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Critical Care Care Plans
AUGUST 1989, VOL. 50. NO 2
AORN JOURNAL
Book Reviews
NURSING PRACTICE Synopsis of Critical Care, third ed. Edited by William J. Sibbald 1988, 334 pp $29.95 paperback The target audience for Synopsis of Critical Care would aptly be emergency services personnel (both those who transport patients and those in the hospital setting), the operating room staff, and members of the intensive care unit team. The editor's purpose is to help the reader maintain competence in the management of the critically ill patient. In this third edition, he provides a composite of current, supplemental information to expand the data base and maintain a perspective on changes in this field of medicine. The inclusive chapters address major topics, including organ-based donor systems, trauma, specific syndromes, appendices of monitoring techniques, normal values, and medications commonly used. The final chapter, which focuses on emotional concerns and ethical issues, could be more purposefully presented as an introduction. All of the information on medical management is best implemented if the reader considers the information in this section. It presents ethical concerns that may arise in the decision-making process regarding diverting efforts from aggressive to compassionate care. With the advancements in knowledge and lifesupport equipment, an appropriate perspective on the goals of patient resuscitation and maintenance must be scrutinized. Can such efforts honestly be appreciated in the patient's best interest, with a reasonable prospect of recovery and a return to
quality life? What about the ethical issues involved in the prolonged care of an elderly or debilitated patient who is maintained solely by life-support and monitoring systems? In critical care, the practitioner is a bedside care giver in an intimate, ongoing relationship with a dependent patient. The emotional concerns are important in that they target the psychological responses of the patient and his or her family. The care giver must recognize these concerns. A tremendous adjunct would have been a discussion of the emotional concerns of the care giver. The book should mention how staff members caring for critically ill patients handle emotional involvement and stress factors. Discussion of the establishment and maintenance of support groups, however informal, or access to counseling or a chaplain needed presentation. The clinical information is specific and concise; the diagnosis and treatment goals, and the criteria used to arrive at them, are well defined. This book is an inclusive manual of updated information for the care giving team, in whatever setting it functions. It is available from Williams & Wilkins, 428 E Preston St, Baltimore, MD 21202 N. JOANNE GUINN,RN, BS STAFF NURSE/OR MCKEEMEDICAL CENTER COLO LOVELAND, Critical Care Care Plans By Nancy M.Hollo way 1988, 331 pp $26.95 paperback American and Canadian clinical experts contributed to 30 comprehensive clinical care plans that contain the depth, detail, and organization
d447
AORN J O U R N A L
appropriate for education and reference. Written with the “front line” nurse in mind, this book integrates three major trends: care planning, nursing diagnoses, and diagnosis related groups (DRGs). It distinguishesnursing from medical care and reconciles cost containment and quality care. After general introductory chapters on nursing diagnoses and care planning, the book presents clinical care plans for critically ill patients. These plans are organized by body system and principle medical diagnosis. Each care plan highlights assessment guidelines, nursing diagnoses, measurable outcome criteria, specific interventions, and discharge planning guidelines for the relevant DRG. Actual and potential patient problems and corresponding medical and nursing responsibilities are treated as collaborative problems. Space is provided at the conclusion of each problem for “additional individualized intervention,” and the target outcome criteria is summarized in a highlighted box. Tips on how and when to document, references, and a comprehensive bibliography conclude each plan. The book also includes contemporary topics such as acquired immune deficiency syndrome, drug overdoses, multiple trauma, and general conditions encountered daily, such as acute pain, grieving, and dying. Nurses already familiar with critical care will find Section I11 a most useful reference tool. It includes selected condensed care plans (arranged alphabetically with color-coded pages), followed by tables, criteria, and parameters (including a pediatric section). Perioperative nurses may find this section of value when setting their priorities of care for critical patients. The care plans will help save time and avoid repetitions while promoting personalized care and maintaining fiscal control. Use of the book as a resource is facilitated by content pages in the front and the index at the end. The book is available from Springhouse Corp, I I 1 1 Bethlehem Pike, Springhouse, PA 19477. JACQUELINE PAWLOWSKI, RN OR STAFF NURSE ST FRANCIS HOSPITAL TULSA,OKLA
AUGUST 1989, VOL. 50, NO 2
Save a Life: The ABCs of CPR By Barbara W Treft 1988, 113pp $3.95 paperback Cardiopulmonary resuscitation is definitely something that people of all ages should be aware of and know how to do. It requires no special equipment, just proper training. This little handbook provides the reader with appropriate information; however, skill practice and written and practical testing must be provided by, and take place in the presence of, an authorized instructor. The book is a course outline with questions and answers at the end of each chapter. It is well written in an appropriate order, and contains a great deal of information. A negative aspect is that it is not clear who the target audience would be. The book is much too technical for a lay person, yet too simple for a medical person. The book is available from the American Academy of Orthopaedic Surgeons, 222 S Prospect Ave, Park Ridge, IL 60068. PATRICIA FRITZ. RN, BS, CNOR PERIOPERATIVE HEAD NURSE UNIVERSITY OF PENNSYLVANIA HOSPITAL PHILADELPHIA
Addiction in the Nursing Profession By Mary R. Haack, Tonda L. Hughes 1989, 270 p p $26.95 clothbound In this age of nursing shortages and burnout, we in the nursing profession need to support our nursing colleagues in times of trouble. Addiction looms large as a threat to swallow up our brightest and best. This volume, a collection of works by some of the leading nurses practicing in the field of addiction, is an excellent guide to understanding addiction as a disease. The articles are arranged in a logical sequence to aid the reader in development of knowledge in this field. The programs available to help nurses with addictions become functioning members of the profession again are explored with positive emphasis toward
AORN JOURNAL
Book Reviews
NURSING PRACTICE Synopsis of Critical Care, third ed. Edited by William J. Sibbald 1988, 334 pp $29.95 paperback The target audience for Synopsis of Critical Care would aptly be emergency services personnel (both those who transport patients and those in the hospital setting), the operating room staff, and members of the intensive care unit team. The editor's purpose is to help the reader maintain competence in the management of the critically ill patient. In this third edition, he provides a composite of current, supplemental information to expand the data base and maintain a perspective on changes in this field of medicine. The inclusive chapters address major topics, including organ-based donor systems, trauma, specific syndromes, appendices of monitoring techniques, normal values, and medications commonly used. The final chapter, which focuses on emotional concerns and ethical issues, could be more purposefully presented as an introduction. All of the information on medical management is best implemented if the reader considers the information in this section. It presents ethical concerns that may arise in the decision-making process regarding diverting efforts from aggressive to compassionate care. With the advancements in knowledge and lifesupport equipment, an appropriate perspective on the goals of patient resuscitation and maintenance must be scrutinized. Can such efforts honestly be appreciated in the patient's best interest, with a reasonable prospect of recovery and a return to
quality life? What about the ethical issues involved in the prolonged care of an elderly or debilitated patient who is maintained solely by life-support and monitoring systems? In critical care, the practitioner is a bedside care giver in an intimate, ongoing relationship with a dependent patient. The emotional concerns are important in that they target the psychological responses of the patient and his or her family. The care giver must recognize these concerns. A tremendous adjunct would have been a discussion of the emotional concerns of the care giver. The book should mention how staff members caring for critically ill patients handle emotional involvement and stress factors. Discussion of the establishment and maintenance of support groups, however informal, or access to counseling or a chaplain needed presentation. The clinical information is specific and concise; the diagnosis and treatment goals, and the criteria used to arrive at them, are well defined. This book is an inclusive manual of updated information for the care giving team, in whatever setting it functions. It is available from Williams & Wilkins, 428 E Preston St, Baltimore, MD 21202 N. JOANNE GUINN,RN, BS STAFF NURSE/OR MCKEEMEDICAL CENTER COLO LOVELAND, Critical Care Care Plans By Nancy M.Hollo way 1988, 331 pp $26.95 paperback American and Canadian clinical experts contributed to 30 comprehensive clinical care plans that contain the depth, detail, and organization
d447
AORN J O U R N A L
appropriate for education and reference. Written with the “front line” nurse in mind, this book integrates three major trends: care planning, nursing diagnoses, and diagnosis related groups (DRGs). It distinguishesnursing from medical care and reconciles cost containment and quality care. After general introductory chapters on nursing diagnoses and care planning, the book presents clinical care plans for critically ill patients. These plans are organized by body system and principle medical diagnosis. Each care plan highlights assessment guidelines, nursing diagnoses, measurable outcome criteria, specific interventions, and discharge planning guidelines for the relevant DRG. Actual and potential patient problems and corresponding medical and nursing responsibilities are treated as collaborative problems. Space is provided at the conclusion of each problem for “additional individualized intervention,” and the target outcome criteria is summarized in a highlighted box. Tips on how and when to document, references, and a comprehensive bibliography conclude each plan. The book also includes contemporary topics such as acquired immune deficiency syndrome, drug overdoses, multiple trauma, and general conditions encountered daily, such as acute pain, grieving, and dying. Nurses already familiar with critical care will find Section I11 a most useful reference tool. It includes selected condensed care plans (arranged alphabetically with color-coded pages), followed by tables, criteria, and parameters (including a pediatric section). Perioperative nurses may find this section of value when setting their priorities of care for critical patients. The care plans will help save time and avoid repetitions while promoting personalized care and maintaining fiscal control. Use of the book as a resource is facilitated by content pages in the front and the index at the end. The book is available from Springhouse Corp, I I 1 1 Bethlehem Pike, Springhouse, PA 19477. JACQUELINE PAWLOWSKI, RN OR STAFF NURSE ST FRANCIS HOSPITAL TULSA,OKLA
AUGUST 1989, VOL. 50, NO 2
Save a Life: The ABCs of CPR By Barbara W Treft 1988, 113pp $3.95 paperback Cardiopulmonary resuscitation is definitely something that people of all ages should be aware of and know how to do. It requires no special equipment, just proper training. This little handbook provides the reader with appropriate information; however, skill practice and written and practical testing must be provided by, and take place in the presence of, an authorized instructor. The book is a course outline with questions and answers at the end of each chapter. It is well written in an appropriate order, and contains a great deal of information. A negative aspect is that it is not clear who the target audience would be. The book is much too technical for a lay person, yet too simple for a medical person. The book is available from the American Academy of Orthopaedic Surgeons, 222 S Prospect Ave, Park Ridge, IL 60068. PATRICIA FRITZ. RN, BS, CNOR PERIOPERATIVE HEAD NURSE UNIVERSITY OF PENNSYLVANIA HOSPITAL PHILADELPHIA
Addiction in the Nursing Profession By Mary R. Haack, Tonda L. Hughes 1989, 270 p p $26.95 clothbound In this age of nursing shortages and burnout, we in the nursing profession need to support our nursing colleagues in times of trouble. Addiction looms large as a threat to swallow up our brightest and best. This volume, a collection of works by some of the leading nurses practicing in the field of addiction, is an excellent guide to understanding addiction as a disease. The articles are arranged in a logical sequence to aid the reader in development of knowledge in this field. The programs available to help nurses with addictions become functioning members of the profession again are explored with positive emphasis toward