Nursing Acutely Ill Adults
Philip Woodrow
- 356 pages
- English
- ePUB (mobile friendly)
- Available on iOS & Android
Nursing Acutely Ill Adults
Philip Woodrow
About This Book
This comprehensive and clinically-focused textbook is designed for student and qualified nurses concerned with caring effectively for deteriorating and acutely ill adults outside of specialist intensive care units.
Divided into six sections, the book begins with chapters on assessment and the deteriorating patient, including monitoring vital signs and interpreting blood results. This is followed by two sections focusing on breathing and cardiovascular problems respectively. Section 4 explores issues around disability and impairment, including chapters on neurology, pain management, psychological needs and thermoregulation. The penultimate section looks at maintaining the internal environment, with chapters on issues such as nutrition, fluid management and infection control. The text ends with a discussion of legal issues and accountability.
Nursing Acutely Ill Adults includes a full range of pedagogical features, including sections: identifying fundamental knowledge; highlighting implications for practice; giving further reading and resources; using case scenarios to help readers relate theory to practice; and providing 'time out' exercises. It is the ideal textbook for students taking modules in caring for critically ill adults and qualified nurses working with these patients.
Frequently asked questions
Information
Assessment
Chapter 1
The deteriorating patient
Contents
Introduction
- ā year-on-year budget restrictions encouraging cost-saving reductions in numbers of staff (Francis, 2013; Aiken et al., 2014);
- ā national and international directives and legislation, such as the European Union working time directives;
- ā society moving from a duty-based ethic to a rights-based one;
- ā promotion of evidence-based practice (Stevens, 2013).
Staffing levels
- ā mortality (Aiken et al., 2014; Needleman et al., 2011);
- ā pressure ulcer rates (Twigg et al., 2010);
- ā incidence of falls (RCN, 2012);
- ā medication errors (Twigg et al., 2010);
- ā readmission rates (McHugh and Chenjuan, 2013);
Levels of care
Level 0: Patients whose needs can be met through normal ward care in an acute hospital |
Level 1: Patients at risk of their condition deteriorating, or those recently relocated from higher levels of care, whose needs can be met on an acute ward with additional advice and support from the critical care team |
Level 2: Patients requiring more detailed observation or intervention including support for a single failing organ system or post-operative care and those āstepping downā from higher levels of care |
Level 3: Patients requiring advanced respiratory support alone or basic respiratory support together with support of at least two organ systems. This level includes all complex patients requiring support for multi-organ failure |
- ā with single organ system monitoring and support (not advanced respiratory support);
- ā needing preoperative optimisation: invasive monitoring and treatment to improve organ function;
- ā needing extended post-operative care: including short term (less than 24 hours), routine post-operative ventilation with no other organ dysfunction (e.g. fast track cardiac surgery patients);
- ā needing greater degree of observation and monitoring;
- ā moving to step-down care;
- ā major uncorrected physiological abnormalities.
- ā needing more than 50% oxygen;
- ā with haemodynamic instability due to hypovolaemia/haemorrhage/sepsis;
- ā with acute impairment of renal, electrolyte or metabolic function;
- ā having undergone major elective surgery;
- ā with tachycardia above 120 bpm;
- ā with hypotension (systolic below 80 mmHg for more than one hour);
- ā with Glasgow Coma Scale (GCS) score below 10 and at risk of acute deterioration.