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Biomedical subjects

Nancy Munro

Publications and source records attributed to Nancy Munro.

4 recordsLinked to original sources
PubMed2006

Weaning smokers from mechanical ventilation.

Because smoking causes oxidant stress, inflammation, and protease-antiprotease imbalance of the lung tissue, smokers may have a lower threshold for initiation of mechanical ventilation. Critical care team members should realize that not only the pulmonary system is compromised but also other protective response mechanisms of the body. Therefore, the role of every critical care team member is pivotal to ensure a successful weaning and extubation process for smokers. This article addresses how to best do that with a collaborative and evidence-based approach.

Blood Gas Analysis↗
PubMedDate not supplied

Evidence-based assessment: no more pride or prejudice.

Evidence-based practice is an important force in healthcare today. Its impact on the practice of the advanced practice nurse (APN) is becoming more apparent with the development of practice guidelines and protocols. The phrase, "That's the way I've always done it," is being replaced by, "This practice is evidence based." The philosophy of supporting practice with scientific evidence is not new but has been revitalized and emphasized as protocols have been developed to "mold" practice to achieve successful outcomes. This revolution is being applied to all areas of healthcare practice. Assessment of the patient is usually the first contact the APN has with the patient. It is an important time to gather information from the patient interview, physical examination, laboratory data, and test interpretation. Scientific evidence, properly interpreted, is applied in this step of assessment. The APN will then use clinical judgment and the knowledge gained from graduate education to assist with the formulation of a diagnosis. The APN has a unique opportunity to promote an evidence-based practice model at the grass roots level and persuade the bedside nurse to integrate this process into his or her practice. Ultimately, patients will receive better care and outcomes will be improved using evidence-based assessment.

Clinical Competence↗
PubMedDate not supplied

Assessment of the mechanically ventilated patient: an advanced practice approach.

Multiple perspectives must be considered when assessing the mechanically ventilated patient. Assessment begins before the advance practice nurse (APN) encounters the patient. Important information about the patient can be gleaned from the history, medications, and social history. The APN then observes the patient to determine if patient-ventilator synchrony has been achieved. Physical findings are gathered and correlated with the chest radiogram. Data from the ventilator are evaluated to assess compliance, minute ventilation, tidal volume, and other parameters that will assist in the evaluation of the patient's needs. Electrolytes, acid-base state, and nutrition must all be considered to obtain a complete assessment of these patients. From all these data points, the APN can develop a detailed plan of care that will enhance positive patient outcomes.

Critical Care↗