Critical Care Nursing Clinics of North America RSS feed: Current Issue. Critical Care Nursing Clinics of North America provides the latest diagnostic and therapeutic information in the field of critical care nursing. Each single topic issue is guest edited by a distinguished expert in the field who invites other experts as contributors. Recent topics have included congestive heart failure, burn & wound care, obstetric and neonatal intensive care. The Clinic is included in CINAHL and is recommended for purchase in the Brandon-Hill Study, Selected List of Nursing Books and Journals.http://www.ccnursing.theclinics.com/?rss=yesElsevier Inc.en © 2009 Published by Elsevier Inc. All rights reserved. Critical Care Nursing Clinics of North America0899-5885213September 2009 © 2009 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.ccnursing.theclinics.com/article/PIIS0899588509000732/abstract?rss=yesContents10.1016/S0899-5885(09)00073-2Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5vviihttp://www.ccnursing.theclinics.com/article/PIIS0899588509000744/abstract?rss=yesForthcoming Issues10.1016/S0899-5885(09)00074-4Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5viiiviiihttp://www.ccnursing.theclinics.com/article/PIIS0899588509000501/abstract?rss=yesThis issue of Critical Care Nursing Clinics tackles a significant and growing issue in critical care: obesity. Obese patients pose unique challenges to critical care nurses and the increasing numbers of these patients make this an important area of study.PrefaceLinda Harrington10.1016/j.ccell.2009.07.014Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5ixixhttp://www.ccnursing.theclinics.com/article/PIIS0899588509000458/abstract?rss=yesObesity has become a global health crisis. The effects of obesity on the cardiovascular system pose a unique challenge for the critical care nurse. This article reviews the scope of the problem, the alterations in the cardiovascular structures and function, and the implications for critical care nursing.Cardiovascular Effects of Obesity: Implications for Critical CareWendy C. Peavy10.1016/j.ccell.2009.07.005Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5293300http://www.ccnursing.theclinics.com/article/PIIS0899588509000525/abstract?rss=yesCritically ill obese patients have many challenging pulmonary problems. The first key is to understand pathophysiology in the pulmonary system related to obesity. Second, it is important to identify the altered physical assessments and diagnostics that occur because of the pulmonary pathophysiology of obesity. Lastly, one should be aware of medical and nursing intervention options that treat symptoms or pulmonary problems of obesity. This article summarizes pulmonary issues related to obesity in critical care.Pulmonary Aspects of Obesity in Critical CareDebra Siela10.1016/j.ccell.2009.07.015Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5301310http://www.ccnursing.theclinics.com/article/PIIS0899588509000471/abstract?rss=yesAlmost one-third of intensive care unit (ICU) patients are obese. Obese patients pose a unique challenge for preventing skin breakdown, healing wounds, and preventing complications of surgery and prolonged immobility. Yet little research to date has been done to study the effects of obesity on skin integrity and wound healing in this patient population. This article discusses common skin conditions and wound complications associated with obese patients and general treatment guidelines as they pertain to the critically ill patient.Skin Integrity in Critically Ill Obese PatientsJeanne Redlin Lowe10.1016/j.ccell.2009.07.007Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5311322http://www.ccnursing.theclinics.com/article/PIIS0899588509000483/abstract?rss=yesAchieving pain control in critically ill patients is a challenging problem for the health care team, which becomes more challenging in morbidly obese patients. Obese patients may experience drug malabsorption and distribution, which may lead to either subtherapeutic or toxic drug levels. To manage pain effectively for the critically ill obese patient, nurses must have an understanding of how obesity alters a patient's physiologic response to injury and illness. In addition, nurses must be knowledgeable about physiologic pain mechanisms, types and manifestations of pain, differing patterns of drug absorption and distribution, pharmacokinetic properties of analgesic medications, and pain management strategies. This article explores factors affecting pharmacokinetics in obese patients, trends in pain management, and treatment strategies for the obese patient.Pain Management in Critically Ill Obese PatientsSonia M. Astle10.1016/j.ccell.2009.07.012Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5323339http://www.ccnursing.theclinics.com/article/PIIS0899588509000410/abstract?rss=yesSedation of the obese critical care patient presents unique challenges that include altered respiratory function and a predisposition to respiratory suppression and airway obstruction. Sedative drugs have pronounced effects on obese patients. Knowledge of the anatomic and physiologic changes associated with obesity, airway management, and sedation agents better prepares one to care for these patients safely and effectively.Sedation Considerations for the Nonintubated Obese Patient in Critical CareMark Welliver, Michele Bednarzyk10.1016/j.ccell.2009.07.001Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5341352http://www.ccnursing.theclinics.com/article/PIIS0899588509000495/abstract?rss=yesCaring for obese critically ill patients is not always the same as caring for critically ill patients who are not obese. Fortunately, nurses have many resources available to them to guide them in this process. However, research that specifically addresses the needs of obese critically ill patients is still lacking in many areas and should be considered as potential areas to develop evidence-based practices.Providing Nutrition to Critically Ill Obese Adults: Use of the Nursing ProcessSusan Smith, Kathleen Fedyszen10.1016/j.ccell.2009.07.013Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5353367http://www.ccnursing.theclinics.com/article/PIIS0899588509000434/abstract?rss=yesObesity has become a major health problem in the United States and is well known to be a risk factor for the development of cardiovascular disease. Many clinicians perceive obesity, particularly severe or morbid obesity, to be associated with increased risk for mortality and morbidity following coronary artery bypass graft (CABG) surgery. This article provides a review of the literature related to mortality and morbidity, including the impact of diabetes, risk for acute respiratory failure, and sternal wound infection associated with obese patients undergoing CABG surgery. Implications for nursing practice are addressed with recommendations for practice in this patient population.Impact of Obesity on Care of Postoperative Coronary Bypass PatientsBarbara Leeper10.1016/j.ccell.2009.07.003Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5369375http://www.ccnursing.theclinics.com/article/PIIS0899588509000446/abstract?rss=yesRecently, the impact of obesity on the outcomes of trauma patients has been the focus of several investigations. There have been several studies addressing the impact of obesity on trauma patients. These studies have explicated the impact of obesity on negative outcomes of trauma patients. Several studies have identified a relationship between obesity and injury pattern, increased complications in outcomes related to surgical procedures, and increase mortality and morbidity rates in obese trauma patients. However, the literature in nursing management in this patient population is virtually nonexistent and vague. The purpose of this article is to delineate the nursing implications of obesity in trauma patients and to provide guidelines for care of obese trauma patients.Trauma in Obese Patients: Implications for Nursing PracticeSherry N. VanHoy, V. Tereceita Laidlow10.1016/j.ccell.2009.07.004Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5377389http://www.ccnursing.theclinics.com/article/PIIS089958850900046X/abstract?rss=yesIn America today, more than one third of adults are obese. Increasingly, obese patients are admitted to critical care units. Critical care nurses must have additional knowledge and skills to identify health risks to obese patients and implement interventions to prevent untoward problems. Critical care nurses are also at risk when taking care of obese patients. The purpose of this article is to identify risks to both patients and nurses and to provide recommendations to address those risks.Obesity-related Risks and Prevention Strategies for Critically Ill AdultsMargaret McAtee, Rebecca J. Personett10.1016/j.ccell.2009.07.006Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5391401http://www.ccnursing.theclinics.com/article/PIIS0899588509000422/abstract?rss=yesObese patients in the ICU present unique challenges to the health care team and specific challenges to nurses. This article reviews the science and art of resource use for obese patients in the ICU. Staff nurses and advanced practice nurses can make important contributions in evaluating optimal resource use and improving outcomes in this population of vulnerable patients.The Impact of Obesity on Critical Care Resource Use and OutcomesChris Winkelman, Beverly Maloney, Janet Kloos10.1016/j.ccell.2009.07.002Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5403422http://www.ccnursing.theclinics.com/article/PIIS0899588509000513/abstract?rss=yesAn error occurred in the article “Continuous ST-Segment Monitoring: Raising the Bar,” by Sonya A. Flanders, Volume 18, Issue 2, Page 172 (June 2006). The time measurements on page 172 in the first full paragraph and in Fig. 1 should be 0.06 seconds and 0.08 seconds.Erratum10.1016/j.ccell.2009.07.019Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5423423http://www.ccnursing.theclinics.com/article/PIIS0899588509000756/abstract?rss=yesIndex10.1016/S0899-5885(09)00075-6Critical Care Nursing Clinics of North America 21, 3 (2009)2009-09-01Critical Care Nursing Clinics of North America2009-09-01213S0899-5885(09)X0005-5425434