The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
-
In 195 elderly head-injured patients, Glasgow Coma Scale (GCS) scores (admission and 72 hours) and intracranial pressure (ICP) 0-12 days after injury were compared to 6 month Glasgow Outcome Scores. All patients remaining comatose at least 72 hours after injury died within 6 months. ⋯ The 6 month mortality rate was 75% overall and 90% among patients with elevated ICP. This increased mortality in elderly patients with initially elevated ICP indicates that nurses and other health professionals should consider ICP as well as level of consciousness when counseling patients and families regarding the likely outcome after major head injuries.
-
The purpose of this nursing intervention study, which used a pre- and posttest design, was to determine the effect of an education program on parents' knowledge of hydrocephalus and shunt dynamics in a sample of parents of children with hydrocephalus. Study participants were parents of hydrocephalic children treated with an initial shunt or a shunt revision. The convenience sample of 41 subjects was divided into two groups (A or B). ⋯ The posttest was given 2-3 weeks after the patient's surgery. There was a statistically significant change in the scores from the pre- and posttests for Group A (p = 0.0092). The nursing education appeared to have a positive effect upon this group's knowledge of hydrocephalus and shunts.
-
Fever or pyrexia is a common clinical phenomenon. Among survivors of traumatic brain injury, it may appear immediately after injury, signal the presence of infection or reflect dysfunction of the thermoregulatory system. ⋯ Guidelines for decision making regarding the nursing management of patients with fever are presented. Given the potential benefit of fever, the ability of most patients to tolerate temperature elevations and the adverse effects, costs and discomforts associated with therapy, our habit of automatically reducing temperature should be examined.
-
Problems surrounding issues of dying and death are many. Health professionals, families and individuals all must cope with different aspects of these problems. The living will has been discussed as one way people can alleviate many of the problems associated with the decision to die with dignity. ⋯ By initiating a living will, individuals can make their wishes known to both family and the medical establishment. Increased public education concerning state living will legislation and concomitant rights under these laws is needed. Through education, many of the legal and ethical issues that arise from ignorance of the law may be avoided before they become problems.
-
Critical care patients become confused in the intensive care setting. Several dangers exist in acute confusional states. Confused patients jeopardize their own safety, are more likely to die than nonconfused patients and are more likely to become cognitively impaired and require institutionalization. This article reviews the literature about patients experiencing acute confusional states in the critical care setting including intensive care unit (ICU) psychosis, postcardiotomy delirium and confusion in the elderly.