摘要:

It is difficult to accurately determine the number of people affected annually by the devastating effects of traumatic brain injury. It is clear, however, that the impact of traumatic brain injury exceeds the financial cost of acute health care. The long-term outcome of patients with traumatic brain injury has been targeted specifically for improvement during this decade. The initial brain injury–known as the primary injury–may occur in one area. of the brain (focal injury) or may affect the entire brain (diffuse injury). The outcome depends on many factors, including the severity of the brain injury and the effectiveness of the interventions received. Accurate assessment of the scope of the problem would be improved by the development of a national database and the standardization of assessment practices. Critical care nurses can contribute skill and knowledge in the care of patients with traumatic brain injury and in efforts to prevent the accidents and violence that cause traumatic brain injury

ISSN:1046-7467    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Traumatic brain injury affects approximately 500,000 persons each year. For those patients who survive until they reach the hospital, the major goal of the health care team is to prevent secondary injuries or insults that may follow the initial event and worsen the brain injury. Factors that can cause secondary insults to the brain include hypoxia, hypercapnia, hypotension, and intracranial hypertension. Prevention of these factors begins in the pre-hospital care phase and continues into the critical care unit. Early recognition of these factors and prompt intervention can improve the neurologic outcome of the patient with severe head injury. An understanding of the causes and effects of these secondary insults is critical to the appropriate medical and nursing management of these patients

ISSN:1046-7467    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Head trauma in the pediatric population older than 1 year occurs in approximately 100,00 children per year, resulting in 250,000 to 500,000 hospitalizations annually. Head trauma accounts for 80% of all trauma deaths. The pathophysiology and management of severe pediatric head trauma is discussed. Traumatic injury to the central nervous system, its sequelae, and approaches to maximize cerebral resuscitation and stabilization are reviewed

ISSN:1046-7467    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Spinal cord injury is devastating to the victim, as well as being costly in terms of medical expenses, lost wages, and lost independence. The initial damage to the spinal cord results from several mechanisms of injury–flexion, extension, compression, penetration, rotation, and the disease process. When the spinal cord is injured and there is necrosis of the nervous tissue, no regeneration of that tissue occurs. Unlike in the peripheral nervous system, where regeneration is possible, the spinal cord is part of the central nervous system, as is the brain. The spinal cord extends from the base of the skull to the LI vertebrae: the cervical levels innervate the diaphragm and muscles of the arms; the thoracic levels innervate the muscles of the chest and abdomen; and the lumbar and sacral levels innervate the muscles of the legs. In addition, the sacral levels are responsible for bowel, bladder, and sexual function. The higher the level of injury, the more severe the loss of function because, not only is the level of injury affected, but also the levels below. Injury occurs by initial trauma to the surrounding ligaments, bones, and muscles, which then affect the spinal cord. There may be total loss of function with damage completely across the cord or partial loss of function with damage affecting only part of the cord. No current treatment can reverse this initial injury, which causes irreversible damage within minutes of injury. Secondary damage occurs as the injury spreads over several hours. Treatment can help prevent this secondary damage

ISSN:1046-7467    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:1046-7467    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A growing number of elderly patients (aged 70 years and older) are seen in critical care units after valve surgery or coronary artery bypass grafting. While studies show that the elderly demonstrate overall successful results after cardiac surgery, the mortality and morbidity risks are higher than in younger adults. The elderly patient is more likely to experience postoperative complications, prolonging the recovery phase. Commonly reported postoperative complications include dysrhythmias, pneumonia, cerebral vascular accidents, and infection. Elderly surgical candidates must be evaluated preoperatively to determine risk factors that may affect the critical care recovery phase. The length of stay tends to be longer in the intensive care unit, requiring nursing care that takes the aging process into consideration. The following article focuses on trends in cardiac surgery in the elderly, physiologic factors that affect outcome and recovery, and nursing interventions aimed at preventing or limiting postoperative complications

ISSN:1046-7467    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Afflicting as many as 80% of critically ill elderly (older than 65 years) patients, adverse psychologic reactions (e.g., acute confusional states) to critical illness and its treatment present a unique challenge to medical and nursing intensive care practitioners. Additionally, the consequences of these adverse psychologic reactions financially strain health-care organizations, placing additional constraints on the delivery of health-care services. This article presents information regarding the origins of these adverse psychologic reactions and nursing strategies for the prevention, identification, and management of these clinical states. With such information, nurses who work in critical care units may be better equipped to identify and care for patients at risk of or experiencing an adverse psychologic reaction to critical illness

ISSN:1046-7467    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In the United States, approximately 12.5 million persons aged 65 and older have some form of cardiovascular disease, and many of these will experience an acute cardiac event. The ensuing crisis necessitates the formulation of a strong support system with the spouse or other significant person. The nurse is in a unique position to be at the helm of this support structure. The ultimate goal is to enable the older heart patient to return home and to be safely guided to as full a recovery as possible within physical limitations

ISSN:1046-7467    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Half of Americans aged 65 and older suffer from some form of cardiovascular problem. This fact necessitates attention to an adequate program of patient education during the hospital course, in order for the patient or the significant other to assume responsibility for home care after discharge. Consideration should be given to providing a complete and effective means of assessing the patient so that a teaching plan to meet specific needs can be formulated. Objectives must be set, with the patient included in this part of the process. Once teaching has been completed, there should be evaluation to determine whether the education goals were met. Only when the geriatric patient is regarded as a unique individual can the nurse-instructor hope to be successful with teaching endeavors

ISSN:1046-7467    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Emergency department nursing care of the older individual requires a specific knowledge base to ensure optimal outcomes. Health-care resource utilization specific to elderly patients in the emergency department and selected common health problems that bring older people to the emergency department are described. Distinctions between normal age-related changes and disease signs and symptoms are explained to provide emergency department nurses with the requisite information to care for the elderly appropriately

ISSN:1046-7467    

出版商:OVID    

年代:1992

数据来源: OVID