The Nursing clinics of North America
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Intraspinal drug delivery provides agents directly to their site of action. These sites, receptors within the spinal cord, are bound to a greater degree when drugs are administered intraspinally. The purpose for drug therapy, the acute or chronic nature of delivery, and the drug administration system affect the choice of epidural versus intrathecal route of delivery. ⋯ Those who benefit should not be denied this therapy. Much research is necessary as this modality develops. Nurses who comprehend the science of intraspinal drug delivery, as well as the art of patient management, can contribute to this advancing field.
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When assessing a patient's ocular complaint, one must listen carefully to the description of the symptoms. A decrease in vision is most frequently the symptom that prompts a person to seek attention. ⋯ Visual acuity must be checked, for this is the vital sign by which exacerbation or improvement of many conditions is measured. We all take our eyes for granted until we suddenly cannot see, then the world takes on a completely different complexity, for loss of vision may mean loss of livelihood and independence.
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With increased technology, increased patient longevity, and burgeoning health care knowledge, pulmonary assessment of clients has become more complex, and nurses are now challenged to develop more comprehensive skills. These include a more focused patient history on selected clients as well as careful inspection, palpation, percussion, and auscultation. Additional techniques such as voice sounds provide the nurse with even more assessment data. An understanding of common pathologic pulmonary problems and their corresponding assessment findings as well as knowledge about acid-base imbalances will result in more effective professional nursing care.
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The term confusion describes a plethora of possible cognitive deficits and behavioral manifestations. A subjective assessment of confusion must be followed by an objective systematic evaluation to develop the cognitive-behavior profile. Because of age-associated physiologic and pathologic changes, elderly patients are at high risk for developing acute confusion. ⋯ Nursing can play a significant role in the prevention and the early detection of acute confusion. Preventing or identifying confusion early will decrease the physical and psychological stress of the patient as well as decrease the cost of hospitalization by shortening length of stay. Additional research is needed to determine the efficacy of present nursing activities and to identify new approaches for management.
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Although nausea, vomiting, and retching have plagued mankind since antiquity, limited attention has been given to the three symptoms as separate entities. Although knowledge of symptom occurrence is essential to practice, nurses must focus on patients' response or distress to the occurrence of symptoms. The differentiation of symptom occurrence and symptom distress of nausea, vomiting, and retching is critical to the management and self-care demands of patients and the enhancement of their quality of life. Basic research on patterns of these individual symptoms and their components promises to provide a more progressive and fruitful approach to the patient response to these symptoms.