Miller, Britney Ross, and Michael DiNapoli Recent data support the use of nutritional agents for use as targeted medical therapy. This article reviews some of the pharmacologic roles that parenteral nutritional ingredients (selenium,

lipid emulsion, insulin, and levocarnitine) can play in the setting of critical illness. Index 289 “
“Sonya R. Hardin Linda Bell The selleck chemical world and US population continues to increase with an extended lifespan. Disability rates in older adults have not changed; however, they are living longer with disabilities that affect quality of life and complicate acute and critical illness. Because increasing numbers of older adults will live with disabilities and chronic disease, new strategies are needed CDK phosphorylation to improve both quality of life and end-of-life decision making. Mandi Walker, Mark Spivak, and Mary

Sebastian Aging physiology greatly impacts care delivery in the geriatric patient population. Consideration should be given to addressing the patient-specific needs regarding the systemic changes seen in the aging patient. Each major body system presents its own unique challenges to the critical care practitioner, and a comprehensive understanding of these changes is necessary to effectively care for this patient population. This article summarizes these changes and provides key points for the practitioner to consider when caring for the aging patient in the critical care arena. Bethany Gentleman This article presents an overview of the focused subjective and objective assessment of the older adult for the critical care nurse. Discussion includes the distinguishing features inherent to older adults, and relevant evidence-based click here screening tools that the nurse can use in assessing the critically ill older adult. Sonya R. Hardin This article discusses the increased diversity of older adults expected to be treated in intensive care units over the next 10 years. The importance of the integration of an ethnogeriatric assessment to include ethnicity, level of acculturation, religion/spirituality, preferred interaction pattern, facilitation of communication, and physical examination constraints due to ethnicity are discussed. Rose Ann DiMaria-Ghalili and Michele Nicolo Nutrition

and hydration are vital components of critical care nursing. However, meeting the nutrition and hydration needs of the critically ill older adult is often complex because of preexisting risk factors (malnutrition, unintentional weight loss, frailty, and dehydration) as well as intensive care unit–related challenges (catabolism, eating and feeding, end-of-life care). This article highlights the challenges of managing nutrition and hydration in the critically ill older adult, reviews assessment principles, and offers strategies for optimizing nutrition and hydration. Camille Lineberry and Deborah E. Stein The elderly are vulnerable to developing sepsis due to functional and immune changes, and frequent instrumentation and contact with the health care system.