The elderly patient in critical care:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
1996
|
| Series: | Critical care nursing clinics of North America
8,1 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XIV, 106 S. Ill., graph. Darst. |
Staff View
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| adam_text | The Elderly Patient in Critical Care
Contents
Foreword xi
Kathleen Ahern Gould
Preface xiii
Suzanne S. Prevost
Sepsis in the Elderly 1
Mickey Stanley
Sepsis in the elderly occurs frequently and carries a high rate of mortality. In consideration of the
increasing number of elderly patients being cared for in critical care units, the critical care nurse must
have a thorough understanding of the unique aspects of this patient population. Nurses must be
prepared to deliver expert nursing care that is knowledge based and incorporates current research
findings. Unit protocols that encompass the preventive measures needed by these special patients
will assist in reducing the incidence of sepsis. When sepsis occurs, careful trending of data will signal
the need for timely and precise interventions that may result in a good outcome for the elderly patient
with sepsis.
Failure to Wean: Exploring the Influence of Age related
Pulmonary Changes 7
Laura F. Thompson
Half of the patients admitted to the critical care unit are elderly (aged 65 or older). These patients
often require mechanical ventilation for respirator) failure. Despite resolution of the underlying disease
process, some patients will fail to wean. Two major factors that contribute to weaning failure are
impaired gas exchange and impaired ventilator^ pump failure. Age related pulmonary changes may
be another factor contributing to weaning failure. There is a lack of research, however, focusing
specifically on weaning failure in the elderly as a unique group with special needs different from
those of other patients.
Protecting the Skin of the Elderly Patient in the Intensive
Care Unit 17
Mary L. Shannon and Cheryl A. Lehman
Elderly patients, especially those who are critically ill, are at great risk for the development of pressure
ulcers. Age. underlying chronic conditions, anil acute illness or injury all increase the high risk of
skin breakdown in this patient population. Other multiple laclors. including nutrition, medications.
pain, support surfaces, infection, and incontinence also may play a pail in the development and
progression of pressure ulcers. Staff awareness of the potential effeiis of these contributing . r compli¬
cating factors and how to manage the eifeets can be a major step toward pressure ulcer prevention
in the intensive care unit setting.
Continence Management 29
Mikel Gray and Suzanne M. Burns
Urinary and fecal incontinence are common among community dwelling and institutionalized elderly
individuals. The risk is increased dramatically for the critically ill elderly patienl. Fortunately, much
CRITICAL CARE NURSING CLINICS OF NORTH AMERICA
Volume 8 / Number 1 / March 1996 vii
of this incontinence is transient and preventable. This article discusses the principles of continence
management in the critically ill adult, including strategies to minimize the effects of chronic or
established leakage of urine or stool and to prevent or manage transient incontinence.
Sleep Promotion 39
Kathleen Culpepper Richards
The aging process introduces many changes that affect the whole person, including sleep. Age related
changes in the nervous system, acute and chronic illness, medications, primary sleep disorders, and
hospitalization in the critical care unit are factors associated with sleep disturbances in the elderly.
Potentially effective nursing interventions for sleep promotion in critically ill patients are caring
interventions that focus on the body mind connection, such as back massage, relaxing music, imagery,
and muscle relaxation.
Delirium in Hospitalized Elderly Patients: Off Track 53
Jeanne St. Pierre
Delirium is an acute confusional state, associated with increased morbidity and mortality rates, that
can occur in up to half of hospitalized, critically ill elderly patients. Complex in presentation and
multifactorial in origin, it often is exacerbated by a lack of recognition and inappropriate treatment.
As the discipline in the best position to assess patients at risk for delirium, nursing plays a key role
in its prevention and management.
Physical Restraint of Elderly Patients in Critical Care: Historical
Perspectives and New Directions 61
Eileen B. Wilson
This article provides an historic and current overview of physical restraint use with emphasis on
elderly patients in the critical care setting. The primary recipients of restraint application in American
health care institutions today are older adults who are at risk for falls or who demonstrate disturbing
behaviors, such as interference with medical treatments, agitation, or confusion. This article reviews
the current literature about the effectiveness of physical restraint for these problems and other situations
that historically have justified the use of restraints in health care. Alternatives to physical restraints
and guidelines for restraint use also are presented.
Seizures and the Elderly 71
Jeanette C. Hartshorn
Although seizure activity frequently is associated with the young, the incidence of seizures in the
elderly is similarly high. Considering the increasing numbers of the elderly being cared for in critical
care units, it is essential that the critical care nurse has an understanding of the uniqueness of this
phenomena in the elderly and the resulting care needed. In this article, the incidence, causes,
and treatment of seizure disorders in the elderly are reviewed. Unique responses of the elderly to
anticonvulsant therapy and the related nursing care are highlighted.
Pharmacokinetic and Pharmacodynamic Monitoring of the
Elderly in Critical Care 79
Norann Y. Planchock and Larry E. Slay
The risk of adverse drug reactions increases with age and the number of drugs administered. Critically
ill elderly patients are particularly at risk. In this article, case studies are used to illustrate clinical
presentations and interventions for several of the common pharmacokinetic and pharmacodynamic
changes in this patient population.
Interventions for Aged Family Members 91
Jane Stover Leske and Susan M. Heidrich
Hospitalization for a critical injury can disrupt even the most highly organized and functional family.
Family focused care may mitigate family stress by providing support based on the unique needs of
each family. Family members often suffer as much pain as the patient, and they also deserve special
attention and consideration. Professionals who are interested in the welfare and functioning of the
family must ensure that the family members of the patient receive adequate and appropriate care,
no matter what their age. This article illustrates these issues using a case study approach.
Index 103
Subscription Information Inside back cover
Viii Contents
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| publisher | Saunders |
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| series2 | Critical care nursing clinics of North America |
| spelling | The elderly patient in critical care Suztanne S. Prevost, ... guest ed. Philadelphia [u.a.] Saunders 1996 XIV, 106 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Critical care nursing clinics of North America 8,1 Soins intensifs - Sujet âgé Critical Care nursing Geriatric Nursing Geriatric nursing Intensive care nursing Older people Medical care Prevost, Suzanne S. Sonstige oth Critical care nursing clinics of North America 8,1 (DE-604)BV011338306 8,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007920043&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | The elderly patient in critical care Critical care nursing clinics of North America Soins intensifs - Sujet âgé Critical Care nursing Geriatric Nursing Geriatric nursing Intensive care nursing Older people Medical care |
| title | The elderly patient in critical care |
| title_auth | The elderly patient in critical care |
| title_exact_search | The elderly patient in critical care |
| title_full | The elderly patient in critical care Suztanne S. Prevost, ... guest ed. |
| title_fullStr | The elderly patient in critical care Suztanne S. Prevost, ... guest ed. |
| title_full_unstemmed | The elderly patient in critical care Suztanne S. Prevost, ... guest ed. |
| title_short | The elderly patient in critical care |
| title_sort | the elderly patient in critical care |
| topic | Soins intensifs - Sujet âgé Critical Care nursing Geriatric Nursing Geriatric nursing Intensive care nursing Older people Medical care |
| topic_facet | Soins intensifs - Sujet âgé Critical Care nursing Geriatric Nursing Geriatric nursing Intensive care nursing Older people Medical care |
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