Background Many patients admitted to coronary care unit(CCU) and receive several drugs, these drugs save their life at the other hand these drugs are considered threatened to their life so that nurses should ensure that is safe and effective through careful evaluation of the patient's response to therapy by direct observation of physiological measures Aim of this study: was to evaluate the effect of teaching program about drugs that affect blood coagulation on nurses' performance in CCU. Study design: Quasi experimental (pre-posttest) design was used. Setting: the study was conducted in CCU at Assuit General Hospital. Sample: (30) nurses from the previous mentioned setting. Tools; two tools: were utilized in the present study Tool (1) Knowledge assessment tool by using structure interview questionnaire for nurses was utilized, Tool (2) Assessment tool for nurses' practice by using observational check list for nurses' practice was utilized, Results: nurses' knowledge was improved significant from 25.8±6.48 to 60.63±1.19 and nurses practice was improved from 103.87±9.83 to 169.9±1.86 after implementation of teaching program about drugs that effect blood coagulation in CCU. Recommendation: continues nursing education and training program at CCU should be organized regarding drugs affecting blood coagulation.

Background: Patients with head and neck cancer are in danger of creating carotid artery rupture that may cause lifethreatening problems and death Aim: to assess the nursing performance regarding immediate management of carotid artery rupture. Study design: A descriptive research design was utilized in this study. Setting: The study was conducted in the critical care unit at south Egypt cancer institute at Assiut University hospital. Sample: A convenience sample of all available nurses (forty nurses) Tools: two tools were used for data collection, Nurses' knowledge assessment and observational checklist. Results: The majority of studied nurses (80%) were having an unsatisfactory level of knowledge regarding carotid artery rupture. Conclusion: Nurses` knowledge regarding carotid artery rupture and practice regarding immediate care of carotid artery rupture in critical care unit at south Egypt cancer institute at Assiut University hospital is unsatisfactory and have an inadequate level of knowledge and practice. Recommendation: Nurses need for in-service training programs to improve their knowledge and practice regarding the management of carotid artery rupture.

Background Patients with Acute myeloid leukemia are at risk of bleeding that may cause life-threatening and death Aim: To investigate the effect of implementing nursing instructions on minimize bleeding among patients with Acute Myeloid Leukemia. Study design: Quasi experimental research design was utilized in this study. Setting: The study was conducted in the critical care unit at south Egypt cancer institute at Assiut University hospital. Sample: A convenient sample of 60 adult patients divided randomly into (30 study and 30 control) groups. Tools: Two tools used for data collection, tool (I);An interview questionnaire, tool (II); assessment of bleeding tendency. Results: There was a statistical difference between study and control group regarding whole blood and amount of blood loss according to class of hemorrhagic Shock in addition this amount decreased after implementation of nursing instructions at 3 rd and 5 th day with P.value (0.008). Conclusion: This study confirmed our hypothesis that implementing of nursing instructions on the patients with acute myeloid leukemia leading to minimize bleeding. Recommendation: Continued nursing instructions at critical care units should be organized within south Egypt cancer institute.

Background: Sepsis is considered to induce immune suppression, leading to increased susceptibility to secondary infections with associated late mortality. Aim: To assess the risk factors of patients with septic shock in the intensive care unit. Study design: a descriptive research design was utilized in this study. Setting: The study was conducted in the general intensive care unit and trauma intensive care unit at Assuit University Hospital. Sample: A purposive 60 patients with septic shock patients. Tools: two tools used for data collection, tool (1), Patient assessment sheet, and tool (2), risk factors assessment sheet. Results: The main risk factors were dysfunction of one or more of the major body systems, tracheostomy (65.0%), diabetes mellitus (65.0%) and respiratory disease, in addition, more than half of them stay more than 20 days in the ICU and half of them suffered from respiratory failure as a complication of septic shock. Conclusion: major factors that were associated with in-hospital mortality among ICU patients with severe sepsis or septic shock were multi-organ failure and DM which despite treatment with early resuscitation. Recommendation: Applied Nursing guidelines and standard precautions infection control of patients with septic shock at the onset of intensive care unit admission.