoses, 212Acetaminophen, 213Drug overview, 213Symptoms of overdose, 213Diagnostic testing and monitoring, 213Antidotes/binding agents, 213Salicylates and nonsteroidal anti-inflammatory drugs, 214Drug overview, 214Symptoms of overdose, 214Monitoring, 214Antidotes/binding agents/treatment, 215Methemoglobin, 215Drug overview, 215Symptoms of overdose, 215Diagnostic testing and monitoring, 216Antidotes/binding agents/treatment, 216Iron, 217Drug overview, 217Symptoms of overdose, 217Diagnostic testing and monitoring, 217Antidotes/binding agents/treatment, 217Drugs of abuse, 218Overview, 218Symptoms of overdose, 218Diagnostic testing, 218Benzodiazepines, 218Drug overview, 218Symptoms of overdose, 218Diagnostic testing and monitoring, 219Antidotes/binding agents/treatments, 219Opiods, 219Drug overview, 219Symptoms of overdose, 219Diagnostic testing and monitoring, 220Antidotes/binding agents/treatment, 220Cocaine, 220Drug overview, 221Symptoms of overdose, 221Diagnostic testing and monitoring, 221Antidotes/binding agents/treatment, 222Amphetamines, 222Drug overview, 222Symptoms of overdose, 222Diagnostic testing and monitoring, 222Antidotes/binding agents/treatments, 223Phencyclidine, 223Drug overview, 223Symptoms of overdose, 223Diagnostic testing and monitoring, 223Antidotes/binding agents/treatments, 223Barbituates, 224Drug overview, 224Symptoms of overdose, 224Diagnostic testing and monitoring, 224Antidotes/binding agents/treatments, 224Hallucinogens, 224Drug overview, 224Symptoms of overdose, 225Monitoring and treatment, 225Club drugs/date rape drugs, 225Drug overview, 225Symptoms of overdose, 225Diagnostic testing and monitoring, 226Antidotes/binding agents/treatments, 226Ketamine, 226Drug overview, 226Symptoms of overdose, 226Diagnostic testing and monitoring, 227Antidotes/binding agents/treatments, 227Fake marijuana, 227Drug overview, 227Symptoms, 227Diagnostic testing, 227Antidote, 228Dextromethorphan, 228Drug overview, 228Symptoms of overdose, 228Diagnostic testing and monitoring, 228Antidotes, 229Bath salts, 229Drug overview, 229Symptoms of overdose/use, 229Diagnostic testing and monitoring, 229Antidotes/binding agents/treatments, 229Skeletal muscle relaxants, 230Drug overview, 230Symptoms of overdose, 230Diagnostic testing and monitoring, 230Antidotes/binding agents/treatments, 231Psychiatric drugs, 231Drug overview, 231Selective serotonin reuptake inhibitors, 231Drug overview, 231Symptoms, 231Diagnostic testing and monitoring, 234Antidotes/binding agents/treatments, 234Monoamine oxidase inhibitors, 234Drug overview, 234Symptoms of overdose, 235Diagnostic testing and monitoring, 235Antidotes, 235Lithium, 236Drug overview, 236Symptom of overdose, 236Diagnostic testing and monitoring, 236Antidotes/binding agents/treatments, 236Neuroleptics, 237Drug overview, 237Symptoms of overdose, 237Diagnostic testing and monitoring, 237Antidotes/binding agents/treatments, 237Tricyclic antidepressants, 238Drug overview, 238Symptoms of overdose, 238Diagnostic testing and monitoring, 238Antidotes/binding agents/treatments, 238Carbon monoxide, 239Drug overview, 239Pharmacology, 239Symptoms, 239Diagnostic testing and monitoring, 239Antidotes/binding agents/treatments, 240Hydrocarbons and toxic inhalants, 240Drug overview, 240Pharmacology, 240Diagnostic testing and monitoring, 241Signs and symptoms, 241Antidotes/treatment, 241Cardiac medications, 241Drug overview, 241Antiarrhythmic agents, 246Toxic alcohols, 248Drug overview, 248Anticholinergics/Cholinergics/Antihistamines (ACA), 251Drug overview, 251ACA symptoms of overdose, 252ACA diagnostic testing and monitoring, 252ACA antidotes/binding agents/treatment, 252Anticonvulsants, 252Drug overview, 252Anticonvulsants symptoms of overdose, 253Anticonvulsants diagnostic testing and monitoring, 253Anticonvulsants antidotes/binding agents, 253Common toxidromes and treatments for poisoning conditions, 253Anticholinergic toxidrome, 255Benzodiazepine toxidrome, 255Cholinergic toxidrome, 256Opioid toxidrome, 256Sympathomimetic toxidromes, 256Rhabdomyolysis syndromes, 257Treatment of hyperkalemia, 257Packidrome, 257Alcohol withdrawal syndrome, 258Anion and non-anion gap acidosis and osmolar anion gap, 258Non-anion gap acidosis, 259Osmolar gap, 259Osmolarity corrected for elevated ETOH level, 259Index, 264

Kathy Booker is Director and Professor, Millikin University School of Nursing, Illinois, USA. She has held former positions as Specialty Director of the Adult Advanced Practice Program in the School of Nursing, Yale University, Connecticut, USA, and Dean of the College of Professional Studies at Millikin University. She has been certified as a Critical Care Registered Nurse (CCRN) for over twenty years, currently holding alumnus status CCRN. She practiced as a critical care RN and Clinical Nurse Specialist for over twenty-five years.

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• Contributors, xv Critical Care Nursing: Monitoring and Treatment for Advanced Nursing Practice, xviiKathy J. Booker1 Philosophy and treatment in US critical care units, 1Kathy J. BookerUS critical care units, 1Organization of critical care delivery, 1Monitoring and surveillance in critical care, 2Surveillance, 2Nursing certification and competency in critical care units, 3US national critical care organizations, 4American Association of Critical Care Nurses, 4Society of Critical Care Medicine, 5Acute care advanced practice nursing, 5Clinical nurse specialists, 6Acute care nurse practitioners, 6Critical care and ACNP outcomes research, 7Evolution of families in the critical care unit, 8Progression and development of rapid response teams, 92 Vital measurements and shock syndromes in critically ill adults, 13Kathy J. Booker and Laura Kierol AndrewsMonitoring basic vital signs, 13Temperature monitoring, 14Hypothermia, 14Complications of cooling, 15Hyperthermia, 17Heatstroke management, 17Malignant hyperthermia, 17Heart rate monitoring, 18Blood pressure monitoring, 19Oscillometric blood pressure measurement, 20Aneroid measurement, 20Arterial pressure measurement, 20Respiratory monitoring, 21Capnography, 21Shock conditions in critically ill adults, 22Cardiogenic shock, 23Anaphylactic shock, 24Hypovolemic shock, 24Sepsis syndromes, 26SIRS, sepsis, and septic shock, 26Monitoring and treatment priorities in sepsis syndromes, 28Sepsis diagnosis, 28Body temperature, 29Cultures, 29Intravascular catheters, 29Other infectious complications in critically ill adults, 29Pulmonary infections, 29Urinary tract infections, 30Monitoring during transport, 303 Monitoring for respiratory dysfunction, 35Alexander P. Johnson and Jennifer AbrahamAcid-base disturbances & anion gap, 35Metabolic acidosis, 35Metabolic alkalosis, 37Respiratory acidosis, 37Respiratory alkalosis, 38Mixed acid–base disorders, 38Oxygenation, 38Estimation of the PaO2, 38A–a Gradient, 39PaO2/FiO2 (P/F) ratio, 39Acute respiratory failure, 40Capnography, 40Monitoring ventilation with PetCO2, 40Monitoring blood flow, 41Modes of mechanical ventilation, 41Continuous positive airway pressure (CPAP) with pressure support, 41Synchronized intermittent mandatory ventilation (SIMV), 42Assist/control ventilation (AC), 42Pressure control ventilation, 42Airway pressure release ventilation (APRV), 42Pressure-regulated volume control (PRVC), 42Inverse ratio ventilation, 43Oscillatory ventilation, 43Overview of protective lung ventilation in ARDS, 43ARDSNet protocol goals, 43Monitoring for complications during mechanical ventilation, 43High peak airway pressures on mechanical ventilation, 43Response to bagging—monitoring and treatment, 44Auto-PEEP effect, 44Weaning from mechanical ventilation, 44Postextubation stridor: monitoring and treatment, 46Noninvasive positive pressure ventilation, 47Tension pneumothorax, 47Emergent treatment—needle thoracostomy, 47Chest radiograph interpretation, 48Sleep-disordered breathing in the critical care unit, 48Obstructive sleep apnea, 50Central sleep apnea, 50Obesity hypoventilation syndrome, 51CPAP and BiPAP therapy, 51Approach to cardiogenic dyspnea in acute heart failure, 524 Electrocardiographic monitoring for cardiovascular dysfunction, 57Catherine WinklerPhysiologic guidelines, 57Goals of monitoring, 58Post cardiopulmonary resuscitation, 59Evidence-based treatment guidelines, 60Acute coronary syndromes, 60Evidence-based treatment guidelines, 62Cardiac arrhythmias, 64Evidence-based treatment guidelines, 65Acute heart failure, 67Electrolyte abnormalities, 67Monitoring elements, 68Evidence-based treatment guidelines, 68Critical illnesses, 68Evidence-based treatment guidelines, 68Drug overdose, 69Evidenced-based guidelines, 69Unnecessary arrhythmia monitoring and underutilization of ischemia and QT-interval monitoring, 695 Hemodynamic monitoring in critical care, 73Kathy J. BookerHemodynamic monitoring overview, 73Hemodynamic monitoring systems, 75Pulmonary artery catheter monitoring, 75Central venous pressure monitoring and management, 76Central venous pressure trending limitations, 77Arterial line monitoring and management, 78Hemodynamic monitoring guidelines and outcomes, 78Functional indicators of hemodynamic monitoring, 79Perioperative optimization, 79Transesophageal monitoring, 79Volume responsiveness, 80Pulse contour analysis, 81FloTrac/Vigileo®, 82Transpulmonary dilution techniques, 82Passive leg raising, 83SVV protocols for management, 846 Monitoring for neurologic dysfunction, 87Janice L. Hinkle and Carey HeckPhysiological guidelines, 87Increased intracranial pressure, 87Decreased cerebral blood flow, 88Cerebral response to increased intracranial pressure, 88Rapid assessment of neurologic dysfunction in intensive care unit patients, 89Evidence-based treatment guidelines, 90Intracranial pressure monitoring, 93Evidence-based treatment guidelines, 93Measuring brain temperature, 94Evidence-based treatment guidelines, 95Brain tissue O2 monitoring, 95Monitoring elements, 95Evidence-based treatment guidelines, 95Microdialysis, 95Monitoring elements, 95Evidence-based treatment guidelines, 95Electrophysiological monitoring, 96Monitoring elements, 96Evidence-based treatment guidelines, 96The BiSpectral index monitoring, 96Monitoring elements, 96Evidence-based treatment guidelines, 96Transcranial Doppler ultrasonograpy, 97Monitoring elements, 97Evidence-based treatment guidelines, 97Shunts, 98Monitoring elements, 98Evidence-based treatment guidelines, 98Neuromuscular transmission, 98Monitoring elements, 98Evidence-based treatment guidelines, 98Management of cervical stabilization devices, 98Monitoring elements, 98Evidence-based treatment guidelines, 99Induced coma and sedation protocols, 100Monitoring elements, 100Evidence-based treatment guidelines, 100Research-based neurologic protocols, 1007 Monitoring for renal dysfunction, 104Dawn CooperAcute kidney injury, 104Physiological guidelines, 105Prerenal injury, 105Intrarenal injury, 106Acute tubular necrosis, 107Acute intersitial nephritis, 107Post renal injury, 108Monitoring elements, 108History and physical assessment, 108Laboratory analysis and data trending, 109Diagnostic imaging, 111Renal biopsy, 111Evidenced-based treatment guidelines, 112Prevention, 112Hemodynamic monitoring, 112Volume expansion, 112Management of electrolyte and acid–base imbalance, 112Pharmacologic interventions, 113Prevention of radiocontrast nephropathy, 114Nutrition, 114Renal replacement therapy, 114Intermittant hemodialysis, 114Continuous renal replacement therapies, 114Peritoneal dialysis, 1158 Monitoring for blood glucose dysfunction in the intensive care unit, 119Laura Kierol AndrewsDiabetes management in the ICU, 119Effects of hyperglycemia, 119Hyperglycemia management recommendations, 120Glucose monitoring, 120Carbohydrate administration, 120Insulin therapy, 121Hypoglycemia management, 1219 Monitoring for hepatic and GI dysfunction, 126Eleanor R. FitzpatrickPhysiologic guidelines, 126Gastrointestinal dysfunction, 126Gastrointestinal bleeding, 128Monitoring elements: nasogastric decompression, 128Evidence-based treatment guidelines, 129Gastric pH, 129Evidence-based treatment guidelines, 130Monitoring elements: laboratory tests for GI bleeding, 130Evidence-based treatment guidelines, 130Endoscopic procedures, 130Evidence-based treatment guidelines, 131Evidence-based treatment guidelines for stress ulcers, 132Monitoring elements: gastric tonometry and capnometry, 133Evidence-based treatment guidelines, 134Radiographic diagnostics, 134Evidence-based treatment guidelines, 135Ultrasonography, 135Evidence-based treatment guidelines, 135Intraabdominal pressure management, 135Intraabdominal pressure measurement, 136Treatment of abdominal compartment syndrome, 137Diagnostics for liver function, 137Evidence-based treatment guidelines, 138Liver support devices, 138Evidence-based treatment guidelines, 139Balloon tamponade therapy, 139Evidence-based treatment guidelines, 140ICP monitoring in acute liver failure, 140Evidenced-based treatment guidelines, 140Ascites management, 141Evidence-based treatment guidelines: paracentesis, 141Nutritional assessment and treatment, 142Evidence-based treatment guidelines, 142Critical monitoring in acute pancreatitis, 142Evidence-based treatment guidelines for acute pancreatitis, 143Monitoring elements: pancreatitis, 143Evidence-based treatment guidelines for acute pancreatitis, 14310 Traumatic injuries: special considerations, 146Catherine Bond and Mary Beth VoightsPrimary, secondary, and tertiary surveys, 146Fluid resuscitation, 151Fluid choice, 151End points of resuscitation, 152Intracompartmental monitoring, 152Complications, 153Thromboembolic events, 153Anticoagulation, 154Pain management, 154Early mobilization, 154Thoracic injury management, 154Abdominal trauma, 155Abdominal compartment syndrome, 158Musculoskeletal injuries and management, 159Ongoing hemorrhage, 160Pelvic fractures, 161Crush syndrome management, 161Pain management in orthopedic injury, 162Burns, 162Burn classification, 162Fluid management in burn therapy, 16411 Oncologic emergencies in critical care, 167Lisa M. BarbarottaEvolution of oncology critical management, 167Sepsis in the immunocompromised host, 167Physiologic guidelines, 167Assessment and monitoring in neutropenic patients, 168Neutropenia management, 168Evidence-based guidelines, 169Research, 171Stem cell transplant, 171Infection, 172Graft-versus-host disease, 172Hepatic veno-occlusive disease, 173Pulmonary complications, 174Hematologic complications, 175Hemorrhagic complications, 175Thrombocytopenia, 175Management, 176Thrombotic microangiopathy, 177Physiologic guidelines, 177Management, 179Hyperviscosity syndromes, 179Physiologic guidelines, 179Management, 180Hyperleukocytosis and leukostasis, 180Physiologic guidelines, 180Management, 181Tumor lysis syndrome, 181Physiologic guidelines, 181Treatment, 183Management of electrolyte imbalances, 184Hyperkalemia, 184Hyperphosphatemia with secondary hypocalcemia, 184Hyperuricemia, 185Acute kidney injury, 186Evidence-based treatment guidelines, 186Structural emergencies, 186Cardiac tamponade, 187Physiologic guidelines, 187Management, 189Malignant airway obstruction, 189Physiologic guidelines, 189Management, 190Carotid blowout syndrome, 192Physiologic guidelines, 192Management, 19412 End-of-life concerns, 201Kathy J. BookerIntroduction, 201Assessment and communication issues, 201Family presence, 202Advanced directives, 202Surrogate decision making, 202Delivering bad news, 204Palliative care in the ICU, 204Symptom management, 206Brain death, 20613 Monitoring for overdoses, 210Linda M. DalessioIntroduction, 210General management of drug overdoses, 210Drug screening, 210New and emerging therapies, 211Indexing of drug and toxins seen in overdoses, 212Acetaminophen, 213Drug overview, 213Symptoms of overdose, 213Diagnostic testing and monitoring, 213Antidotes/binding agents, 213Salicylates and nonsteroidal anti-inflammatory drugs, 214Drug overview, 214Symptoms of overdose, 214Monitoring, 214Antidotes/binding agents/treatment, 215Methemoglobin, 215Drug overview, 215Symptoms of overdose, 215Diagnostic testing and monitoring, 216Antidotes/binding agents/treatment, 216Iron, 217Drug overview, 217Symptoms of overdose, 217Diagnostic testing and monitoring, 217Antidotes/binding agents/treatment, 217Drugs of abuse, 218Overview, 218Symptoms of overdose, 218Diagnostic testing, 218Benzodiazepines, 218Drug overview, 218Symptoms of overdose, 218Diagnostic testing and monitoring, 219Antidotes/binding agents/treatments, 219Opiods, 219Drug overview, 219Symptoms of overdose, 219Diagnostic testing and monitoring, 220Antidotes/binding agents/treatment, 220Cocaine, 220Drug overview, 221Symptoms of overdose, 221Diagnostic testing and monitoring, 221Antidotes/binding agents/treatment, 222Amphetamines, 222Drug overview, 222Symptoms of overdose, 222Diagnostic testing and monitoring, 222Antidotes/binding agents/treatments, 223Phencyclidine, 223Drug overview, 223Symptoms of overdose, 223Diagnostic testing and monitoring, 223Antidotes/binding agents/treatments, 223Barbituates, 224Drug overview, 224Symptoms of overdose, 224Diagnostic testing and monitoring, 224Antidotes/binding agents/treatments, 224Hallucinogens, 224Drug overview, 224Symptoms of overdose, 225Monitoring and treatment, 225Club drugs/date rape drugs, 225Drug overview, 225Symptoms of overdose, 225Diagnostic testing and monitoring, 226Antidotes/binding agents/treatments, 226Ketamine, 226Drug overview, 226Symptoms of overdose, 226Diagnostic testing and monitoring, 227Antidotes/binding agents/treatments, 227Fake marijuana, 227Drug overview, 227Symptoms, 227Diagnostic testing, 227Antidote, 228Dextromethorphan, 228Drug overview, 228Symptoms of overdose, 228Diagnostic testing and monitoring, 228Antidotes, 229Bath salts, 229Drug overview, 229Symptoms of overdose/use, 229Diagnostic testing and monitoring, 229Antidotes/binding agents/treatments, 229Skeletal muscle relaxants, 230Drug overview, 230Symptoms of overdose, 230Diagnostic testing and monitoring, 230Antidotes/binding agents/treatments, 231Psychiatric drugs, 231Drug overview, 231Selective serotonin reuptake inhibitors, 231Drug overview, 231Symptoms, 231Diagnostic testing and monitoring, 234Antidotes/binding agents/treatments, 234Monoamine oxidase inhibitors, 234Drug overview, 234Symptoms of overdose, 235Diagnostic testing and monitoring, 235Antidotes, 235Lithium, 236Drug overview, 236Symptom of overdose, 236Diagnostic testing and monitoring, 236Antidotes/binding agents/treatments, 236Neuroleptics, 237Drug overview, 237Symptoms of overdose, 237Diagnostic testing and monitoring, 237Antidotes/binding agents/treatments, 237Tricyclic antidepressants, 238Drug overview, 238Symptoms of overdose, 238Diagnostic testing and monitoring, 238Antidotes/binding agents/treatments, 238Carbon monoxide, 239Drug overview, 239Pharmacology, 239Symptoms, 239Diagnostic testing and monitoring, 239Antidotes/binding agents/treatments, 240Hydrocarbons and toxic inhalants, 240Drug overview, 240Pharmacology, 240Diagnostic testing and monitoring, 241Signs and symptoms, 241Antidotes/treatment, 241Cardiac medications, 241Drug overview, 241Antiarrhythmic agents, 246Toxic alcohols, 248Drug overview, 248Anticholinergics/Cholinergics/Antihistamines (ACA), 251Drug overview, 251ACA symptoms of overdose, 252ACA diagnostic testing and monitoring, 252ACA antidotes/binding agents/treatment, 252Anticonvulsants, 252Drug overview, 252Anticonvulsants symptoms of overdose, 253Anticonvulsants diagnostic testing and monitoring, 253Anticonvulsants antidotes/binding agents, 253Common toxidromes and treatments for poisoning conditions, 253Anticholinergic toxidrome, 255Benzodiazepine toxidrome, 255Cholinergic toxidrome, 256Opioid toxidrome, 256Sympathomimetic toxidromes, 256Rhabdomyolysis syndromes, 257Treatment of hyperkalemia, 257Packidrome, 257Alcohol withdrawal syndrome, 258Anion and non-anion gap acidosis and osmolar anion gap, 258Non-anion gap acidosis, 259Osmolar gap, 259Osmolarity corrected for elevated ETOH level, 259Index, 264

Kathy Booker is Director and Professor, Millikin University School of Nursing, Illinois, USA. She has held former positions as Specialty Director of the Adult Advanced Practice Program in the School of Nursing, Yale University, Connecticut, USA, and Dean of the College of Professional Studies at Millikin University. She has been certified as a Critical Care Registered Nurse (CCRN) for over twenty years, currently holding alumnus status CCRN. She practiced as a critical care RN and Clinical Nurse Specialist for over twenty-five years.

Select Guide Rating

• Contributors, xv Critical Care Nursing: Monitoring and Treatment for Advanced Nursing Practice, xviiKathy J. Booker1 Philosophy and treatment in US critical care units, 1Kathy J. BookerUS critical care units, 1Organization of critical care delivery, 1Monitoring and surveillance in critical care, 2Surveillance, 2Nursing certification and competency in critical care units, 3US national critical care organizations, 4American Association of Critical Care Nurses, 4Society of Critical Care Medicine, 5Acute care advanced practice nursing, 5Clinical nurse specialists, 6Acute care nurse practitioners, 6Critical care and ACNP outcomes research, 7Evolution of families in the critical care unit, 8Progression and development of rapid response teams, 92 Vital measurements and shock syndromes in critically ill adults, 13Kathy J. Booker and Laura Kierol AndrewsMonitoring basic vital signs, 13Temperature monitoring, 14Hypothermia, 14Complications of cooling, 15Hyperthermia, 17Heatstroke management, 17Malignant hyperthermia, 17Heart rate monitoring, 18Blood pressure monitoring, 19Oscillometric blood pressure measurement, 20Aneroid measurement, 20Arterial pressure measurement, 20Respiratory monitoring, 21Capnography, 21Shock conditions in critically ill adults, 22Cardiogenic shock, 23Anaphylactic shock, 24Hypovolemic shock, 24Sepsis syndromes, 26SIRS, sepsis, and septic shock, 26Monitoring and treatment priorities in sepsis syndromes, 28Sepsis diagnosis, 28Body temperature, 29Cultures, 29Intravascular catheters, 29Other infectious complications in critically ill adults, 29Pulmonary infections, 29Urinary tract infections, 30Monitoring during transport, 303 Monitoring for respiratory dysfunction, 35Alexander P. Johnson and Jennifer AbrahamAcid-base disturbances & anion gap, 35Metabolic acidosis, 35Metabolic alkalosis, 37Respiratory acidosis, 37Respiratory alkalosis, 38Mixed acid–base disorders, 38Oxygenation, 38Estimation of the PaO2, 38A–a Gradient, 39PaO2/FiO2 (P/F) ratio, 39Acute respiratory failure, 40Capnography, 40Monitoring ventilation with PetCO2, 40Monitoring blood flow, 41Modes of mechanical ventilation, 41Continuous positive airway pressure (CPAP) with pressure support, 41Synchronized intermittent mandatory ventilation (SIMV), 42Assist/control ventilation (AC), 42Pressure control ventilation, 42Airway pressure release ventilation (APRV), 42Pressure-regulated volume control (PRVC), 42Inverse ratio ventilation, 43Oscillatory ventilation, 43Overview of protective lung ventilation in ARDS, 43ARDSNet protocol goals, 43Monitoring for complications during mechanical ventilation, 43High peak airway pressures on mechanical ventilation, 43Response to bagging—monitoring and treatment, 44Auto-PEEP effect, 44Weaning from mechanical ventilation, 44Postextubation stridor: monitoring and treatment, 46Noninvasive positive pressure ventilation, 47Tension pneumothorax, 47Emergent treatment—needle thoracostomy, 47Chest radiograph interpretation, 48Sleep-disordered breathing in the critical care unit, 48Obstructive sleep apnea, 50Central sleep apnea, 50Obesity hypoventilation syndrome, 51CPAP and BiPAP therapy, 51Approach to cardiogenic dyspnea in acute heart failure, 524 Electrocardiographic monitoring for cardiovascular dysfunction, 57Catherine WinklerPhysiologic guidelines, 57Goals of monitoring, 58Post cardiopulmonary resuscitation, 59Evidence-based treatment guidelines, 60Acute coronary syndromes, 60Evidence-based treatment guidelines, 62Cardiac arrhythmias, 64Evidence-based treatment guidelines, 65Acute heart failure, 67Electrolyte abnormalities, 67Monitoring elements, 68Evidence-based treatment guidelines, 68Critical illnesses, 68Evidence-based treatment guidelines, 68Drug overdose, 69Evidenced-based guidelines, 69Unnecessary arrhythmia monitoring and underutilization of ischemia and QT-interval monitoring, 695 Hemodynamic monitoring in critical care, 73Kathy J. BookerHemodynamic monitoring overview, 73Hemodynamic monitoring systems, 75Pulmonary artery catheter monitoring, 75Central venous pressure monitoring and management, 76Central venous pressure trending limitations, 77Arterial line monitoring and management, 78Hemodynamic monitoring guidelines and outcomes, 78Functional indicators of hemodynamic monitoring, 79Perioperative optimization, 79Transesophageal monitoring, 79Volume responsiveness, 80Pulse contour analysis, 81FloTrac/Vigileo®, 82Transpulmonary dilution techniques, 82Passive leg raising, 83SVV protocols for management, 846 Monitoring for neurologic dysfunction, 87Janice L. Hinkle and Carey HeckPhysiological guidelines, 87Increased intracranial pressure, 87Decreased cerebral blood flow, 88Cerebral response to increased intracranial pressure, 88Rapid assessment of neurologic dysfunction in intensive care unit patients, 89Evidence-based treatment guidelines, 90Intracranial pressure monitoring, 93Evidence-based treatment guidelines, 93Measuring brain temperature, 94Evidence-based treatment guidelines, 95Brain tissue O2 monitoring, 95Monitoring elements, 95Evidence-based treatment guidelines, 95Microdialysis, 95Monitoring elements, 95Evidence-based treatment guidelines, 95Electrophysiological monitoring, 96Monitoring elements, 96Evidence-based treatment guidelines, 96The BiSpectral index monitoring, 96Monitoring elements, 96Evidence-based treatment guidelines, 96Transcranial Doppler ultrasonograpy, 97Monitoring elements, 97Evidence-based treatment guidelines, 97Shunts, 98Monitoring elements, 98Evidence-based treatment guidelines, 98Neuromuscular transmission, 98Monitoring elements, 98Evidence-based treatment guidelines, 98Management of cervical stabilization devices, 98Monitoring elements, 98Evidence-based treatment guidelines, 99Induced coma and sedation protocols, 100Monitoring elements, 100Evidence-based treatment guidelines, 100Research-based neurologic protocols, 1007 Monitoring for renal dysfunction, 104Dawn CooperAcute kidney injury, 104Physiological guidelines, 105Prerenal injury, 105Intrarenal injury, 106Acute tubular necrosis, 107Acute intersitial nephritis, 107Post renal injury, 108Monitoring elements, 108History and physical assessment, 108Laboratory analysis and data trending, 109Diagnostic imaging, 111Renal biopsy, 111Evidenced-based treatment guidelines, 112Prevention, 112Hemodynamic monitoring, 112Volume expansion, 112Management of electrolyte and acid–base imbalance, 112Pharmacologic interventions, 113Prevention of radiocontrast nephropathy, 114Nutrition, 114Renal replacement therapy, 114Intermittant hemodialysis, 114Continuous renal replacement therapies, 114Peritoneal dialysis, 1158 Monitoring for blood glucose dysfunction in the intensive care unit, 119Laura Kierol AndrewsDiabetes management in the ICU, 119Effects of hyperglycemia, 119Hyperglycemia management recommendations, 120Glucose monitoring, 120Carbohydrate administration, 120Insulin therapy, 121Hypoglycemia management, 1219 Monitoring for hepatic and GI dysfunction, 126Eleanor R. FitzpatrickPhysiologic guidelines, 126Gastrointestinal dysfunction, 126Gastrointestinal bleeding, 128Monitoring elements: nasogastric decompression, 128Evidence-based treatment guidelines, 129Gastric pH, 129Evidence-based treatment guidelines, 130Monitoring elements: laboratory tests for GI bleeding, 130Evidence-based treatment guidelines, 130Endoscopic procedures, 130Evidence-based treatment guidelines, 131Evidence-based treatment guidelines for stress ulcers, 132Monitoring elements: gastric tonometry and capnometry, 133Evidence-based treatment guidelines, 134Radiographic diagnostics, 134Evidence-based treatment guidelines, 135Ultrasonography, 135Evidence-based treatment guidelines, 135Intraabdominal pressure management, 135Intraabdominal pressure measurement, 136Treatment of abdominal compartment syndrome, 137Diagnostics for liver function, 137Evidence-based treatment guidelines, 138Liver support devices, 138Evidence-based treatment guidelines, 139Balloon tamponade therapy, 139Evidence-based treatment guidelines, 140ICP monitoring in acute liver failure, 140Evidenced-based treatment guidelines, 140Ascites management, 141Evidence-based treatment guidelines: paracentesis, 141Nutritional assessment and treatment, 142Evidence-based treatment guidelines, 142Critical monitoring in acute pancreatitis, 142Evidence-based treatment guidelines for acute pancreatitis, 143Monitoring elements: pancreatitis, 143Evidence-based treatment guidelines for acute pancreatitis, 14310 Traumatic injuries: special considerations, 146Catherine Bond and Mary Beth VoightsPrimary, secondary, and tertiary surveys, 146Fluid resuscitation, 151Fluid choice, 151End points of resuscitation, 152Intracompartmental monitoring, 152Complications, 153Thromboembolic events, 153Anticoagulation, 154Pain management, 154Early mobilization, 154Thoracic injury management, 154Abdominal trauma, 155Abdominal compartment syndrome, 158Musculoskeletal injuries and management, 159Ongoing hemorrhage, 160Pelvic fractures, 161Crush syndrome management, 161Pain management in orthopedic injury, 162Burns, 162Burn classification, 162Fluid management in burn therapy, 16411 Oncologic emergencies in critical care, 167Lisa M. BarbarottaEvolution of oncology critical management, 167Sepsis in the immunocompromised host, 167Physiologic guidelines, 167Assessment and monitoring in neutropenic patients, 168Neutropenia management, 168Evidence-based guidelines, 169Research, 171Stem cell transplant, 171Infection, 172Graft-versus-host disease, 172Hepatic veno-occlusive disease, 173Pulmonary complications, 174Hematologic complications, 175Hemorrhagic complications, 175Thrombocytopenia, 175Management, 176Thrombotic microangiopathy, 177Physiologic guidelines, 177Management, 179Hyperviscosity syndromes, 179Physiologic guidelines, 179Management, 180Hyperleukocytosis and leukostasis, 180Physiologic guidelines, 180Management, 181Tumor lysis syndrome, 181Physiologic guidelines, 181Treatment, 183Management of electrolyte imbalances, 184Hyperkalemia, 184Hyperphosphatemia with secondary hypocalcemia, 184Hyperuricemia, 185Acute kidney injury, 186Evidence-based treatment guidelines, 186Structural emergencies, 186Cardiac tamponade, 187Physiologic guidelines, 187Management, 189Malignant airway obstruction, 189Physiologic guidelines, 189Management, 190Carotid blowout syndrome, 192Physiologic guidelines, 192Management, 19412 End-of-life concerns, 201Kathy J. BookerIntroduction, 201Assessment and communication issues, 201Family presence, 202Advanced directives, 202Surrogate decision making, 202Delivering bad news, 204Palliative care in the ICU, 204Symptom management, 206Brain death, 20613 Monitoring for overdoses, 210Linda M. DalessioIntroduction, 210General management of drug overdoses, 210Drug screening, 210New and emerging therapies, 211Indexing of drug and toxins seen in overdoses, 212Acetaminophen, 213Drug overview, 213Symptoms of overdose, 213Diagnostic testing and monitoring, 213Antidotes/binding agents, 213Salicylates and nonsteroidal anti-inflammatory drugs, 214Drug overview, 214Symptoms of overdose, 214Monitoring, 214Antidotes/binding agents/treatment, 215Methemoglobin, 215Drug overview, 215Symptoms of overdose, 215Diagnostic testing and monitoring, 216Antidotes/binding agents/treatment, 216Iron, 217Drug overview, 217Symptoms of overdose, 217Diagnostic testing and monitoring, 217Antidotes/binding agents/treatment, 217Drugs of abuse, 218Overview, 218Symptoms of overdose, 218Diagnostic testing, 218Benzodiazepines, 218Drug overview, 218Symptoms of overdose, 218Diagnostic testing and monitoring, 219Antidotes/binding agents/treatments, 219Opiods, 219Drug overview, 219Symptoms of overdose, 219Diagnostic testing and monitoring, 220Antidotes/binding agents/treatment, 220Cocaine, 220Drug overview, 221Symptoms of overdose, 221Diagnostic testing and monitoring, 221Antidotes/binding agents/treatment, 222Amphetamines, 222Drug overview, 222Symptoms of overdose, 222Diagnostic testing and monitoring, 222Antidotes/binding agents/treatments, 223Phencyclidine, 223Drug overview, 223Symptoms of overdose, 223Diagnostic testing and monitoring, 223Antidotes/binding agents/treatments, 223Barbituates, 224Drug overview, 224Symptoms of overdose, 224Diagnostic testing and monitoring, 224Antidotes/binding agents/treatments, 224Hallucinogens, 224Drug overview, 224Symptoms of overdose, 225Monitoring and treatment, 225Club drugs/date rape drugs, 225Drug overview, 225Symptoms of overdose, 225Diagnostic testing and monitoring, 226Antidotes/binding agents/treatments, 226Ketamine, 226Drug overview, 226Symptoms of overdose, 226Diagnostic testing and monitoring, 227Antidotes/binding agents/treatments, 227Fake marijuana, 227Drug overview, 227Symptoms, 227Diagnostic testing, 227Antidote, 228Dextromethorphan, 228Drug overview, 228Symptoms of overdose, 228Diagnostic testing and monitoring, 228Antidotes, 229Bath salts, 229Drug overview, 229Symptoms of overdose/use, 229Diagnostic testing and monitoring, 229Antidotes/binding agents/treatments, 229Skeletal muscle relaxants, 230Drug overview, 230Symptoms of overdose, 230Diagnostic testing and monitoring, 230Antidotes/binding agents/treatments, 231Psychiatric drugs, 231Drug overview, 231Selective serotonin reuptake inhibitors, 231Drug overview, 231Symptoms, 231Diagnostic testing and monitoring, 234Antidotes/binding agents/treatments, 234Monoamine oxidase inhibitors, 234Drug overview, 234Symptoms of overdose, 235Diagnostic testing and monitoring, 235Antidotes, 235Lithium, 236Drug overview, 236Symptom of overdose, 236Diagnostic testing and monitoring, 236Antidotes/binding agents/treatments, 236Neuroleptics, 237Drug overview, 237Symptoms of overdose, 237Diagnostic testing and monitoring, 237Antidotes/binding agents/treatments, 237Tricyclic antidepressants, 238Drug overview, 238Symptoms of overdose, 238Diagnostic testing and monitoring, 238Antidotes/binding agents/treatments, 238Carbon monoxide, 239Drug overview, 239Pharmacology, 239Symptoms, 239Diagnostic testing and monitoring, 239Antidotes/binding agents/treatments, 240Hydrocarbons and toxic inhalants, 240Drug overview, 240Pharmacology, 240Diagnostic testing and monitoring, 241Signs and symptoms, 241Antidotes/treatment, 241Cardiac medications, 241Drug overview, 241Antiarrhythmic agents, 246Toxic alcohols, 248Drug overview, 248Anticholinergics/Cholinergics/Antihistamines (ACA), 251Drug overview, 251ACA symptoms of overdose, 252ACA diagnostic testing and monitoring, 252ACA antidotes/binding agents/treatment, 252Anticonvulsants, 252Drug overview, 252Anticonvulsants symptoms of overdose, 253Anticonvulsants diagnostic testing and monitoring, 253Anticonvulsants antidotes/binding agents, 253Common toxidromes and treatments for poisoning conditions, 253Anticholinergic toxidrome, 255Benzodiazepine toxidrome, 255Cholinergic toxidrome, 256Opioid toxidrome, 256Sympathomimetic toxidromes, 256Rhabdomyolysis syndromes, 257Treatment of hyperkalemia, 257Packidrome, 257Alcohol withdrawal syndrome, 258Anion and non-anion gap acidosis and osmolar anion gap, 258Non-anion gap acidosis, 259Osmolar gap, 259Osmolarity corrected for elevated ETOH level, 259Index, 264