The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Comparative Study
Learning needs of persons with epilepsy: a comparison of perceptions of persons with epilepsy, nurses and physicians.
The purpose of this study was to describe and compare patients', nurses' and physicians' perceptions of learning needs of persons with epilepsy. The study is based on adult learning theory which states that learning needs dictate receptivity to information and knowledge of learning needs can help structure teaching sessions. Study participants were recruited from patients attending epilepsy clinics, neuroscience nurses employed at study hospitals or working with neurologists or neurosurgeons and neurologists or neurosurgeons practicing in the state. ⋯ Data analysis revealed that patients, nurses and physicians similarly ranked major areas of learning needs. However, differences in the ranking of individual learning needs were noted between patients and health care providers. An understanding of the differences and similarities among the groups provides useful information for educational programs for epilepsy patients.
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The development of microcatheters and newer embolytic agents has made it possible to treat persons with arteriovenous malformations, arteriovenous fistulas and aneurysms. Until recently, endovascular embolization was usually performed to devascularize tumors prior to surgical removal. The growing number of neurovascular conditions that can be treated by endovascular embolization has led to the need for neuroscience nurses to be knowledgeable about indications, materials, methods, risks, patient preparation and nursing implications in the care, education and discharge planning for the embolization patient.
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The purpose of this study was to identify characteristic factors in children who sustained closed head injury (CHI) between birth and less than 15 years of age. A two-year retrospective audit of charts from a large metropolitan pediatric hospital with a trauma center yielded a sample of 138 charts that met the established criteria for inclusion in the study. Using a descriptive design, data were gathered on age, sex, race, cause of injury, severity of injury, season of accident, time of accident and length of hospital stay. ⋯ CHI occurred less frequently in the winter (13.8%) than any other season. Using the Glasgow Coma Scale scores, 56.5% of the injuries were categorized as mild, 17.4% were moderate and 26.1% were severe. There was an 8% mortality rate secondary to injury in the sample.
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The declaration of death by neurological criteria has become more commonly accepted and used within the medical community, especially within the past 10 years. There remains, however, a great deal of misunderstanding and lack of awareness among health care professionals as to the criteria used to determine brain death and the importance of adhering to brain death determination protocols. ⋯ Physicians and nurses are usually not involved in brain death pronouncements more than a few times each year. Because of this, hospitals need to develop and maintain brain death protocols which are in keeping with the most current scientific literature and accepted medical practice.
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In head-injured adults sudden increases in intracranial pressure (ICP) frequently occur in response to noxious stimuli, such as endotracheal suctioning (ETS). Transient increased ICP may have potentially harmful effects upon head-injured patients. One intervention clinicians believe to be efficacious in blunting ICP response to ETS is administration of lidocaine hydrochloride. ⋯ The literature to date, while providing conflicting results, does demonstrate tentative support for the use of lidocaine prior to ETS as a means of attenuating a rise in ICP. Support was found for the intratracheal route of administration. Additionally when intratracheal lidocaine was coupled with muscle relaxants or other anesthetic agents administered at appropriate times prior to suctioning, large rises in ICP may be effectively blunted.