December 2, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In its final stages, uncontrolled intracranial hypertension will result in downward herniation of the cerebellar tonsils through the foramen magnum, thereby compressing critical cardiorespiratory centers in the medulla.

December 1, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Adaptation to increased intracranial volume is initially accomplished by shifting CSF from the intracranial to spinal subarachnoid compartment. Approximately two-thirds of cerebral blood volume is contained in the cerebral veins and dural sinuses.

November 30, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In septic shock related to an abscess, aggressive infection (eg, necrotizing fasciitis) or wound (eg, toxic shock syndrome), removal of the infectious stimulus through surgical intervention should proceed as soon as practical.

November 29, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Controlling hemorrhage remains the cornerstone of treating hemorrhagic shock and evidence supports immediate surgery when direct vascular control cannot otherwise be obtained. Gastrointestinal bleeding may require urgent endoscopy.

November 28, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Intubation reduces the work of breathing, which, in the patient with hypoperfusion, further exacerbates lactic acidemia. Strenuous use of accessory respiratory muscles can increase oxygen consumption and decrease cerebral blood flow.

November 27, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Rapid sequence intubation is the preferred method of airway control in most patients with refractory shock. Tissue hypoperfusion leads to increasing fatigue and respiratory failure commonly supervenes in patients with persistent shock.

November 26, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Mixed venous oxygen saturation (SvO2) measurements reflect the balance between oxygen delivery and oxygen consumption. The SvO2 can be used as a surrogate for cardiac index.

November 25, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
If the lactate concentration has not decreased by 10-20% two hours after resuscitation has begun, steps should be taken to improve systemic perfusion. Resuscitation should continue until the lactate concentration drops below 2 mM/L.

November 24, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Lactate clearance has been shown to be equivalent to central venous oxygen saturation as an endpoint of early septic shock resuscitation. Lactate clearance measurements are the preferred endpoint of resuscitation.

November 23, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Muffled heart sounds with jugular venous distention suggest cardiac tamponade, whereas a loud, machine-like, systolic murmur indicates acute rupture of a papillary muscle or interventricular septum.

November 22, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
A rising lactate concentration (or refractory hypotension, with worsening base deficit), despite ongoing resuscitation, calls for more intensive measures. Once shock has been discovered, the next step is to consider the cause of the shock.

November 21, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
A downward trend of the serum lactate concentration or upward trend of the base deficit, with correspondingly improving vital signs and urine output, reliably gauge the adequacy of resuscitation and prognosis in shock from any cause.

November 20, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Arterial or venous lactate concentration and the base deficit provide accurate assessment of global perfusion status. A lactate concentration greater than 4.0 mM or base deficit more negative than -4 mEq/L indicates circulatory insufficiency.

November 19, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Neurogenic shock results from interrupted sympathetic and parasympathetic input from the spinal cord to the heart and peripheral vasculature, typically resulting from acute traumatic injury.

November 18, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Cardiogenic shock results when more than 40% of the myocardium becomes dysfunctional from ischemia, inflammation, toxins or immune injury. Impaired baseline cardiac function can contribute to the development of circulatory shock.