The elderly patient in critical care

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Sprache:English
Veröffentlicht: Philadelphia [u.a.] Saunders 1996
Schriftenreihe:Critical care nursing clinics of North America 8,1
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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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physical XIV, 106 S. Ill., graph. Darst.
publishDate 1996
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series Critical care nursing clinics of North America
series2 Critical care nursing clinics of North America
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
url 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
volume_link (DE-604)BV011338306
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