Critical care plans: Guidelines for patient care

Critical care plans: Guidelines for patient care

BOOK REVIEWS Hand Book of Dialysis by J. T. Daugirdas and S. I. Todd Little, Brown & Co., 1988, 566 pages. Price Ll8.95 This book is a well-written ...

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Hand Book of Dialysis by J. T. Daugirdas and S. I. Todd Little, Brown & Co., 1988, 566 pages. Price Ll8.95 This book is a well-written and comprehensive guide to dialysis therapy, contributors being an impressive array of experienced renal physicians. The text covers all aspects of therapy-‘Indications for Treatment’; ‘Haemodialysis’; ‘Peritoneal Dialysis’; ‘Special Problems in the Dialysis Patient’ (eg ‘Psychology and Rehabilitation’; ‘Aluminium Toxicity’); ‘Special Problems Pertaining to Various Organ Systems’ -and has a useful index of appropriate drugs and dosages. Although the editors state that: ‘The Handbook is written in such a way as to require little foreknowledge of chemistry, physiology, or the dialysis procedure’ the presentation is such that at least basic knowledge of haemodynamics and physical chemistry is required to make the text comprehensible. Each main subject area is neatly divided into quite specific sections which are well-illustrated and tabulated where appropriate, and contain a helpful bibliography. However specific points of research, for example, are not directly referenced, which is a drawback, albeit a minor one. The text is written in a crisp, succinct style, with clear presentation of information, and is easy to read. The major disadvantage of the book is its cost. However, despite this, it is to be recommended due to its clarity and comprehensive nature. The book has the feel of having been written with junior medical staff in mind, although as the editors point out, it would be a useful text for renal nursesparticularly more experienced ones, or those undertaking the ENB course. It is less suited to new renal nurses than, say, the texts by Wing and Magowan or Uldall. In conclusion, it gives a good resume of basic principles and current therapy, as well as exploring some novel treatment options, and would be an enhancement to the bookshelves of any renal unit.


ANN LOUISE CARESS cert in D.N, HVcert.

Critical Care Plans: Guidelines for Patient Care by M. F. Moorhouse, A. C. Geissler and I\I. E. Doenges F. A. Davis Company, 1987,472 pages. Price L22.50 This American text concentrates on the planning of ‘holistic care’ for patients in a critical care environment. In order to achieve this aim care plans based on the framework of Nursing Diagnosis as proposed by the North American Nursing Diagnosis Association have been developed. Given the current interest in the user of the nursing process within a framework of a nursing model, it is interesting to find a text which firmly grounds the nursing process in a decision making model with nursing interventions based on ‘scientific rationale’ ie a medical framework. This is perhaps inevitable given that the care plans consist of independent and collaborative interventions. A comprehensive assessment tool is given at the front of the text to allow nurses to identify the relevant nursing diagnosis for their patients. For 31 medical diagnoses (eg cardiogenic shock) a care plan has been developed. Each care plan presents a comprehensive assessment data base, the identification of nursing priorities and detailed interventions centre around each nursing diagnosis. The interventions with accompanying rationales are numerous, there being for example, ten nursing diagnoses for cardiogenic shock. Once the reader becomes accustomed to the stylealteration in, decreasedthe care Cardiac output, plans do provide a useful educational tool, both for use in the classroom setting and in the clinical environment. This book does provide an interesting section on psychosocial aspects of critical care which would serve to promote discussion for all staff in the clinical area. The practical use of the care plans would present many problems as they are so lengthy and detailed. The comprehensive use of all the nursing diagnoses would require a computer and selective print-out facilities at the least. However, the book serves as a useful addition to any library as a reference for all those staff interested in the assessment of patients and the planning of care in intensive care units. The use of nursing diagnoses provides a different perspective on the debate on nursing models and in itself may provide a fruitful avenue for intensive care nurses to explore.