The clinical nurse specialist and empowerment: say goodbye to the fairy godmother.
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Biomedical subjects
Publications and source records attributed to A N Hotter.
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While the ultimate goal of discharge planning is discharge from the hospital, many steps come between admission and discharge of the head-injured patient. This article outlines those steps.
Multiple trauma mortality in the critical care setting most often occurs as a result of multi-system organ failure (MSOF). Mortality rates increase exponentially as successive organ systems fail. Although the role of shock in determining patient outcome has been extensively investigated, inflammatory factors and sepsis are becoming increasingly implicated in the development of MSOF. The physiologic effect of these factors on individual organ systems is explained. Signs, symptoms, and key criteria for determining organ system failure also are presented to assist the nurse in recognition and prevention.
A better understanding of the physiology of wound healing has been the impetus for the development of a large number of wound care products. However, infection remains the primary deterrent to successful wound closure; often those factors (both internal and external) that make the patient more susceptible to infection also negatively affect the quality of any wound that does heal. Factors that contribute to immunocompromise significantly impact on wound inflammatory response and maturation. The nurse has an exciting and vital role now and in the future not only in supporting the patient's own immune defenses, but in promoting those factors that will hasten wound repair.
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Shock brain is becoming more recognized as a distinct clinical problem. However, in order to effectively prevent and treat it, the clinician must have a firm grasp of the metabolic requirements and oxygen supply and demand of the normal brain. In addition, it is useful to understand how various types of shock compare and contrast in their ability to injure the brain. In this way, health professionals will be able to base assessment findings and therapies on sound physiologic principles, and thus hopefully improve patient outcomes.
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