Geriatric nursing
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Comparative Study
Comparison of pain assessment instruments in cognitively intact and cognitively impaired nursing home residents.
This study was conducted to determine which pain severity and location instruments were most useful in the nursing home setting. Pain severity and location were assessed monthly for 1 year in 37 participants enrolled in a restorative rehabilitation program. Pain location was determined by the residents' indications on a diagram, a doll, and their body. ⋯ The McGill Word Scale was used most to determine pain severity. Pointing to themselves most frequently determined pain location among residents. New strategies are needed for pain assessment in the elderly, especially the cognitively impaired elderly, and a combination of instruments to assess pain in the latter group may be necessary.
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Comparative Study
A comparison of infrared ear thermometry with electronic predictive thermometry in a geriatric setting.
This project had three purposes: to determine the test/retest reliability of three thermometers--an infrared ear thermometer, an oral electronic predictive thermometer, and an oral mercury-in-glass thermometer (MIGT); determine the validity (accuracy) of the first two thermometers using the MIGT as the gold standard; and calculate the thermometers' sensitivity and specificity for detecting fever using 37.5 degrees C on the MIGT as the criterion. The MIGT had the best reliability, followed by the electronic predictive and infrared ear thermometer (for validity, the former was more accurate than the latter). Little difference existed in the latter two thermometers' sensitivity and specificity. However, the confidence intervals were wide, and further studies with larger samples need to be done to elucidate the thermometers' diagnostic properties.
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Cancer pain in the cognitively impaired elderly is a challenging problem for clinicians. Nursing and medical literature on the subject is sparse because the problem has not been adequately studied. ⋯ Traditional, pharmacologic, and alternative therapies are reviewed. Common etiologies for pain and confusion also are presented.
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Review Practice Guideline Guideline
Standard of practice protocol: acute confusion/delirium. NICHE Faculty.
Acute confusion, also known as delirium, is a prevalent disorder that contributes to poor outcomes of care. Because of their inability to think clearly, delirious patients are unable to care for themselves and often exhibit unsafe behaviors, resulting in an increased use of physical and pharmacologic restraints. Consequently, the goal of this article is to delineate prevention and treatment guidelines for acutely confused patients and thereby improve nursing care for this vulnerable patient population.
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Despite the approval of the use of tissue plasminogen activator for the treatment of acute stroke, less than 10% of all patients with stroke are able to reach a medical facility in time to receive the treatment. This article reviews the current concepts of stroke management and emphasizes the importance of public awareness for the signs and symptoms of stroke and the need for immediate attention when a stroke is suspected.