Hematology and oncology in critical care:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2000
|
| Schriftenreihe: | Critical care nursing clinics of North America
12,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 249 - 401 Ill., graph. Darst. |
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Datensatz im Suchindex
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| adam_text | Hematology and Oncology in
Critical Care
Contents
Preface xi
Jan Foster
Surgery for Cancer Patients: Critical Care Needs 249
Paula M. Muehlbauer and Richard L. White, Jr
The demand for critical care services has continued to escalate as technology and cancer research
have increased patient longevity. With the advent of multimodality cancer care, surgery is used more
frequently in conjunction with other therapeutic interventions. Critical care nurses proficient in caring
for patients with hemodynamic instability, respiratory distress, and sepsis must consider the added
challenges associated with the postoperative care of patients with cancer. It is imperative for critical
care nurses to have a thorough understanding of a patient s disease and cancer treatment history,
and the special needs of the immunocornpromised patient.
Selected Neurologic Complications in the Patient with Cancer:
Brain Metastases and Spinal Cord Compression 269
Mari Rude
This article describes the incidence, pathophysiologies, clinical presentations, diagnostic procedures,
and medical treatments of the two most common neurologic sites of metastic cancer: the brain and spinal
cord. Because nurses in all areas of practice come in contact with these metastic processes, nursing
management is an important issue. Early recognition is crucial to optimize a patient s quality of life.
Pulmonary Toxicities of Cancer Therapy 281
Cynthia Chernecky and Linda Sarna
Pulmonary toxicities secondary to cancer treatments are often greater problems than the cancer itself.
Often, the outcome of these toxicities can negatively affect a patient s quality of life and may even
result in death. Toxicity of the pulmonary system in patients with cancer can be singular or multidimen¬
sional in etiology. There are seven distinct pulmonary toxicities: pulmonary emboli, pulmonary
edema, pulmonary fibrosis, pleural effusion, alveolitis, bronchiolitis obliterans. and radiation induced
pneumonitis. All of these toxicities can be minimized or prevented by early assessment and immediate
intervention, but they are often difficult to diagnose.
Glycemic Crises in Patients with Hematologic Malignancies 297
Betty Thomas Daniel
Glycemic crises associated with hematologic malignancies include diabetic ketoacidosis (DKA) and
hyperosmolar hyperglycemic nonketotic syndrome (III INS). The treatment of hematologic malignan¬
cies often includes administering high doses of steroids. Steroid therapy in patients with known
diabetes can lead to uncontrolled hyperglycemia. Patients who have undiagnosed diabetes but present
with risk factors may develop diabetes as a result of the steroids. This article reviews the pathophysiol
ogy and treatment of DKA and HNNS, two complications of uncontrolled hyperglycemia.
CRITICAL CARE NURSING CLINICS OF NORTH AMERICA
Volume 12 / Number 3 / September 2000 vii
Liver Metastases: A Case Example 307
Beverly Hughes
The development of liver metastases in a patient with cancer is a potentially life threatening event.
Each patient with hepatic metastases presents a unique challenge to the oncology nurse. This article
discusses the pathophysiology, clinical presentation, diagnosis, and treatment of liver metastases with
particular emphasis on treatment modalities. A case describing a patient with colon cancer and liver
metastases is presented.
Immunosuppression in Transplantation: A New Millennium
in Care 315
Pat Poole and Elaine Greer
Transplantation has become an increasingly successful and cost effective means of treating end stage
organ failure. A cornerstone in the success of transplantation is the protection that can be provided
to the new graft by advances in immunosuppressive therapy. This article provides an overview of
currently available drugs used for induction therapy, maintenance therapy, and rescue therapy,
and a glimpse into the ever changing immunosuppressive arsenal with new agents and therapies
currently under development.
Opportunistic Fungal Infections in the Critically III 323
Brenda K. Shelton
Over the past decade, fungal infections have become an increasingly common source of morbidity
for patients in intensive care units Candidal infections are currently the fourth most common source
of septicemia among intensive care patients, and they are responsible for the highest actual mortality
rate of all bloodstream infections. Despite the clinical importance of fungal infections in care of the
critically ill, little nursing literature has focused on this topic. This article outlines current trends
regarding fungal illness in the critically ill, describes the infectious manifestations of candidiasis and
aspergillosis, and reviews the available antifungal therapies.
Management of Disseminated Intravascular Coagulation 341
Jan Hawthorne Maxson
Disseminated intravascular coagulation (DIG) is a condition in which normal coagulation is overstimu
lated, causing diffuse clotting and profuse hemorrhaging to occur simultaneously. Patients with cancer
and those receiving cancer therapy are at risk for developing the condition. This article addresses
the pathophysiology, etiology, clinical manifestations, laboratory findings, and management strategies
for patients with DIC.
Hemorrhagic Disorders Associated with Thrombolytic Therapy 353
Nancy M. Scroggins
Thrombolytic treatment for acute myocardial infarction, acute ischemic stroke, and massive pulmonary
embolism has shown significant benefit. Along with the potential increase in perfusion and decrease
in cell death, however, come potential complications. Using research based algorithms, protocols,
or standardized physician order sets, organization of a multidisciplinary approach to successfully treat
patients receiving thrombolytic therapy can be achieved. Although challenges exist in the management
of patients receiving thrombolytic therapy, the alternative—failure to restore perfusion to the myocar¬
dium, brain, or pulmonary va.seulature—presents both a different set of challenges and a dismal
outcome.
Ethical Perspectives of Reimbursement Under
Economic Pressures 365
Vicki D. Marsee
Health care is a primary need and an important goal for individuals and society overall. From an
ethical perspective, resources should be allocated appropriately so everyone can enjoy the best health
care possible. With limited resources available from an economic reimbursement perspective, the
philosophy and values that are important to us need to be analyzed in order to make ethical decisions.
This article describes key values and philosophies, and concerns about societal attempts to reform
the system.
Viii CONTENTS
Advance Directives in Critically III Cancer Patients 373
Susannah K. Kish, Charles G. Martin, and Kristen J. Price
This prospective observational research study evaluates the frequency with which critically ill patients
present to the intensive care unit with advance directives; describes the demographic and clinical
characteristics of patients with advance directives; and determines if the presence of an advance
directive is associated with the hospital outcome of a critically ill cancer patient. The study emphasizes
the cultural and clinical differences among patients with and without advance directives in the context
of critically ill cancer patients.
The Influence of Do Not Resuscitate Orders on Care Provided
for Patients in the Surgical Intensive Care Unit of a
Cancer Center 385
Cheryl H. Keenan and Susannah K. Kish
With the accessibility of technology, advanced life support, and numerous other treatment options
available to the critically ill, the decision of when to terminate aggressive care often creates a dilemma,
particularly when there is pressure to contain costs. Do not resuscitate (DNR) orders are commonly
written when it becomes apparent that a patient s condition is terminal and irreversible. Team members
involved in the patient s care, however, can interpret the DNR order in various ways. This study
evalutes how a DNR order impacts the care provided by various disciplines for patients in the surgical
intensive care unit of a comprehensive cancer center.
Incorporating Critical Care Oncology Nursing in a Baccalaureate
of Science in Nursing Curriculum 391
Ainslie T. Nibert
N ursing educatt rs face a daunting task f preparing graduates to meet the high demand ft r pr ifessii nal
nurses who are able to care for an aging population suffering from multiple chronic anil debilitating
health problems, including cancer. Preparing graduates for this reality can be accomplished through
the blending of oncological emergencies as a content area within an existing critical care focused
course. The merging of oncology and critical care concepts results in several benefits, including
greater comprehension and retention of oncology content and a newfound interest in oncology
nursing as a desired career path.
Index 397
Subscription Information Inside back cover
CONTENTS iX
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