Priorities in Critical Care Nursing, 2nd Edition

Visiting Hours in the ICU: Finding the Balance among Patient, Visitor and Staff Needs

“…Much of the research related to visiting in critical care units has focused on family needs with little emphasis on the perspective of the nurse at the bedside. In fact, very little is known about what strategies nurses actually use in working with visitors or the effectiveness of these strategies, although authors of critical care textbooks and a few articles have offered suggestions [see for example, Chulay, Guzzetta, and Dossey (1997), Hudak, Gallo, and Morton, (1998), Kupferschmid, Briones, Dawson, and Drongowski, (1991), Urden, Lough, and Stacy (1996)].…”

Patient-family Centred Care

“…Decision-making involves family members, such as, a patient's spouse, children and daughter-in law especially when patients are critically ill or incapacitated in an acute or critical care setting or need long-term care (Gilbert, Tudor & Paolillo, 1994;Hill, 2001). Consequently, immediate family members are crucial to the fulfilment of a patient's care plan since they assume a primary caregiving role (Urden, Stacy & Lough, 2012); discuss and plan for advance directives and end-of-life considerations; interact with the attending physician, nurses and others; and decide about alternative treatments (Haley et al, 2002). In fact, the dominant logic suggests that critical care nurses perceive the patient and the family as a single, integrated unit and treat them as such and that nurses acknowledge interdependence between the nursing team and patient's family (Cypress, 2011).…”

Pulmonary Assessment: What You Need to Know

“…The patient history will give many clues as to the cause of a pulmonary problem and the physical examination will serve to reinforce the tentative diagnosis. The goal of the history is to identify and describe key clinical manifestations that will aid in the identification of the cause of illness 1 …”

“…A cough is described as strong or weak or as loud or soft. The pitch or quality may be described as brassy, barking, dry, moist, hoarse, harsh, or bubbling 1,4 . A “brassy” cough may indicate compression of the airways by a tumor, and a “barking” or hoarse cough may indicate the presence of croup 2 .…”

“…Skin color may be described as ashen or pale (pallor) 2 . Cyanosis, a frequently misinterpreted and insensitive tool for the detection of hypoxemia, is a blue‐gray or purplish discoloration of the skin that occurs when the blood contains >5 gm/dL reduced hemoglobin 1,5 . Detection of cyanosis depends on the acuity of the observer, light intensity, skin pigmentation, and hemoglobin level.…”