AACN clinical issues最新文献_第3页

The endogenous opioid system and clinical pain management. 内源性阿片系统与临床疼痛管理。

AACN clinical issues Pub Date : 2005-07-01 DOI: 10.1097/00044067-200507000-00003

Janean E Holden, Younhee Jeong, Jeannine M Forrest

引用次数: 149

Management options for angina refractory to maximal medical and surgical interventions. 对顽固性心绞痛进行最大限度的内科和外科治疗的治疗选择。

AACN clinical issues Pub Date : 2005-07-01 DOI: 10.1097/00044067-200507000-00006

Julie A Stanik-Hutt

{"title":"Management options for angina refractory to maximal medical and surgical interventions.","authors":"Julie A Stanik-Hutt","doi":"10.1097/00044067-200507000-00006","DOIUrl":"https://doi.org/10.1097/00044067-200507000-00006","url":null,"abstract":"Despite the seemingly daily advances in the primary, secondary, and tertiary prevention for coronary artery disease, many patients will ultimately experience progression of their disease and experience angina refractory to further active treatment. In these patients, disabling angina occurs at rest or during simple activities of daily living. When this occurs, symptom management, a predominant focus of nursing, becomes the goal of care. Several medical and surgical alternatives are available to patients with refractory angina. Enhanced external counterpulsation and transmyocardial laser revascularization are Food and Drug Administration approved therapies that can be used to attempt to restore the balance of supply and demand. Modulation of sympathetic tone via procedures such as stellate ganglion blocks has also been employed. Other methods to control the pain are techniques that alter pain perception such as spinal opioids, transcutaneous electrical nerve stimulation, and spinal cord stimulation. Too few patients with refractory angina are referred for any of these palliative therapies. Armed with knowledge regarding these therapies, nurses will be better prepared to provide anticipatory guidance to patients and their families and to support the patient's hope for relief as they cope with this devastating condition.","PeriodicalId":79311,"journal":{"name":"AACN clinical issues","volume":"16 3","pages":"320-32"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00044067-200507000-00006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25232405","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: 12

Orofacial pain--Part I: Assessment and management of musculoskeletal and neuropathic causes. 口面部疼痛——第一部分:肌肉骨骼和神经病变原因的评估和管理。

AACN clinical issues Pub Date : 2005-07-01 DOI: 10.1097/00044067-200507000-00007

Eleni Sarlani, Birute A Balciunas, Edward G Grace

{"title":"Orofacial pain--Part I: Assessment and management of musculoskeletal and neuropathic causes.","authors":"Eleni Sarlani, Birute A Balciunas, Edward G Grace","doi":"10.1097/00044067-200507000-00007","DOIUrl":"https://doi.org/10.1097/00044067-200507000-00007","url":null,"abstract":"Orofacial pain is a common complaint, affecting the lives of millions of people around the world. Chronic orofacial pain often constitutes a challenging diagnostic problem that can be complicated by psychosocial factors and typically requires multidisciplinary treatment approaches. The fundamental prerequisite for successful management of orofacial pain is an accurate diagnosis. Generating a differential diagnosis, which will ultimately lead to a definite diagnosis, requires thorough knowledge of the diagnostic range of orofacial pain. There is a vast array of orofacial pain categories including: (1) musculoskeletal, (2) neuropathic, (3) vascular, (4) neurovascular, (5) idiopathic, (6) pain caused by local, distant, or systemic pathology, and (7) psychogenic. This article presents the salient clinical features and the therapeutic approaches for the various subtypes of musculoskeletal and neuropathic pain. Musculoskeletal pain is the most prevalent orofacial pain, with temporomandibular disorders and tension-type headache being the main examples. Neuropathic pain develops secondary to neural injury and/or irritation and can be distinguished into episodic, including trigeminal neuralgia and glossopharyngeal neuralgia, as well as continuous, such as herpetic and postherpetic neuralgia, traumatic neuralgia, and Eagle's syndrome.","PeriodicalId":79311,"journal":{"name":"AACN clinical issues","volume":"16 3","pages":"333-46"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00044067-200507000-00007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25232406","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: 56

Nurse practitioners in pediatric critical care: results of a national survey. 儿科重症护理的护士从业人员:一项全国性调查的结果。

AACN clinical issues Pub Date : 2005-07-01 DOI: 10.1097/00044067-200507000-00012

Judy T Verger, Kelly Keefe Marcoux, Maureen A Madden, Tom Bojko, Jane H Barnsteiner

{"title":"Nurse practitioners in pediatric critical care: results of a national survey.","authors":"Judy T Verger, Kelly Keefe Marcoux, Maureen A Madden, Tom Bojko, Jane H Barnsteiner","doi":"10.1097/00044067-200507000-00012","DOIUrl":"https://doi.org/10.1097/00044067-200507000-00012","url":null,"abstract":"The nurse practitioner in pediatric critical care is a distinct advanced practice nursing role that has seen a tremendous increase in development and implementation over the past 10 years. There is a paucity of literature on this unique and valuable role. A total of 74 nurse practitioners practicing in pediatric critical care were surveyed. Part I of the survey solicited descriptive information of the nurse practitioner including background, work environment, reporting structure, and salary. The respondents also identified their role responsibilities that included direct patient management, nursing and medical education, coordination of care, research, and consultation. Part II of the questionnaire addressed skill level and need for supervision for technical procedures and leadership activities. These respondents described expert or proficient skill levels for the majority of technical procedures (ie, lumbar puncture, central line placement) and leadership activities (ie, discharge planning, participation in medical rounds). This is the first published report to delineate the role of the nurse practitioner in pediatric critical care based on responses from a national survey.","PeriodicalId":79311,"journal":{"name":"AACN clinical issues","volume":"16 3","pages":"396-408"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00044067-200507000-00012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25233420","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: 34

Orofacial Pain--Part II: Assessment and management of vascular, neurovascular, idiopathic, secondary, and psychogenic causes. 口面部疼痛——第二部分:血管、神经血管、特发性、继发性和心理原因的评估和管理。

AACN clinical issues Pub Date : 2005-07-01 DOI: 10.1097/00044067-200507000-00008

Eleni Sarlani, Birute A Balciunas, Edward G Grace

{"title":"Orofacial Pain--Part II: Assessment and management of vascular, neurovascular, idiopathic, secondary, and psychogenic causes.","authors":"Eleni Sarlani, Birute A Balciunas, Edward G Grace","doi":"10.1097/00044067-200507000-00008","DOIUrl":"https://doi.org/10.1097/00044067-200507000-00008","url":null,"abstract":"Chronic orofacial pain is a common health complaint faced by health practitioners today and constitutes a challenging diagnostic problem that often requires a multidisciplinary approach to diagnosis and treatment. The previous article by the same authors in this issue discussed the major clinical characteristics and the treatment of various musculoskeletal and neuropathic orofacial pain conditions. This second article presents aspects of vascular, neurovascular, and idiopathic orofacial pain, as well as orofacial pain due to various local, distant, or systemic diseases and psychogenic orofacial pain. The emphasis in this article is on the general differential diagnosis and various therapeutic regimens of each of these conditions. An accurate diagnosis is the key to successful treatment of chronic orofacial pain. Given that for many of the entities discussed in this article no curative treatment is available, current standards of management are emphasized. A comprehensive reference section has been included for those who wish to gain further information on a particular entity.","PeriodicalId":79311,"journal":{"name":"AACN clinical issues","volume":"16 3","pages":"347-58"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00044067-200507000-00008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25232407","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: 23

Skin-to-skin contact (Kangaroo Care) analgesia for preterm infant heel stick. 皮肤与皮肤接触(袋鼠式护理)用于早产儿脚跟贴镇痛。

AACN clinical issues Pub Date : 2005-07-01 DOI: 10.1097/00044067-200507000-00010

Susan M Ludington-Hoe, Robert Hosseini, Deborah L Torowicz

{"title":"Skin-to-skin contact (Kangaroo Care) analgesia for preterm infant heel stick.","authors":"Susan M Ludington-Hoe, Robert Hosseini, Deborah L Torowicz","doi":"10.1097/00044067-200507000-00010","DOIUrl":"https://doi.org/10.1097/00044067-200507000-00010","url":null,"abstract":"The purpose of the study was to compare a heel stick conducted during Kangaroo Care (skin-to-skin contact) with the mother to a heel stick in a warmer in reducing premature infant physiologic and behavioral pain responses. Twenty-four premature infants in a university-based neonatal intensive care unit were recruited and randomized to 2 sequences: sequence A group received 3 hours of Kangaroo Care (with a heel stick in Kangaroo Care) followed by 3 hours in a warmer (with a heel stick in the warmer). Sequence B group had warmer care and a heel stick (in the warmer) before Kangaroo Care and a heel stick (in Kangaroo Care). Heart rate, respiratory rate, oxygen saturation, crying time, and behavioral state were measured before, during, and after heel stick. Repeated measures ANOVA and Mann Whitney U statistics were performed. Heart rate and length of crying in response to pain were significantly reduced during Kangaroo Care and the Kangaroo Care heel stick as compared to when infants were in the warmer and had a heel stick in the warmer. Three infants did not cry at all during the Kangaroo Care heel stick; infants slept more during Kangaroo Care than in the warmer. Kangaroo Care positioning before and during heel stick is a simple and inexpensive analgesic intervention to ameliorate pain in stable premature infants.","PeriodicalId":79311,"journal":{"name":"AACN clinical issues","volume":"16 3","pages":"373-87"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00044067-200507000-00010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25232410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 163

Surgery-induced immunosuppression and postoperative pain management. 手术诱导的免疫抑制和术后疼痛处理。

AACN clinical issues Pub Date : 2005-07-01 DOI: 10.1097/00044067-200507000-00004

Gayle Giboney Page

引用次数: 68

The physiology and processing of pain: a review. 疼痛的生理和处理:综述。

AACN clinical issues Pub Date : 2005-07-01 DOI: 10.1097/00044067-200507000-00002

Cynthia L Renn, Susan G Dorsey

引用次数: 68

Acute musculoskeletal pain in the emergency department: a review of the literature and implications for the advanced practice nurse. 急诊科的急性肌肉骨骼疼痛:文献综述及对高级执业护士的启示。

AACN clinical issues Pub Date : 2005-07-01 DOI: 10.1097/00044067-200507000-00005

Roxanne Garbez, Kathleen Puntillo

{"title":"Acute musculoskeletal pain in the emergency department: a review of the literature and implications for the advanced practice nurse.","authors":"Roxanne Garbez, Kathleen Puntillo","doi":"10.1097/00044067-200507000-00005","DOIUrl":"https://doi.org/10.1097/00044067-200507000-00005","url":null,"abstract":"Acute pain assessment and management and their accurate documentation have been identified by The Joint Commission on the Accreditation of Healthcare Organization as significant components of the emergency department experience. Research studies have historically focused on the subjective perception of the physician or nurse for evidence of acute musculoskeletal pain assessment for the patient; however, the lack of interrater reliability between caregivers and patients has illustrated the need to evaluate the patient's perception of pain. A review of the literature for acute musculoskeletal pain in the emergency department shows that a patient's pain experience is often underestimated, and severity of pain often does not predict pain management. Relying on patient satisfaction surveys as a surrogate marker for effectiveness of pain management is inadequate, and factors, such as age, gender, or ethnicity, may contribute to a disparity in pain management. The purpose of this article is to review pain management practices for patients with acute musculoskeletal pain who present to the emergency department and to provide recommendations for advanced practice nurses working with this emergency department patient population. Promising areas for future research include targeting mechanisms of pain with specific medications, identifying vulnerable populations at risk for inadequate pain management, and universal use of a standardized pain rating scale.","PeriodicalId":79311,"journal":{"name":"AACN clinical issues","volume":"16 3","pages":"310-9"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00044067-200507000-00005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25232548","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: 20

Complex pain consultations in the pediatric intensive care unit. 儿科重症监护室的复杂疼痛咨询。

AACN clinical issues Pub Date : 2005-07-01 DOI: 10.1097/00044067-200507000-00011

Helen N Turner

引用次数: 23