conversations.from: human
conversations.value: What could be a title for a story about Critical, CCRN, h5>AACN with the genre: New, Used & Rental Textstorys, Medicine & Health Sciences?
conversations.from: assistant
conversations.value: A title for this story could be 'AACN Essentials of Critical Care Nursing'
conversations.from: human
conversations.value: Give me the first three paragraphs for the story.. End with the sentence ' Depending on the size of the thrombi, and the location of the occlusion, mild to severe obstruction of blood flow occurs beyond the thrombi.'.
conversations.from: assistant
conversations.value: AACN Essentials of Critical Care Nursing
  In addition to the high morbidity and mortality associated with pneumonia in critically ill patients, high priority must be given to strategies to prevent the development of VAPs. The development of a VAP in a critically ill patient increases requirements for ventilatory support (mechanical ventilation, oxygen, duration of treatment). It is estimated that a hospital-acquired pneumonia increases hospitalization 4 to 10 days, and increases costs by $20,000 to $40,000 per episode. Prevention strategies (Table 10-12) include the following:
  Pulmonary embolism (PE) is a complication of deep venous thrombosis (DVT), long bone fracture, or air entering the circulatory system. There are many risk factors for PE (Table 10-13), with critically ill patients being especially prone due to the presence of central venous and PA catheters, immobility, use of muscle relaxants, and heart failure.
  Venous thrombi form at the site of vascular injuries or where venous stasis occurs, primarily in the leg or pelvic veins. Thrombi that dislodge travel through the venous circulation until they become wedged in a branch of the pulmonary circulation. Depending on the size of the thrombi, and the location of the occlusion, mild to severe obstruction of blood flow occurs beyond the thrombi.
conversations.from: human
conversations.value: Give me five more paragraphs.
conversations.from: assistant
conversations.value: Hypomagnesemia frequently occurs in alcoholic and critically ill patients and is often associated with hypocalcemia and hypokalemia. Hypomagnesemia can be caused by decreased intake, increased excretion such as with diuretic therapy, and excessive loss of body fluids. The hypomagnesemia seen in the critically ill is most often the manifestation of a compromised nutritional status, secondary to starvation and malabsorption.
  The most common cause of hyperphosphatemia in all patients, including the critically ill, is renal failure; the regulation of phosphate in the body is done by the kidneys. Hyperphosphatemia is also seen in hypoparathyroidism, excessive intake of alkali or vitamin D, Addison disease, and with bone tumors or fractures. Hyperphosphatemia is often associated with hypocalcemia.
  Hypophosphatemia is caused by hyperparathyroidism, hyperinsulinism, administration of IV glucose, and conditions that cause bone deterioration, such as osteomalacia. This condition is not often seen in critically ill patients. When seen, it is frequently in conjunction with hypercalcemia.
  Of all the potential electrolyte disorders, hyperkalemia is considered the most life-threatening because of potassium's profound impact on the electrophysiology of the heart. Hyperkalemia is also the most common reason for initiation of dialysis in the ARF patient.
  For many years, hemodialysis and peritoneal dialysis were the only therapies available to manage renal failure or situations in which the patient becomes volume overloaded. Many critically ill patients cannot tolerate the rapid fluid and electrolyte shifts associated with traditional hemodialysis because of hemodynamic instability and cardiac arrhythmias. Peritoneal dialysis, an option for patients who cannot tolerate the hemodynamic changes associated with hemodialysis, is limited to patients without recent abdominal incisions, respiratory distress, or bowel perforations.
conversations.from: human
conversations.value: Delete the first sentence.
conversations.from: assistant
conversations.value: Hypomagnesemia can be caused by decreased intake, increased excretion such as with diuretic therapy, and excessive loss of body fluids. The hypomagnesemia seen in the critically ill is most often the manifestation of a compromised nutritional status, secondary to starvation and malabsorption.
  The most common cause of hyperphosphatemia in all patients, including the critically ill, is renal failure; the regulation of phosphate in the body is done by the kidneys. Hyperphosphatemia is also seen in hypoparathyroidism, excessive intake of alkali or vitamin D, Addison disease, and with bone tumors or fractures. Hyperphosphatemia is often associated with hypocalcemia.
  Hypophosphatemia is caused by hyperparathyroidism, hyperinsulinism, administration of IV glucose, and conditions that cause bone deterioration, such as osteomalacia. This condition is not often seen in critically ill patients. When seen, it is frequently in conjunction with hypercalcemia.
  Of all the potential electrolyte disorders, hyperkalemia is considered the most life-threatening because of potassium's profound impact on the electrophysiology of the heart. Hyperkalemia is also the most common reason for initiation of dialysis in the ARF patient.
  For many years, hemodialysis and peritoneal dialysis were the only therapies available to manage renal failure or situations in which the patient becomes volume overloaded. Many critically ill patients cannot tolerate the rapid fluid and electrolyte shifts associated with traditional hemodialysis because of hemodynamic instability and cardiac arrhythmias. Peritoneal dialysis, an option for patients who cannot tolerate the hemodynamic changes associated with hemodialysis, is limited to patients without recent abdominal incisions, respiratory distress, or bowel perforations.
conversations.from: human
conversations.value: Give me the last five paragraphs.
conversations.from: assistant
conversations.value: Faul M, Xu L, Wald MM, Coronado VG. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002-2006. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010.
  National Spinal Cord Injury Statistical Center. Spinal Cord Injury Facts and Figures at a Glance. February 2012. Retrieved March 2, 2013 from <https://www.nscisc.uab.edu/>.
  Alexander S, Gallek M, Presciutti M, Zrelak P. Care of the patient with aneurysmal subarachnoid hemorrhage: AANN Clinical Practice Guidelines Series [electronic version]. Glenview, IL: American Association of Neuroscience Nurses; 2011. Available at <http://www.aann.org/pubs/content/guidelines.html>
  Consortium for Spinal Cord Medicine. Early Acute Management in Adults with Spinal Cord Injury: A Clinical Practice Guideline for Health-Care Providers. Washington, DC: Paralyzed Veterans of America; 2008.
  West TA, Bergman K, Biggins MS, et al. Care of the patient with mild traumatic brain injury: AANN and ARN clinical practice guideline series [electronic version]. Glenview, IL: American Association of Neuroscience Nurses and Association of Rehabilitation Nurses. 2011. Available at <http://www.aann.org/pubs/content/guidelines.html>
conversations.from: human
conversations.value: Delete the last sentence.
conversations.from: assistant
conversations.value: Faul M, Xu L, Wald MM, Coronado VG. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002-2006. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010.
  National Spinal Cord Injury Statistical Center. Spinal Cord Injury Facts and Figures at a Glance. February 2012. Retrieved March 2, 2013 from <https://www.nscisc.uab.edu/>.
  Alexander S, Gallek M, Presciutti M, Zrelak P. Care of the patient with aneurysmal subarachnoid hemorrhage: AANN Clinical Practice Guidelines Series [electronic version]. Glenview, IL: American Association of Neuroscience Nurses; 2011. Available at <http://www.aann.org/pubs/content/guidelines.html>
  Consortium for Spinal Cord Medicine. Early Acute Management in Adults with Spinal Cord Injury: A Clinical Practice Guideline for Health-Care Providers. Washington, DC: Paralyzed Veterans of America; 2008.
  West TA, Bergman K, Biggins MS, et al. Care of the patient with mild traumatic brain injury: AANN and ARN clinical practice guideline series [electronic version]. Glenview, IL: American Association of Neuroscience Nurses and Association of Rehabilitation Nurses. 2011. Available at <http://www.aann.org/pubs/content/guidelines.