The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Stroke is estimated to occur in approximately 2.5-3.2 children per 100,000 annually. While some aspects of mothering a disabled child are currently known, there are other aspects of this experience that remain unknown. Much of the research focuses on children who are severely disabled, thus leaving a gap in what is known about the experience of mothers of mildly to moderately disabled children. ⋯ In-depth, face-to-face interviews were conducted, audiotaped, and transcribed verbatim. By using Colaizzi's method for data analysis, the following six themes emerged: (1) Mothers' Way to Know, (2) Being Blown Away, (3) Gradual Awakening to an Uncertain Future, (4) Fiercely Advocating for My Child, (5) Living in a Middle World, and (6) A Heart Filled with Joy and Sorrow. This study provided data that were used to provide a beginning description of the experience of mothering a child with hemiparesis.
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Respiratory insufficiency is a problem that develops in nearly all people diagnosed with amyotrophic lateral sclerosis (ALS). Noninvasive positive pressure ventilation (NIPPV) is the treatment of choice for ALS patients with respiratory insufficiency. ⋯ This case study introduces an ALS patient who had normal FVC results, symptoms of respiratory insufficiency, and abnormal nocturnal oximetry. After NIPPV initiation, the patient reported improved sleep and less daytime fatigue, which he associated with the start of NIPPV treatment.
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Review Case Reports
Using the BIS monitor in palliative care: a case study.
The majority of deaths occur in the hospital setting, and of these deaths, 20% are in an intensive care unit (ICU). Care provided on the ICU shifts from curative to palliative when a patient's death appears to be imminent. Nursing care decisions made at the end of life are critical to the experience of the patient, and leave a lasting impression on the patient's family and the nurses involved in providing care. ⋯ Assessing comfort can be especially difficult in the patient who is unresponsive. One tool that can assist the nurse in the assessment and management of analgesic effectiveness is the Bispectral (BIS) Index Monitor. As the use of BIS monitoring grows in the ICU setting, more information will be available that will help all involved in the palliative care process ensure patients have a peaceful death.
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Hyperglycemia in acute stroke patients increases cerebral infarct size and worsens neurologic outcome with and without preexisting diabetes mellitus. Hyperglycemia results from metabolic alterations in glucose metabolism, and is most common in patients with acute illness such as stroke. ⋯ Insulin treatment protocols developed and implemented by multidisciplinary teams allow for rapid and effective control of hyperglycemia. Nurses who know about hyperglycemia's often-neglected and detrimental effects can play a vital role in influencing outcomes in stroke patients.
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Neuroleptic malignant syndrome (NMS) is a potentially lethal condition that has been described in patients with idiopathic Parkinson's disease (PD) after long-term dopaminergic medications are suddenly stopped or moderately decreased. If patients with PD develop severe rigidity, stupor, and hyperthermia, L-Dopa withdrawal should be suspected and the dopaminergic drug restarted as soon as possible to prevent rhabdomyolysis and renal failure. Nurses who are knowledgeable about NMS can provide prompt identification of the PD patient's condition and prevent a potentially lethal cascade of symptoms.