Application of Cannabinoids in Neurosciences: Considerations and Implications
Medicinal cannabinoid use continues to evolve across the United States, although legitimate federal recognition for medicinal purpose is lacking. Variability exists across states within the United States with respect to legislation, and health care institutions encounter challenges when patients present with a history of medicinal cannabinoid use. Emerging evidence in the field of neurosciences suggests a role of cannabinoids for neurologic medical conditions such as Parkinson disease, multiple sclerosis, and epilepsy. We aim to provide an overview of cannabinoids including a historical perspective, pharmacology, applicati...
Source: Critical Care Nursing Quarterly - February 22, 2020 Category: Nursing Tags: Original Articles Source Type: research
Challenges in ICU Care: The Patient With Parkinson's Disease
Patients with Parkinson's disease (PD) face unique challenges when admitted to the hospital. The nature of the disease, complexity of the pharmacotherapeutic home regimens, and the medication-related policies of institutionalized care all contribute to the challenges patients and providers face. In addition, medication errors are common in this population. Incorrectly ordered or omitted home medications or delayed administration can have significant negative consequences including worsening of PD symptoms, dopamine agonist withdrawal syndrome, or malignant or hyperpyrexia syndrome. Also, this patient population may commonl...
Source: Critical Care Nursing Quarterly - February 22, 2020 Category: Nursing Tags: Original Articles Source Type: research
CAR T-Cell-Associated Neurotoxicity: Current Management and Emerging Treatment Strategies
The objective of this review is to provide a comprehensive summary of ICANS and strategies for prompt identification and management of patients presenting to the intensive care unit with this syndrome. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - February 22, 2020 Category: Nursing Tags: Original Articles Source Type: research
Pharmacologic Treatment of Neurobehavioral Sequelae Following Traumatic Brain Injury
Traumatic brain injury (TBI) is a leading cause of disability in the United States. With decreasing mortality rates, a higher number of patients are impacted by long-term neuropsychiatric sequelae, such as cognitive deficits, depression, anxiety, and sleep-wake disorders. These sequelae are primarily driven by the disruption of key neurotransmitter homeostasis including dopamine, norepinephrine, serotonin, and acetylcholine. Neurostimulants are centrally acting medications used to assist in restoring these neurotransmitter abnormalities and are pharmacologic options to ameliorate symptoms in post-TBI patients. Examples of ...
Source: Critical Care Nursing Quarterly - February 22, 2020 Category: Nursing Tags: Original Articles Source Type: research
Use of Intraventricular Medications in Critically Ill Patients: A Systematic Review
New evidence and increased use of intracranial devices have increased the frequency of intraventricular (IVT) medication administration in the neurologic intensive care unit. Significant benefits and risks are associated with administration of medications directly into the central nervous system. This review summarizes important literature, along with key information for clinicians regarding the administration, dosing, monitoring, and adverse effects related to IVT medication usage. Multiple medications have supporting literature for their use in critically ill patients including amphotericin B, aminoglycosides, colistimet...
Source: Critical Care Nursing Quarterly - February 22, 2020 Category: Nursing Tags: Original Articles Source Type: research
Pharmacologic Management of Cerebral Vasospasm in Aneurysmal Subarachnoid Hemorrhage
Aneurysmal subarachnoid hemorrhage (aSAH) is responsible for 5% to 10% of all strokes in the United States annually and is a neurologic emergency with considerable morbidity and mortality. A common complication of aSAH is cerebral vasospasm (CVS) or narrowing of the cerebral arteries. While nearly 70% of aSAH patients will develop CVS, approximately 30% of those patients will go on to develop delayed cerebral ischemia, defined as symptomatic vasospasm or cerebral infarction demonstrated on imaging. While the pathophysiology of CVS is unclear, the prevention and treatment of this complication are a focus of ongoing research...
Source: Critical Care Nursing Quarterly - February 22, 2020 Category: Nursing Tags: Original Articles Source Type: research
Indications and Evidence for Dual Antiplatelet Therapy After Acute Ischemic Stroke
The antiplatelet landscape for the secondary prevention of ischemic stroke has changed significantly over the past decade. Poststroke dual antiplatelet regimens are becoming increasingly routine as supported by recent literature and guideline recommendations. Dual antiplatelet therapy after stroke generally consists of aspirin and clopidogrel and is considered in the short term after stroke in select populations including those with mild stroke or transient ischemic attack and in patients with severe intracranial atherosclerosis. When initiating dual antiplatelet therapy, factors that may increase a patient's risk of bleed...
Source: Critical Care Nursing Quarterly - February 22, 2020 Category: Nursing Tags: Original Articles Source Type: research
Blood Pressure Management Following Acute Ischemic Stroke: A Review of Primary Literature
Elevated blood pressure is common in patients with acute ischemic stroke. While this may occur secondary to the body's own response to preserve cerebral blood flow, elevated blood pressure may also increase the risk of hemorrhagic transformation. Current guidelines recommend various blood pressure goals based upon multiple factors, including thresholds specific to certain treatment interventions. Despite these guidelines, there is limited evidence to support specific blood pressure targets, and variability in clinical practice is common. The purpose of this review was to discuss blood pressure management in adult patients ...
Source: Critical Care Nursing Quarterly - February 22, 2020 Category: Nursing Tags: Original Articles Source Type: research
Foreword
No abstract available (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - February 22, 2020 Category: Nursing Tags: Foreword Source Type: research
All-Inclusive Central Line Dressing Kits: A Lean Approach
A team of the frontline nursing staff was assembled to work on central line–associated bloodstream infections (CLABSIs). This team used Lean methodology to identify issues related to central line care and maintenance and then developed countermeasures to systematically eliminate these issues. Since supplies was noted as the number one concern, the team worked to create all-inclusive central line dressing kits. These kits created a standard for dressing changes, leading to a significant decrease in CLABSI rates at a level 1 trauma center. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - December 4, 2019 Category: Nursing Tags: Original Articles Source Type: research
Lifestyle Risk Factors in Esophageal Cancer: An Integrative Review
Esophageal cancer (EC) is a prevalent type of cancer, affecting more than 16 000 people annually in the United States. Being a high-burden disease, the comprehensive management of EC is challenging, particularly for older adults. In addition, Asian countries have some of the highest age-standardized incidence rates of EC in the world. Epidemiologic studies have revealed that cigarette and cigar smoking, alcohol drinking, obesity, being overweight, and areca chewing increase the risk of EC. This integrative review aims to elucidate the association between lifestyle factors such dietary habits, smoking, and alcohol consumpti...
Source: Critical Care Nursing Quarterly - December 4, 2019 Category: Nursing Tags: Original Articles Source Type: research
Music Therapy for Surgical Patients: Approach for Managing Pain and Anxiety
Music therapy (MT) in the inpatient setting has demonstrated positive outcomes worldwide. There was no protocol to utilize MT at this organization. The purpose of this project was to incorporate and evaluate MT as an adjunct intervention to address pain and anxiety in adult surgical step-down patients. Evidence-based practice change using the 8A's method integrated individualized MT provided by a board-certified music therapist to hospitalized patients over a 3-month period. Training was provided to 35 nurses and unit-assigned social worker on the utilization of MT for patients exhibiting pain or anxiety symptoms. The clin...
Source: Critical Care Nursing Quarterly - December 4, 2019 Category: Nursing Tags: Original Articles Source Type: research
Burnout, Compassion Fatigue, and Secondary Trauma in Nurses: Recognizing the Occupational Phenomenon and Personal Consequences of Caregiving
This article summarizes the evolution in moving from viewing burnout as an individual's problem to understanding burnout as an occupational phenomenon, additionally recognizing the powerful role secondary trauma contributes to compassion fatigue. As such, the causes and addressing the solutions of burnout are multifaceted and complex. Causes of burnout stem from external pressure of caring for patients and pressure from organizational policy and practices, including unhealthy work environments, poor communication, stigma, and more. The harm from burnout and secondary trauma in health care professionals can be profound, imp...
Source: Critical Care Nursing Quarterly - December 4, 2019 Category: Nursing Tags: Original Articles Source Type: research
Addressing Needs of Hospitalized Patients With Autism: Partnership With Parents
This article presented some of the helpful approaches that can help in building positive relationships with parents that may help facilitate addressing the needs of their child with autism. Suggestions that nurses can implement to support the parents cope with their daily challenges are presented. The approaches were discussed in relation to literature and suggestions from parents of individuals with autism spectrum disorder. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - December 4, 2019 Category: Nursing Tags: Original Articles Source Type: research
Caring for Adult Patients With Autism in the Critical Care Setting
Many adults with autism spectrum disorders (ASDs) are admitted as an inpatient, and much has been reported on their ASD-related characteristics and aggressive behaviors that complicate their care during hospitalizations. A variety of surgical and medical clinical conditions have required their admissions in the critical care unit. A limited number of case studies are present for hospitalized adults with ASD; most literature about young children was on how to provide care for them. An interdisciplinary approach with a focus on determining information specific to adult patients with ASD, medical problems or common causes of ...
Source: Critical Care Nursing Quarterly - December 4, 2019 Category: Nursing Tags: Original Articles Source Type: research
