Index. Note: Page numbers of article titles are in boldface type.

Transcription

1 Index Note: Page numbers of article titles are in boldface type. A Acute coronary syndrome (ACS), burden of condition, 83 diagnosis of, evaluation of, 83, 87 major complications of, 86 risk for, 82 signs and symptoms of, 83 treatment of, ECG monitoring and, 86 monitoring for bleeding with, 87 oxygen in, 86 pharmacologic, reperfusion therapy in, Acute decompensated heart failure (ADHF), description of, 71 diagnosis of, chest radiograph in, 74 clinical signs and symptoms in, 73 echocardiography in, 74 tests for, factors precipitating, maintenance therapies for, pearls for starting or titrating, 82 medications for, digoxin, 81 dobutamine, 80 inotropes, 76, loop diuretics, milrinone, 80 morphine, 81 vasodilators, 76, 78 signs and symptoms of low output, 73 pulmonary and systemic congestion, shortness of breath and fatigue, 72 treatment of, classification and clinical profiles in, classification in, goals for, 75 pharmacologic, Acute kidney injury (AKI; acute renal failure), 99 grading and classification of, RIFLE criteria for, 100 incidence of, 100 in older adult, defined, 100 management of, prevention strategies in, 102 renal replacement therapy in, 102 morbidity increase with, 103 Crit Care Nurs Clin N Am 26 (2014) ccnursing.theclinics.com /14/$ see front matter ª 2014 Elsevier Inc. All rights reserved.

2 172 Index Acute (continued ) RIFLE (risk, injury, failure, loss, end-stage renal disease) criteria for, 100 risk factors for, anatomic and physiologic changes associated with aging, comorbid conditions, 101 sepsis, surgical procedures, 101 Acute renal failure (acute kidney injury). See Acute kidney injury (AKI; acute renal failure). Advance directives and end-of-life preferences, in ethnogeriatrics, Aging, effects on quality of life, 2 3 Aging muscles and joints, mobilization and, Aging physiology, cardiovascular, 9 categorization of aging, 8 cellular, 8 gastrointestinal, impact in critical care, 7 14 integumentary, musculoskeletal, 11 neurologic, 9 pulmonary, 10 renal, 11 systems and impact of, summary of, 12 Anxiety, categories of, 124 nonpharmacologic interventions for, screening for, 124 symptoms of, Assessment. See Focused assessment of older adult. B BP, in hypertension crisis, accurate reading of, 65 assessment in treatment of, 66 C Cardiovascular aging, 9, 12 Cardiovascular issue(s), acute coronary syndrome, heart failure, hypertension, in older adult, physiologic changes to heart, age-related, Catabolic state, 33 Cellular aging, 8, 12 Coagulation system, interaction with immune system, synergistic, COPD, pulmonary support in, 95 D Dehydration, diagnosis of, 37 effects of, 33 enteral nutrition and, 38 preexisting, challenge to hydration, 33

3 Index 173 risk for, in enteral nutrition, 38 Delirium, case study and treatment of, causes of, challenges with, admission data from proxy or family member, 142 EEG to rule out subclinical seizure, 142 cinical criteria for, 143 Confusion Assessment Method for the ICU (CAM-ICU) for, definition of, 140 dementia vs., key features of, 140 management of, ABCDE bundle in, 143 mobilization in, 143 nonpharmacologic, 143 neurologic examination in, 141 subtypes of, 140 Delirium in elderly adult in critical care, Dementia, description of, 127 medications for, neuropsychiatric symptoms in, 128 stage of and interventions in, 128 types of, Drug metabolism, renal aging and, 11 E End-of-life care, delivery of, 4 End-of-life issues, and tube feeding, 34 in ethnogeriatrics, in palliative care, 161, 166 Enteral nutrition, contraindications to, 38 formulas for, 38 Epidemiology of acute and critical illness, effects of aging on quality of life, 2 3 end-of-life care delivery, 4 hospital admissions, age and, 1 2 from community, 1 from nursing homes, 1 ICU admissions, diagnoses in, by age group, 2 risks for, 2 3 transitions from and readmissions to, 3, 4 in older adults, 1 5 mortality in hospitalized older adults, 3 4 Ethnogeriatrics, advance directives and end-of-life preferences, assessment for cultural-specific care in, 26 communication strategies and, emotional expression and, 24 patient involvement in decision-making, 25 touch and, 24 trained interpreter in, 24 with ethnic elders, cultural competence and, 23

4 174 Index Ethnogeriatrics (continued ) key nursing competencies, 26 training in, 25 Culturally and Linguistically Appropriate Services (CLAS) standards for health care providers, culture and, 22 definition of, 22 ethnicity and, 22 explanatory models of health in, 25 health risks and health disparities, beliefs regarding treatments and procedures, 23 by race and ethnicity, 22 cultural systems of illness belief and, 22 organizational integration of, F Focused assessment of older adult, baseline assessment and, activities of daily living in, cognition in, 18 delirium in, 18 general overview in, 18 history in, 17 medications in, 18 physical, 18 preadmission cognitive status in, 17 components of, 16 framework for, 16 physical, in HTN crisis, 66 tools for, 16 Frailty, defined, 32 interventions for, 33 G Gastrointestinal aging, H Heart failure, acute decompensated.see Acute decompensated heart failure (ADHF). burden of, 71 risk factors for, 71 Hospitalization, effect on mobility, 105 function decline with, 106 Hypertension (HTN), burden of, 2 systolic, in heart failure, 71 Hypertension (HTN) crisis, accurate BP reading in, 65 cause of, consequences of, emergency, 64 evaluation of patients with, focused physical examination in, 66 nursing care for, 67 68

5 Index 175 signs and symptoms of, treatment of, BP assessment in, 66 common medications for, implications of, 68 medication dosing in, 68 routes of medication administration in, 68 urgency in, 62, 64 I Immune system, adaptive, B-lymphocytes in, 53 T-lymphocytes in, evaluation of, in infection, 55 innate, Infection, common, in elderly, 55 diagnostic workup for, 55 hospital admissions from nursing homes for, 1 immune system evaluation in, 55 nonspecific signs of, in sepsis, 54 risk factors for, 52 severe, risk factors for, 50 Infection, sepsis, and immune function in older adult, Inflammation, in catabolic state, 33 in systemic inflammatory response syndrome, 49 markers of, 35 with aging and chronic disease states, 33 Informed consent, and patient with psychiatric disorder, Integumentary aging, J Joints, aging. See also Mobilization. articular cartilage and, 107 muscles, ligaments, tendons and, M Malnutrition, 32 diagnosis of, Mobility, hospitalization effect on, 105 Mobilization. See also Joints, aging; Muscles, aging. aging joints and, aging muscles and, 106 barriers to, 108 challenges in critical care, 108 core interventions for, interdisciplinary, patient physiologic status stratification for, delay in or termination of, 109 factors affecting in older adult, 107 inadequate dietary protein, 107 factors essential to, 108

6 176 Index Mobilization (continued) interventions on ICU, 108 patient assessment for, 109 patient selection criteria for, programs for, themes across, 109 systems assessment for, Mortality, in hospitalized older adults, 3 4 in sepsis, as outcome, rate of, 48 risk for, 50 Muscles, aging. See also Mobilization. effects of, 106 subsystems and, age-related changes in, 106 Musculoskeletal aging, 13 bony mass in, 11 factors in, 11 N Neurologic aging, 9, 12 Nutrition and hydration, assessment of, current conditions in, 35 fluid status in, 36 goal of, 35 inflammatory markers in, 35 muscle strength and mass in, 36 physical, 36 weight in, 35 diagnosis and, of dehydration, 37 of malnutrition, eating and feeding issues, end-of-life issues and tube feeding, 34 nutrition screening and, oral intake, enteral nutrition, 38 hydration status, monitoring during parenteral nutrition, 39 ICU issues related to, catabolic state, 33 in older adults, interventions, fluid requirements, 37 nutrition needs, 37 nutrition support, 37 practice guidelines for, 38 nutrition support in, evaluation of, monitoring for tolerance and impact of, protocols and algorithms for, 39 oral nutrition, barriers to, 33 parenteral nutrition, preexisting challenges to, dehydration, 33 frailty, malnutrition, 32 weight loss and, unintentional, 32

7 Index 177 O Oncologic issue(s), adverse drug reactions, causes of, 151 agonists and antagonists and, 150 cancer, incidence of, projected increase in, 148 cancer patient on ICU, admitting diagnoses and, 151 reasons for admission to, recommendations for, survival and, 151 drug interactions and, 150 in older adult, oncologic emergencies, sepsis, 153 pharmacologic implications of aging and, drug-drug interactions, 150 pharmacokinetics, pharmadodynamics, 150 sepsis as emergency, 152 P Palliative care, American College of Critical Care Medicine recommendations for, 159 and nursing practice with critically ill older adults, aspects of care in, cultural, 164 ethical and legal, 165 for imminently dying patient, 164 physical, 162 psychological and psychiatric, 163 social, 163 spiritual, religious, existential, 163 structure and processes, 162 Clinical Practice Guidelines for Quality Palliative Care, 156 domains in, nursing practice and, definition of, 156 ethical and sociopolitical issues in, for nurses, 158 models for, consultative, integrative, National Consensus Project and, 156, nursing practice and, communication in, 166 End of Life National Education Consortium initiative and, 161, 166 family meetings in, physical environment of ICU and, 161 with the elderly, standards for, Center to Advance Palliative care initiative and, National Hospice and Palliative Care Organization and, suvival after ICU hospitalization and, 157 vs. hospice care, Parenteral nutrition, hydration status during, 39 risks with, 38 39

8 178 Index Pharmacokinetics and aging, absoprtion in, distribution and, 149 excretion and, metabolism and, 149 Psychiatric disorder(s), anxiety, and depression in hospitalized older adults, 117 nonpharmacologic interventions for, pharmacologic interventions for, 127 behavioral approaches to, 131 bipolar disorder, 123 case example: PTSD, depression, and comorbid illness, assessment for withdrawal issues, 132 preoperative planning in, 132 psychiatric consult in, dementia, diagnoses, 120 goals of care for, 116 impacting critical illness, informed consent issues and, capacity and competence, mood disorders, depression, 119, 123 screening for, treatment of, 119, 123 preoperative geriatric assessments and, components of, 118 schizophrenia, 129 screening for and assessment of, 122 stigma of, and nurse stereotyping, substance use, suicide and associated illnesses, 123 symptoms of, 121 Pulmonary aging, 10, 12 Pulmonary issue(s), age-related changes, dysphagia, 93 pulmonary function and, 94 static secretions and pneumonia, tachypnea and, 94 thickened mucus and sputum clearance, 93 ventilation-perfusion matching and shunting changes, 94 anatomy of pulmonary system and, 92 assessment of pulmonary system and, laboratory values in, respiratory rate in, 92 breathlessness, assessment of, 95 COPD, pulmonary support in, 95 in older adult, interventions, noninvasive ventilation support, 96 oral care, 96 oxygen, 96 water, 96 typical respiratory diseases, community-acquired pneumonia, COPD, 95

9 Index 179 Q Quality of life, aging effects on, 2 3 R Renal aging, Renal issues, acute kidney injury.see also Acute kidney injury (AKI; acute renal failure). in older adults, S Schizophrenia, medication for, 129 symptoms of, 129 Sepsis. See also Systemic inflammatory response syndrome (SIRS). acute kidney injury from, as oncologic emergency, 152 clinical presentation in, nonspecific signs of infection and, 54 coagulation system in, criteria for, immune system and, adaptive, immunosenescence, 51 in elderly, innate, management of, corticosteroids for hypoperfusion, 56 early, aggressive intervention in, key principles and interventions in, 57 mortality from, as outcome, rate of, 48 risk factors for, 50 pathophysiology of, 51 patient perspective, DNR orders and, 58 predisposing factors for, 48 risk factors for, 50 Septic shock, criteria for, 50 Substance use disorder(s), definition of, 130 increase in, management of, 131 prevalence of, projected, 130 screening for, 130 substance abuse vs., 130 late onset, substance-induced disorders, 130 Suicide and associated illnesses, 123 Systemic inflammatory response syndrome (SIRS), criteria for, 49