The Journal of perinatal & neonatal nursing
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Acute fatty liver is a rare but potentially fatal complication of the third trimester of pregnancy. Significant improvements in morbidity and mortality have been reported in the last several years. Despite accumulation of more data about the disease, the exact pathogenesis is unknown. ⋯ Supportive care and expeditious delivery represent the only known treatment. More data are needed about acute fatty liver of pregnancy, but the rare nature of the disease and the likelihood that most cases are not reported in the literature limit the ability systematically to study causation, disease process, and treatment options. Because of the serious condition of most women who develop acute fatty liver of pregnancy, collaboration between critical care and perinatal care providers is essential for optimal maternal-fetal outcomes.
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J Perinat Neonatal Nurs · Sep 1997
ReviewMinimizing infant exposure to and risks from medications while breastfeeding.
The advantages of breastfeeding to the mother and newborn are many. Lactating mothers frequently ask about the safety of taking medications and the risk to their newborn. It is well established that all drugs are excreted into breast milk. ⋯ With the availability of numerous resources on drug use while breastfeeding, a medication can be identified as contraindicated or compatible with breastfeeding. By understanding the anatomy of the breast, principles of lactation, and drug passage into breast milk, an approach to minimize the transfer of the medications in the breast milk to the newborn can be developed. The plan should usually support and encourage the mother to continue to breastfeed her infant.
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The article presents the role of advanced practice nurses as change agents in the clinical setting. Research utilization is needed to shape and form the basis of nursing practice. As change agents, the advanced practice nurses in one institution established a research-based minimal stimulation protocol for the very low-birth weight infant and implemented it using a video presentation. Knowledge of change theory, research utilization, and video production was necessary in making this project a success.
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Pain in children has been historically undertreated for a variety of reasons, including the complexity of pain assessment, inadequate research and training, and assumptions concerning pain. Lack of consistency in pain assessment and personal attitudes about pain have been identified as concerns in the NICU population. Some of the factors that are thought to affect caregivers include personal experience with pain and the idea that some procedures are more painful than others. ⋯ A variety of factors complicates the observation of neonates in an NICU. Premature birth, range of physiologic stability, the level of activity in the environment, and other possible sources of discomfort may confuse or blunt observations. While this observational design was difficult, it succeeded in delineating behaviors associated with a painful stimulus that provides a basis for further study.