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The three Cs: change, conflict, and challenge. 三个c:改变、冲突和挑战。
ANNA journal Pub Date : 1999-08-01
C Cronk
{"title":"The three Cs: change, conflict, and challenge.","authors":"C Cronk","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4","pages":"434"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21683439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An analysis of body weight and hemodialysis adequacy based on the urea reduction ratio. 基于尿素还原比的体重和血液透析充分性分析。
ANNA journal Pub Date : 1999-08-01
K R Culp, M Flanigan, Y Hayajneh
{"title":"An analysis of body weight and hemodialysis adequacy based on the urea reduction ratio.","authors":"K R Culp,&nbsp;M Flanigan,&nbsp;Y Hayajneh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The purpose of this study was to evaluate inadequate hemodialysis risk in patients with body weights in the upper quartile of a sample distribution using the urea reduction ratio (URR). Using a case-control design and a simple random sample (n = 315) of hemodialysis (HD) patients, postdialysis weights were divided into quartiles based with a cut-off value at the upper quartile, which was equal to > 81 kilograms (kg). The dichotomous outcome, URR > 65% and URR < 65% constituted the classification for inadequate dialysis risk. The odds ratio (OR) was used to evaluate inadequate dialysis risk based on this outcome. A multivariate logistic regression model was used to adjust for confounding variables and validated for goodness of fit. Those in the > 81 kg group were given more dialysis session time in minutes and used higher efficiency dialyzers as indicated by the coefficient of ultrafiltration (KUf), yet were more likely to have URRs < 65% compared to other patients in the sample (p < 0.001). This finding persisted in the logistic regression model when simultaneously fitting both gender and dialysis session time. Patients weighing > 81 kg experienced an increased risk of inadequate dialysis when compared to all others (OR 4.02, 95% CI [confidence interval] 2.217-7.29). A postdialysis weight > 81 kg increased the risk of inadequate dialysis for patients in this sample. This effect was confounded by a dialysis time x weight interaction term. Also, women were found to have a lower inadequate dialysis risk compared to men after adjusting for weight classification. We, therefore, conclude that patients who weigh > 81 kg may experience inadequate dialysis despite longer, more efficient dialysis sessions. Longer dialysis sessions may benefit some patients, but the effect in larger patients may not be a uniform response.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4","pages":"391-400; discussion 401"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21682937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Limitations of ferritin as a marker of anemia in end stage renal disease. 铁蛋白作为终末期肾病贫血标志物的局限性。
ANNA journal Pub Date : 1999-08-01
H A Dennison
{"title":"Limitations of ferritin as a marker of anemia in end stage renal disease.","authors":"H A Dennison","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Management of anemia in patients with end stage renal disease (ESRD) requires careful monitoring of iron status. Although serum ferritin is used as an indicator of iron stores, its value is limited because ferritin is an acute-phase reactant; its level increases sharply in the presence of inflammation and infection. This article presents information on the value and limitations of serum ferritin as a marker of storage iron in healthy individuals and in patients with ESRD. It also discusses the need to consider the percentage of transferrin saturation, total iron-binding capacity, and immature reticulocyte fraction as markers of iron storage, particularly in patients with infection and inflammation.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4","pages":"409-14; quiz 419-20"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21682942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Methicillin-resistant staphylococcus aureus infection. 耐甲氧西林金黄色葡萄球菌感染。
ANNA journal Pub Date : 1999-08-01
J Briggs
{"title":"Methicillin-resistant staphylococcus aureus infection.","authors":"J Briggs","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4","pages":"425"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21682944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment stressors: it's time to study nursing interventions. 治疗压力源:是时候研究护理干预了。
ANNA journal Pub Date : 1999-06-01
S D McCulloch
{"title":"Treatment stressors: it's time to study nursing interventions.","authors":"S D McCulloch","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 3","pages":"283"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21489182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nursing's future: past the year 2000. 护理的未来:2000年后。
ANNA journal Pub Date : 1999-06-01
B Vandenberg
{"title":"Nursing's future: past the year 2000.","authors":"B Vandenberg","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 3","pages":"362-3"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21489061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A diversified patient education program for transplant recipients. 为移植受者提供多元化的患者教育计划。
ANNA journal Pub Date : 1999-06-01
M Bass, J Galley-Reilley, D E Twiss, D Whitaker
{"title":"A diversified patient education program for transplant recipients.","authors":"M Bass,&nbsp;J Galley-Reilley,&nbsp;D E Twiss,&nbsp;D Whitaker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patients who receive a solid organ transplant not only have many learning needs, but also lifestyle changes related to the transplant. Previous experiences with health care, beliefs about health, language and reading skills, cultural influences, education preparation, and disabilities are a few of the factors that influence how each patient learns posttransplantation, and adjusts to a new lifestyle. Staff nurses on our transplant unit have taken these factors into consideration when developing various concrete teaching tools that include a book, medication card, color-coded medication guide, audiocassette, computer printouts, and clinical pathways. Because each patient comes with a unique story, approaches for patient learning are individualized by the nursing staff. The use of the tools, combined with an individualized and nonjudgmental approach, has created a caring environment for patient learning.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 3","pages":"287-92, 343"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21489184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hemodialysis patients' noncompliance with oral medications. 血液透析患者口服药物的不依从性。
ANNA journal Pub Date : 1999-06-01
R B Curtin, B L Svarstad, T H Keller
{"title":"Hemodialysis patients' noncompliance with oral medications.","authors":"R B Curtin,&nbsp;B L Svarstad,&nbsp;T H Keller","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The purpose of this study was to describe the prevalence, severity, and patterns of noncompliance with prescribed medications among hemodialysis patients; and to identify patient, disease and/or treatment characteristics associated with noncompliance. Demographic and medical history information were collected from chart reviews and patient interviews. Compliance data were collected via self-report, pill count, and a medication event monitoring system (MEMS, Product of Aprex, a division of Apria Healthcare; Costa Mesa, CA). A total of 135 hemodialysis patients from 11 dialysis facilities in a large Midwestern metropolitan area participated. Overall, medication compliance rates were very low. Of the patient, disease, and treatment characteristics considered, only race was found to be associated with patient noncompliance; African-American patients had higher rates of noncompliance with both monitored medications. The results of this study confirm that noncompliance with medication regimens continues to be an unremitting problem for hemodialysis patients and that demographic, medical history, and treatment characteristics do not adequately explain this behavior. Also, estimates of patient compliance as measured by self-report, pill count, and microelectronic monitoring are disparate enough to suggest that relying exclusively on patients' self-report of compliance might be insufficient.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 3","pages":"307-16; discussion 317, 335"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21489186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of renal replacement therapy on toddler time. 肾脏替代疗法对学步时间的影响。
ANNA journal Pub Date : 1999-06-01
N E Moghal, E Wittich, D V Milford
{"title":"The impact of renal replacement therapy on toddler time.","authors":"N E Moghal,&nbsp;E Wittich,&nbsp;D V Milford","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The impact of renal replacement therapy on the day-to-day activity of 5 toddlers is presented. For those on hemodialysis, 50% of the waking hours involved activity related to management of the renal failure; the remainder was spent feeding or in normal (play) activity. Peritoneal dialysis demanded only 10% of waking hours for direct renal activity. The data are potentially useful in counseling families when discussing the impact of renal failure and its management on the toddler.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 3","pages":"331-5"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21489188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Renagel: a new and different phosphate binder. Renagel:一种新的不同的磷酸盐粘合剂。
ANNA journal Pub Date : 1999-06-01
R Ramsdell
{"title":"Renagel: a new and different phosphate binder.","authors":"R Ramsdell","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Renagel is a novel, nonabsorbed, phosphate binding polymer free of aluminum and calcium. In hemodialysis patients, Renagel: lowers serum phosphorus levels; lowers intact parathyroid hormone levels; lowers calcium x phosphorous levels; lowers total serum and low density lipoprotein (LDL) cholesterol; and is safe and well tolerated (Bleyer et al., 1997; Chertow, Burke, Dillon, et al., 1998; Chertow, Burke, Goldberg, et al., 1997; Chertow, Burke, Lazarus, et al., 1997; Goldberg et al., 1998; Slatopolsky, Burke, Dillon, & The Renagel Study Group, 1999). Renagel treatment decreased total and low-density lipoprotein (LDL) cholesterol, but had no effect on high-density lipoprotein (HDL) cholesterol and triglycerides (Goldberg et al., 1998; Slatopolsky et al., 1999). This cholesterol-lowering effect of Renagel was most apparent in patients with LDL cholesterol of 100 mg/dl or greater at baseline; therefore, it may be beneficial for some patients. Longer-term studies in ESRD patients are required to determine the potential benefit of lipid lowering (Slatopolsky et al., 1999). The nephrology staff is responsible for delivering optimal patient care. This new drug allows for adequate control of phosphorous without incidence of hypercalcemia, or aluminum related problems.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 3","pages":"346-7"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21489192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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