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Related Concept Videos

Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

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Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
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Water balance disorders are medical conditions that occur when there is a deviation from the body's water volume or osmolarity, disrupting normal homeostasis and leading todehydration, hypotonic hydration, hyperhydration, edema, or water intoxication.
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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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Hemodialysis III: Nursing Management01:25

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The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
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Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
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Heart Failure VI: Adjunct Therapies01:22

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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Related Experiment Video

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Author Spotlight: Exploring Venous Waveforms in Porcine Models to Tackle Volume Overload in Medicine
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Identifying Opportunities for Fluid Balance Optimization in Critically Ill Children.

Denise C Hasson1, Ami Shah1, Chloe G Braun2

  • 1Dept of Pediatrics, Hassenfeld Children's Hospital at NYU Langone Health, NY, NY.

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|July 16, 2025
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Fluid overload is common in pediatric intensive care units (PICUs). Understanding site-specific fluid balance (FB) drivers and barriers is crucial for improving patient management and outcomes.

Keywords:
acute kidney injuryfederated data collectionfluid accumulationfluid managementfluid overload

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Area of Science:

  • Pediatric Intensive Care
  • Critical Care Medicine
  • Fluid Balance Management

Background:

  • Fluid overload (FO) is a significant issue in Pediatric Intensive Care Units (PICUs), linked to increased morbidity and mortality.
  • Accurate fluid balance (FB) reporting and management are challenging due to varying needs and limitations across different PICUs.

Purpose of the Study:

  • To investigate the prevalence of cumulative fluid balance (CFB) exceeding 5% and 10% on ICU days 1 and 2.
  • To identify site-specific drivers of positive FB, barriers to accurate FB recording, and opportunities for improvement.

Main Methods:

  • A concurrent mixed methods study using retrospective and prospective designs across four tertiary pediatric ICUs.
  • Extracted FB data from electronic health records and utilized a federated data collection framework.
  • Analyzed %CFB on ICU days 1 and 2, comparing results across sites using statistical tests.

Main Results:

  • Day 2 CFB >5% ranged from 39% to 54% and >10% from 16% to 25% across sites.
  • Significant inter-site variations observed in urine recording and fluid administration on Day 1.
  • Common barriers to accurate FB reporting included issues with patient/family reporting and standardized charting.

Conclusions:

  • High %CFB is prevalent in pediatric ICUs, with significant variation across institutions.
  • Targeting individual ICU-specific drivers of FO is essential for effective fluid balance management.