Abstract
Nursing management of the patient with an open abdomen presents unique challenges. The goal of care for the open abdomen patient is to close the abdomen as soon as feasible. This chapter reviews the nurse’s role in stabilizing the patient’s hemodynamics, managing intra-abdominal hypertension, and supporting nutrition and mobility. Skin protection is a challenge with the open abdomen patient, and the nurse needs to use creative strategies due to the enteric drainage. The open abdomen patient is also confronted with psychosocial and financial issues, particularly if the patient requires to have a ventral hernia prior to definitive closure.
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References
Nightingale F. Notes on nursing: what it is and what it is not. London: Harrison; 1860.
Burns SM, editor. AACN essentials of critical care nursing. 3rd ed. New York: McGraw Hill; 2014.
Abdominal Compartment Society: http://www.wsacs.org/for-patients.html. Accessed on 1 September 2016.
Burlew CC. The open abdomen: practical implications for the practicing surgeon. Am J Surg. 2012;204:826–35.
Huang Q, Zhao R, Yue C, et al. Fluid volume overload negatively influences delayed primary facial closure in open abdomen management. J Surg Res. 2014;187:122–7.
Malbrain M, DeWaele J. Cardiovascular system and IAH. In: Vuylsteke, editor. Intra-abdominal hypertension: core critical care. Cambridge: Cambridge University Press; 2013. p. 131–40.
McLean B. Chapter 22 goal directed hemodynamics. In: Lough, editor. Hemodynamic monitoring: evolving technologies and clinical practice. Missouri: Elsevier; 2016. p. 713–26.
Mahjoub Y, et al. The passive leg-raising maneuver cannot accurately predict fluid responsiveness in patients with intra-abdominal hypertension. Crit Care Med. 2010;38(9):1824–9. doi:10.1097/CCM.0b013e3181eb3c21.
Lehman LH, Saeed M, Talmor D, Mark R, Malhotra A. Methods of blood pressure measurement in the ICU. Crit Care Med. 2013;41(1):34–40.
Malbrain M, De Laet I, DeWaele J. IAH/ACS: the rationale for surveilance. World J Surg. 2009;33(6):1110–5.
Abdominal Compartment Syndrome: medical management algorithm. http://www.wsacs.org/images/algorithms/IAH_ACS_medical_management_2014.pdf. Accessed 1 September 2016.
Metheny N. AACN practice alert: initial and ongoing verification of feeding tube placement in adults. Crit Care Nurse. 2016;36(2):e8–e13. 10.4037/ccn2016141.
Taylor BE, McClave SA, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Crit Care Med. 2016;44(2):390–438. doi:10.1097/CCM.0000000000001525.
MacLeod JBA, Lefton J, Houghton D, Roland C, et al. Prospective randomized control trial of intermittent versus continuous gastric feeds for critically ill trauma patients. J Trauma. 2007;63:57–61.
Marik PE (2016) Chapter 32 nutrition in the ICU: it’s whey cool. In: Marik (auth) Evidence based critical care 3. Springer, Heidelberg.
Vollman KM. Hemodynamic instability: is it really a barrier to turning critically ill patients? Crit Care Nurse. 2012;32(1):70–5.
Malbrain M, DeWaele J. Principles of IAP management. In: Vuylsteke, editor. Intra-abdominal hypertension: core critical care. Cambridge: Cambridge University Press; 2013. p. 25–33.
Society of Critical Care Medicine: ICU Liberation http://www.iculiberation.org. Accessed on 15 August 2016.
Curtis K, Judson K. Management of fistulae in patients with an open abdomen. Nurs Stand. 2014;28(25):56–64.
Zarzaur BL, 2011, DiCocco JM, Shahan CP et al Quality of life after abdominal wall reconstruction following open abdomen. J Trauma. 70(2) p 285–291.
Clark JM, Cheatham ML, Safcsak K, Alban RF. Effects of race and insurance on outcomes of the open abdomen. Am Surg. 2013;79(9):928–32.
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Lee, R.K. (2018). The Nursing Management of Open Abdomen Patients. In: Coccolini, F., Ivatury, R., Sugrue, M., Ansaloni, L. (eds) Open Abdomen. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-319-48072-5_16
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DOI: https://doi.org/10.1007/978-3-319-48072-5_16
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