AACN Essentials of Critical Care Nursing Marianne Chulay , AN , ONSc , FAAN Consultant, Critical Care Nursing and Clinical Research Chapel Hill, North Carolina Suzanne M Burns, RN , MSN, ART , ACNP, CCRN , FAAN , FCCM Professor of Nursing Acute and Specialty Care School of Nursing Advanced Practice Nurse Level Medicine/Medical Intensive Care Unit Universily of Virginia Health System Charlottesville, Virginia McGraw-Hill Medical Publishing Division New York Chicago San Francisco lisbon London Madrid Mexico City Milan New Oelh1 San Juan Seoul Singapore Sydney Toronto The McGrow·Hi/1 Companies · AACN Essentials of Critkal Care Nursing Copyright I!) 2006 by The McGra\\ -Hill Companie~ Inc All righh reserved Printed in the United State~ of Am.,rica E~cept a' pcrrnitt~d under the Unit"d Stat.:' Copyright Act of 1976 no part of this publication may be repmJu~.:J ur di,tributctl in any ltmn ur by an) mean,, ur Mored in a data bu ~e or retrieval ')l>tem w ithout the prior written ~rmio;,ion of the publi,her ~ K9 QPD/QPD I! ISBN 0-07-1-'4771·7 NOTICE M.:Jicin~ j, an ever-~:hanging s~:ience A> new research anJ clinical experience broaden our knowkdge change!'> in trt!atment and drug therapy are required The authors and The publisher of this work ha\'C •·heckcd with 'ourccs believed to be reliable in their effons to provide information that is complete and generally in accord w ith the standard' accepted at the time of publication However in view of the possibility of human error or changes in medical sciences neither the author' nor the publi~her nor any other par1y who ha~ been involved in the preparation or publication of this work warrant' that tbe information :onrained herein is in :very respect a.:cunue or complet.: and the} di ~claim all respon•ihility for any errors or omis~ion~ or for the results obtained from use of the infom1ativn contained in thi' work Reader~ ar.: encouraged to confirm the infonnation contained herein Y.ith other snun:es For c x.ample and in par1icular readers are advised to check the product infom1ation :.heel included in the package of each dmg they plan to administer to be cenain that the infonnation contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindication, for administration This recommendation i~ of pani.:ular impor1ancc in connection with ne\\ or infrequently used drugs Thi' book wa' 'et in Time' Ruman by Mid-Atlantic Book" and Joumab Inc The editor wa' Mi~hacl Brown The production >Upef\ i~or wa~ Sherri Souffmnce Project manag~mk i~ printed on acid-free paper PlcJ't: tell the author and publi,her what you think ••f thi, book hy ;;ending your comment~ to nursing@mcgraw· tlill.cum Plc.I~C put the authur and title ul th" bonk in the •utlject line Library nr Cnng n., ~ Catalo~:inJ!·in-Puhlication Data AACN e~'ential' of crittcal care I [cJitcd hy] Marianne Chula} SuLanne M Bum, - I 't t'd p ;wt Include' bibliographical ref~r.!ncc' and indl.":\ ISBN 0·07· 1-'4771· 1,uftcnvcr) I Intensive :are nursint: {)utlinc, ~)llabi etc I Title : American A"