Advanced Practice in Critical Care. a Case Study Approach

Advanced Practice in Critical Care provides experienced critical care nurses with a clear and distinct evidence base for contemporary critical care practice. Central to the book is the application of research and evidence to practice and therefore, case studies and key critical care clinical situations are used throughout to guide the reader through the patient care trajectory.

Each chapter introduces an initial patient scenario and as the chapter progresses, the patient scenario develops with the theoretical perspectives and application. In this way, it is evident how multi-organ dysfunction develops, impacting upon and influencing other body systems, demonstrating the multi-organ impact that is often experienced by the critically ill patient. In this way, consequences of critical illness such as acute renal failure, haemostatic failure and liver dysfunction are explored. Throughout the text, key research findings and critical care treatment strategies are referred to, applied and evaluated in the context of the given patient case study. Advanced assessment techniques are explained and the underlying pathophysiology is discussed in depth. Advanced Practice in Critical Care is an essential resource for experienced practitioners within critical care whom primarily care for patients requiring high dependency or intensive care.

Table of Contents

Preface.

Contributors and acknowledgements.

1 Challenges in contemporary critical care (Sarah McGloin).

• Introduction.
• Critical care without walls.
• Advanced practice.
• Interprofessional roles within critical care.
• Conclusion.
• References.

2 The physiological basis of critical illness (Mark Ranson).

• Introduction.
• Patient scenario.
• Mechanisms of cellular damage.
• Impact of reduced perfusion on energy production .
• Evaluation of ischaemia: reperfusion injury.
• The inflammatory response and the role of mediators.
• Mechanisms for haemostasis in relation to critical illness.
• Conclusion.
• References.

3 The patient with haemodynamic compromise leading to renal dysfunction (Tracey Bowden and Anne McLeod).

• Introduction.
• Patient scenario.
• Underlying physiology and pathophysiology.
• Assessment and diagnosis.
• Evidence-based care.
• Ongoing patient scenario.
• Progressing pathophysiology.
• Ongoing assessment.
• Evidence-based care.
• Conclusion.
• References.

4 The septic patient (Sarah McGloin).

• Introduction.
• Patient scenario.
• Underlying physiology and pathophysiology.
• Assessment and diagnosis.
• Evidence-based care.
• Ongoing patient scenario.
• Progressing pathophysiology.
• Ongoing assessment.
• Evidence-based care.
• Conclusion.
• References.

5 The patient with acute respiratory failure (Anne McLeod).

• Introduction.
• Patient scenario.
• Underlying physiology and pathophysiology.
• Assessment and diagnosis.
• Arterial blood gas analysis.
• Evidence-based care.
• Ongoing patient scenario.
• Progressing pathophysiology.
• Ongoing assessment.
• Evidence-based care.
• Conclusion.
• References

6 The patient with chronic respiratory failure (Glenda Esmond and Anne McLeod).

• Introduction.
• Patient scenario.
• Underlying physiology and pathophysiology.
• Assessment and diagnosis.
• Evidence-based care.
• Ongoing patient scenario.
• Weaning from ventilatory support.
• Ongoing care.
• Conclusion.
• References.

7 The patient with an intracranial insult (Anne McLeod).

• Introduction.
• Patient scenario.
• Underlying physiology and pathophysiology.
• Assessment and diagnosis.
• Evidence-based care.
• Ongoing patient scenario.
• Progressing pathophysiology.
• Ongoing assessment.
• Evidence-based care.
• Conclusion.
• References.

8 The patient with a traumatic injury (Elaine Cole and Anne McLeod).

• Introduction.
• Patient scenario.
• Mechanisms of injury.
• Assessment and diagnosis.
• Primary and secondary surveys.
• Underlying physiology and pathophysiology.
• Evidence-based care.
• Continuing patient scenario.
• Evidence-based care.
• Ongoing patient scenario.
• Progressing pathophysiology.
• Ongoing assessment.
• Evidence-based care.
• Management of his pelvic injury.
• Conclusion.
• References.

9 The patient with a diabetic emergency (Sarah McGloin).

• Introduction.
• Patient scenario.
• Underlying physiology and pathophysiology.
• Underlying pathophysiology.
• Assessment and diagnosis.
• Evidence-based care.
• Ongoing care.
• Conclusion.
• References.

10 The long-term patient in intensive care unit(Phillipa Tredant).

• Introduction.
• Patient scenario.
• Impact of being in the critical care environment.
• Psychological effects.
• Underlying physiology and physiological effects.
• Quality of life.
• Rehabilitation process.
• Conclusion.
• References.

11 Ethical considerations in critical care (Anne McLeod).

• Introduction.
• Patient scenario.
• Admission to critical care.
• What are ethics?
• Biomedical ethical model.
• The role of outreach.
• Ongoing patient scenario.
• Futile situations.
• Withdrawal/withholding of treatment or euthanasia?
• Patient autonomy.
• The process of withdrawing or withholding treatment.
• Role of the nurse.
• Collaborative decision-making.
• Conclusion.
• References.

Index.