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Strokes and Predictors of Outcomes
Stroke is a leading cause of long-term disability and fifth leading cause of death. Acute ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage, the 3 subtypes of strokes, have varying treatment modalities. Common themes in management advocate for early interventions to reduce morbidity and mortality but not all perception is supported through randomized controlled trials. Each stroke subtype has varying premorbid-related and ictus-related outcome predictive models that have differing sensitivities and specificities. (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - January 2, 2023 Category: Nursing Authors: Shavonne Williams, Kimberly Glaser, Bappaditya Ray Source Type: research

Decompressive Hemicraniectomy in the Stroke Patient
Decompressive hemicraniectomy (DHC) is a life-saving procedure involving removal of large portions of the skull to relieve intracranial pressure in patients with space occupying cerebral edema such as traumatic brain injury (TBI) and stroke. Although the procedure has been shown to decrease mortality in patients, the risk of severe disability is significant. Quality of life, not just survival, following DHC has emerged as an important consideration when the decision is made to perform a DHC. (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - January 2, 2023 Category: Nursing Authors: Carey Heck Source Type: research

Nursing Management of Temperature in a Patient with Stroke
Fever is common in patients with stroke and is associated with worse outcomes. Studies in brain injury informed interventions commonly termed therapeutic temperature management (TTM) to improve the monitoring and management of fever. While the role and benefit of TTM in stroke patients has not been well studied, the nurse and healthcare team must extrapolate existing data to determine how to best monitor and apply TTM after stroke. Nurses should be knowledgeable about interventions to monitor and manage complications of TTM (eg, shivering), the studies underway to quantify the impact of fever treatment and emerging technol...
Source: Critical Care Nursing Clinics of North America - January 2, 2023 Category: Nursing Authors: Kristine M. McGlennen, Gemi E. Jannotta, Sarah L. Livesay Source Type: research

Invasive Neuromonitoring in the Stroke Patient
With advances in technology, the options to manage patients with neurologic injuries are often complex. Critical care management of neurologic injury has historically focused on the prevention of secondary ischemic injury through aggressive management of intracranial pressure (ICP) and maintenance of adequate cerebral perfusion pressure (CPP). However, ICP monitoring alone does not identify ischemic changes that herald patient deterioration. Advocates of multimodality monitoring cite the value of early detection of changes in brain oxygenation levels and brain metabolism as advantageous in optimizing stroke outcomes. ICP m...
Source: Critical Care Nursing Clinics of North America - January 2, 2023 Category: Nursing Authors: Carey Heck Source Type: research

Preface
A stroke can happen to anyone at any time. Every year, nearly 800,000 Americans suffer a stroke. Despite improvements in stroke treatment in the United States, stroke remains the second leading cause of death worldwide. Stroke is also the third-leading cause of death and disability combined. Worldwide, the annual rate of stroke is 15 million. Of these, 3 million die and another 3 million are left permanently disabled. Stroke occurs every 40 seconds. Rapid and effective evaluation, identification, diagnosis, and treatment of stroke are vital in decreasing stroke morbidity and mortality. (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - January 2, 2023 Category: Nursing Authors: Wandria Dallas Source Type: research

Transitions of Care Considerations for Nephrology Patients
The need for a workforce able to address the health care needs of older adults has been well established. Individuals with kidney disease experience an extensive number of transitions of care across health care settings related to the kidney disease process and the number of health care providers involved in their care. Kidney disease is multifactorial, and the prevention of progression of disease and poor outcomes are key to improving the health of individuals with kidney disease. Nurses and nurse practitioners can improve the outcomes for individuals with complex comorbid conditions and kidney disease especially during t...
Source: Critical Care Nursing Clinics of North America - November 4, 2022 Category: Nursing Authors: Sherry Rivera, Lyn Behnke, M.J. Henderson Source Type: research

Acute Kidney Injury in the Inpatient and Outpatient Setting
The incidence and prevalence of inpatient acute kidney injury is continuing to increase. Acute kidney injury (AKI) is an all-encompassing topic in renal care as well as critical care. The definition and criteria for diagnosis of AKI have evolved over time. There are many causes of AKI and identifying the cause is key in reversing and controlling the progression of disease. Metabolic acidosis, fluid overload, and sepsis require detailed evaluation to best provide the most appropriate plan and execution. Critical care nurses are vitally important when identifying and managing acute kidney injury. Renal replacement therapy is...
Source: Critical Care Nursing Clinics of North America - November 4, 2022 Category: Nursing Authors: Samuel Realista Source Type: research

Principles for the Prevention of Medication-Induced Nephrotoxicity
Medications are a common cause of injury to the kidney and can contribute to the increased progression of disease, poorer outcomes, and increased health care costs. Improved prescribing practices can decrease the risk for the development of acute kidney injury and the progression to end-stage kidney disease. KDIGO Clinical Practice Guidelines recommend the use of caution when prescribing potentially nephrotoxic medications for patients with kidney disease. More than 50 –72% of individuals across all stages of kidney disease utilized potentially nephrotoxic medications contributing to poorer outcomes. Annually, 1.5 millio...
Source: Critical Care Nursing Clinics of North America - November 4, 2022 Category: Nursing Authors: Sherry Rivera Source Type: research

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Kidney disease is a worldwide public health issue that can affect individuals of all ages, races, ethnicities, and socioeconomic status. Approximately 10% of the population worldwide and 15% in the United States have chronic kidney disease. Research has revealed that health care providers and patients have a lack of awareness about kidney disease. According to the National Kidney Foundation, approximately 90% of individuals with kidney disease lack awareness of their disease status. (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - November 4, 2022 Category: Nursing Authors: Sherry Rivera Tags: Preface Source Type: research

Nephrology
CRITICAL CARE NURSING CLINICS OF NORTH AMERICA (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - November 4, 2022 Category: Nursing Authors: Sherry Rivera Source Type: research

Copyright
ELSEVIER (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - November 4, 2022 Category: Nursing Source Type: research

Contributors
DEBORAH GARBEE, PhD, APRN, ACNS-BC, FCNS (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - November 4, 2022 Category: Nursing Source Type: research

Contents
Sherry Rivera (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - November 4, 2022 Category: Nursing Source Type: research

Forthcoming Issues
Neurocritical Care Nursing Management of Stroke (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - November 4, 2022 Category: Nursing Source Type: research

Stroke Risk Related to Coronavirus Disease-2019
Since the intial outbreak of the coronavirus-2019 (COVID-19) in December 2019, a variety of neurologic manifestations have been linked to this virus, including stroke. Comprehensive review of worldwide studies using various methodologies indicated a correlation of increased stroke risk in patients with COVID-19. The literature reivew also revealed increased morbidity and mortality among patients with COVID-19 and stroke as compared to those with only stroke. This pandemic, with its related healthcare staffing shortages, revealed the requisite to utilize innovative technologies such as Tele-Neurology, as well as public heal...
Source: Critical Care Nursing Clinics of North America - October 20, 2022 Category: Nursing Authors: Pamela Pourciau, Britta C. Smith Source Type: research