The Nursing clinics of North America
-
Nurs. Clin. North Am. · Jun 1990
ReviewAdvances in venous access devices and nursing management strategies.
VADs are indicated for many persons who require reliable long-term venous access. Nontunneled, tunneled, and venous access ports are constructed of silicone or polyurethane, the most biocompatible materials identified thus far. These devices are inserted in a similar fashion and are extremely versatile. ⋯ When extravasation is suspected, the infusion is stopped, and the nurse notifies the physician so diagnostic procedures and treatment can be initiated. Other complications occur infrequently but may contribute to patient discomfort, morbidity, and mortality. These include phlebitis, which resolves with conservative management in most instances, and pneumothorax, which occurs in a small percentage of patients within a short period after catheter placement.(ABSTRACT TRUNCATED AT 400 WORDS)
-
Cardiac trauma affects people of all ages from all walks of life. The exact incidence of cardiac trauma is unknown because many individuals die before ever reaching a medical facility for treatment. Reduction in the time from cardiac injury to definitive treatment with continued improvement in rapid emergency transport systems will result in a lower mortality rate. The challenge for nursing is to reduce mortality of victims of cardiac trauma further with prompt nursing diagnosis and effective nursing interventions.
-
The primary survey of a trauma victim always begins with the ABCs used in resuscitation. Chest trauma compromises the normal physiology of respiration and circulation. Although some chest injuries are overt, some are not. ⋯ The care of these patients is very complex. Nursing diagnoses guide the care of chest trauma patients and can include impaired gas exchange, alteration in cardiac output, and altered breathing pattern. The goal of treatment is to restore and maintain stable hemodynamics with adequate respirations and circulation allowing definitive treatment for a positive patient outcome.
-
Trauma is a devastating event that affects all ages. Trauma can be fatal, disabling, or disfiguring. Public awareness, education, and legislation can affect the trauma statistics of the future. ⋯ Appropriate care also includes immediate treatment of life-threatening injuries and shock during the first hour. Nurses are key members in this team approach. By utilizing assessment skills, nursing diagnosis, interventions, and constant evaluation, the trauma nurse will contribute to the decrease in preventable deaths during the first hour.
-
Contemporary nursing ethics education focuses on the use of an analytical model of ethical decision making for both its process and its content. Perhaps this is the case because it bears some resemblance to the nursing process, which is taught in a similar fashion. Thus, a deductivist method of ethical decision making fits within the same general schema of the hypotheticodeductive method of decision making that is taught for nursing diagnosis. ⋯ Whatever the strength of our science, nursing is an inherently moral endeavor and is only as strong as its commitment to its ethical obligations and values. Between the grinding edges of the forces that affect it, nursing must establish its priorities among the aspects of its environment that it attempts to control. Ethics must be chief among those priorities.